title: Hepatitis B virus transmission in pre-adolescent schoolchildren in four multi-ethnic areas of England.
abstract: The aim of this study was to estimate the amount of childhood hepatitis B virus transmission in children born in the UK, a very low-prevalence country, that is preventable only by universal hepatitis B immunization of infants. Oral fluid specimens were collected from schoolchildren aged 7-11 years in four inner city multi-ethnic areas and tested for the presence of antibody to hepatitis B core antigen (anti-HBc). Those found positive or indeterminate were followed up with testing on serum to confirm their hepatitis B status. The overall prevalence of anti-HBc in children was low [0.26%, 95% confidence interval (CI) 0.14-0.44]. The estimated average annual incidence of hepatitis B was estimated to be 29.26/100 000 children (95% CI 16.00-49.08). The total incidence that is preventable only by a universal infant immunization programme in the UK was estimated to be between 5.00 and 12.49/100 000. The study demonstrates that the extent of horizontal childhood hepatitis B virus transmission is low in children born in the UK and suggests that schools in the UK are an uncommon setting for the transmission of the virus. Targeted hepatitis B testing and immunization of migrants from intermediate- and high-prevalence countries is likely to be a more effective measure to reduce childhood transmission than a universal infant immunization programme.
authors: Immunisation, Hepatitis and Blood Safety Department, Health Protection Services Division, Health Protection Agency, London, UK. koye.balogun@hpa.org.uk
authors: M A
authors: MA
authors: Balogun
authors: J V
authors: JV
authors: Parry
authors: K
authors: K
authors: Mutton
authors: C
authors: C
authors: Okolo
authors: L
authors: L
authors: Benons
authors: H
authors: H
authors: Baxendale
authors: T
authors: T
authors: Hardiman
authors: E H
authors: EH
authors: Boxall
authors: J
authors: J
authors: Sira
authors: M
authors: M
authors: Brown
authors: S
authors: S
authors: Barnett
authors: U
authors: U
authors: Gungabissoon
authors: A
authors: A
authors: Williams
authors: D A
authors: DA
authors: Kelly
authors: S
authors: S
authors: Vijeratnam
authors: S
authors: S
authors: Ijaz
authors: B
authors: B
authors: Taylor
authors: C G
authors: CG
authors: Teo
authors: M E
authors: ME
authors: Ramsay
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005190:Family; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000208:ethnology / Q000517:prevention & control / Q000635:transmission*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011795:Surveys and Questionnaires