title: Hepatitis A surveillance and vaccine use in China from 1990 through 2007.
abstract: BACKGROUND
  Hepatitis A vaccines have been highly effective in preventing hepatitis A. To investigate the epidemiology of hepatitis A in China after hepatitis A vaccine became available, we reviewed reported cases of hepatitis A and the use of hepatitis A vaccine in China during the period from 1990 through 2007.
  
  
  METHODS
  Data from the National Notifiable Disease Reporting System from 1990 to 2007 and the Emergency Events Reporting System from 2004 to 2007 were reviewed and epidemiologic characteristics analyzed. Hepatitis A vaccine distribution between 1992 and 2007 was also reviewed.
  
  
  RESULTS
  The incidence of hepatitis A has declined by 90% since 1990, from 56 to 5.9 per 10(5)/year. Declines in age-specific incidence were seen in all age groups, most dramatically among children younger than 10 years. Disease incidence still varies substantially: poorer western provinces have had the highest incidences since 2000. In high-incidence provinces, children younger than 10 years continue to have a high disease incidence. Only 50% of cases were laboratory-confirmed, and only 3% occurred in reported local outbreaks. Over 156 million doses of hepatitis A vaccine have been distributed since 1992, and use has continued to increase since 2003.
  
  
  CONCLUSIONS
  Incidence of hepatitis A has decreased in all age groups, likely due to changing socioeconomic conditions and increasing hepatitis A vaccine use. Nevertheless, western populations remain at high risk, with transmission predominantly occurring among children. The epidemiology of hepatitis A transmission is not well understood. Improved surveillance with better laboratory confirmation is needed to monitor the impact of universal hepatitis A vaccination of young children; this strategy began to be implemented in 2008.
authors: Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Fuqiang
authors: F
authors: Cui
authors: Stephen C
authors: SC
authors: Hadler
authors: Hui
authors: H
authors: Zheng
authors: Fuzhen
authors: F
authors: Wang
authors: Wu
authors: W
authors: Zhenhua
authors: Hu
authors: H
authors: Yuansheng
authors: Xiaohong
authors: X
authors: Gong
authors: Yuansheng
authors: Y
authors: Chen
authors: Xiaofeng
authors: X
authors: Liang
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005843:Geography; D019456:Health Transition; D006506:Hepatitis A / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D022362:Hepatitis A Vaccines; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009790:Occupations; D011159:Population Surveillance; D012737:Sex Factors
chemical_list: D022362:Hepatitis A Vaccines