Epidemiology of hepatitis A virus infections, Germany, 2007-2008.
Approximately 60% of hepatitis A virus infections in Germany occur in persons without a travel history to disease-endemic areas and for whom sources of infection are unknown. Recommendation of pretravel vaccination fails to prevent the remaining imported infections. Using enhanced surveillance in 2007-2008, we analyzed epidemiologic patterns of hepatitis A in Germany and appropriateness and adequacy of current immunization recommendations. Young patients with a migration background who had visited friends and family in their ancestral countries accounted for most imported cases. Phylogenetic analysis showed high diversity of sequence data and clustering of strains with similar regions of origin or patient migration backgrounds. Virologic findings are compatible with those of low-incidence countries, where virtually all infections are directly or indirectly imported from other regions. Germans with a migration background are seen as a special risk group so far insufficiently reached by pretravel vaccination advice.
Faber
Mirko S
MS
Robert Koch Institute, Berlin 13086, Germany.
Stark
Klaus
K
Behnke
Susanne C
SC
Schreier
Eckart
E
Frank
Christina
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D001483:Base Sequence; D002648:Child; D002675:Child, Preschool; D017931:DNA Primers / Q000235:genetics; D004279:DNA, Viral / Q000235:genetics; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D005858:Germany / Q000453:epidemiology; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D030041:Hepatitis A virus / Q000145:classification / Q000235:genetics; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D012307:Risk Factors; D014195:Travel; D055815:Young Adult
D017931:DNA Primers; D004279:DNA, Viral; D012367:RNA, Viral