Has the time come to control hepatitis A globally? Matching prevention to the changing epidemiology

Abstract

For the first time a global meeting on hepatitis A virus (HAV) infection as vaccine preventable disease was organized at the end of 2007. More than 200 experts from 46 countries gathered to investigate the changing global HAV epidemiology reflecting the increasing numbers of persons at risk for severe clinical disease and mortality from HAV infection. The benefits of childhood and adult hepatitis A (HepA) vaccination strategies and the data needed by individual countries and international health organizations to assess current HepA prevention strategies were discussed. New approaches in preventing HAV infection including universal HepA vaccination were considered. This introductory paper summarizes the major findings of the meeting and describes the changing epidemiology of HAV infections and the impact of HepA vaccination strategies in various countries. Implementation of HepA vaccination strategies should take into account the level of endemicity, the level of the socio-economic development and sanitation, and the risk of outbreaks. A stepwise strategy for introduction of HepA universal immunisation of children was recommended. This strategy should be based on accurate surveillance of cases and qualitative documentation of outbreaks and their control, secure political support on the basis of high-quality results, and comprehensive cost-effectiveness studies. The recognition of the need for increased global attention towards HepA prevention is an important outcome of this meeting.

Shifting susceptibility to hepatitis A among children and adolescents over the past decade

“…Fatores tais como mudanças na epidemiologia global da hepatite viral A, refletindo o crescimento de uma população suscetível 8,9 , e a disponibilidade de vacinas eficazes 1,2 têm renovado o interesse nessa doença, ressaltando a necessidade de um conhecimento mais preciso da nova realidade para definir as estratégias de prevenção 10,11 . No Brasil, estudos sorológicos têm demonstrado que a endemicidade da hepatite A está mudando na maioria das regiões, com taxas significativamente menores de anticorpo anti-VHA (anti-VHA) entre as crianças e os adolescentes [12][13][14][15] , especialmente de classe socioeconômica mais favorecida 12,14,15 .…”

Detection and Molecular Characterization of Hepatitis A Virus from Tunisian Wastewater Treatment Plants with Different Secondary Treatments

“…Unfortunately, Tunisia, among other Mediterranean countries with high endemicity of HAV infections, is using contaminated treated wastewater for irrigation and to refill aquifers to palliate the lack of water resources (14), which may pose a real threat for public health. Indeed, the lack of a specific system in Tunisia for surveillance of HAV or other enteric viruses in wastewaters (15) and the changing epidemiology of HAV (16) are among the many risk factors (3,5,12,17) that increase the potential human risk associated with viral contamination in wastewater.…”

Contributions from the systematic review of economic evaluations: the case of childhood hepatitis A vaccination in Brazil

“…In Israel, universal childhood vaccination has been conducted with great success since 1999 6,7 . Argentina in 2005 8 and the United States in 2006 9 also implemented programs for universal childhood vaccination against hepatitis A, with a major impact on the epidemiology of the disease 10 . The pattern of hepatitis A endemicity in Brazil suggests that the introduction of a universal childhood vaccination program would be beneficial.…”