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The Division of Viral Hepatitis, National Center for Infectious Diseases is part of the US Centers for Disease Control. Together with the WHO they are the best source for Hepatitis information. These ACIP (Advisory Committee on Immunization Practices ) recommendations are recent and they represent the latest thinking and …they are ‘Open Access’ . Can hepatitis A be prevented? The answer is ‘yes’ – Active or passive immunization will do the job!
1 Prevention of Hepatitis A through Active or Passive Immunization
Recommendations of the Advisory Committee on Immunization Practices (ACIP).
This is latest published version of the above report. This is not ‘Open Access’ but it is still useful to have a look because the PUBMED page (just type 16775039 in the query box if the hyperlink does not work) gives you access to ‘related links’ and ‘related articles’.
The key conclusion:
‘In poor countries most people are infected as young children. As epidemiologic patterns of Hepatitis A are declining, targeted vaccination of children could produce substantial public health benefits’.
2 Hepatitis A in the era of vaccination.
Wasley A, Fiore A Bell BP
Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
Epidemiol Rev. 2006;28:101-11. Epub 2006 Jun 14. Review.
PMID: 16775039
The 10th international symposium took place in 2002 but the data are still current.
It is very important to realize that in areas of high endemicity disease rates are low because most people are infected from childhood. The disease burden is likely to grow as the patterns are shifting from low endemicity to intermediate endemicity.
3 Global Epidemiology of hepatitis A: implications for control strategies
Beth P Bell,
Division of Viral Hepatitis, CDC Atalanta USA
10th International Sympoosium in Viral Hepatitis and Liver disease.
A very recent (2006) article from the American Academy of Family Physicians – this is an evidence based effort with graded recommendations. There is an interesting table with ‘differential diagnoses’ of acute hepatitis and a table with Extrahepatic Manifestations of Hepatitis A Virus Infection. It is worth checking the lists of references, most of them are freely available.
4 Hepatitis A.
American family physician15 Jun 2006, vol. 73,
no. 12, p. 2162-8,.
Brundage-Stephanie-C, Fitzpatrick-A-Nicole.
PMID 16848078
A very good overview of the key issues in the US. Under the current recommendations, by the age of 18, children in the US will have received up to 44 vaccine injections 28 of which are recommended for all. The article is especially concerned with ‘sustainable costs’ and ‘issues relating to vaccine policy’. Vaccination of all children aged 12-23 months for hepatitis A virus has been recommended in the United States. This raises the total number of recommended immunisations for children and adolescents from 26 to 28 .The estimated cost for full childhood and adolescent immunisations is $1118 per child, but will probably be cost saving. This US reality is a far cry from what happens in large parts of the world. A pity the article is not ‘Open Access’ – the BMJ is getting tougher!
5 Should all children be immunised against hepatitis A?
Temte-Jonathan-L.
BMJ (Clinical research ed 25 Mar 2006, vol. 332, no. 7543,
p. 715-8
PMID 16565129