Hepatitis A outbreak among MSM in Berlin due to low vaccination coverage: Epidemiology, management, and successful interventions

Zimmermann, Ruth; Faber, Mirko; Dudareva, Sandra; Ingiliz, Patrick; Jessen, Heiko; Koch, Judith; Marcus, Ulrich; Michaelis, Kai; Rieck, Thorsten; Ruscher, Claudia; Schilling, Birte; Schumacher, Jakob; Sissolak, Dagmar; Thoulass, Janine; Wenzel, Jürgen J.; Werber, Dirk; Sagebiel, Daniel

doi:10.1016/j.ijid.2020.11.133

Cited by 16 publications

(15 citation statements)

References 19 publications

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“…Since February 2016, hepatitis A outbreaks in MSM populations have been reported in many parts of the world including the major cities of Latin America [3,[18][19][20]. Molecular epidemiology shows similar HAV strains circulating among HAV-infected MSM, suggesting a distinct route of transmission through sexual contact [11].…”

Section: Discussionmentioning

confidence: 99%

The Impact of an Inactivated Hepatitis A Vaccine with One Dose in Brazil: A Retrospective Time-Series

et al. 2021

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Background: In 2014, a recommended one-dose of inactivated hepatitis A vaccine was included in the Brazilian National Immunization Program targeting children 12–24 months. This decision addressed the low to intermediate endemicity status of hepatitis A across Brazil and the high rate of infection in children and adolescents between 5 and 19 years old. The aim of the study was to conduct a time-series analysis on hepatitis A incidence across age groups and to assess the hepatitis A distribution throughout Brazilian geographic regions. Methods: An interrupted time-series analysis was performed to assess hepatitis A incidence rates before (2010–2013) and after (2015–2018) hepatitis A vaccine program implementation. The time-series analysis was stratified by age groups while a secondary analysis examined geographic distribution of hepatitis A cases. Results: Overall incidence of hepatitis A decreased from 3.19/100.000 in the pre-vaccine period to 0.87/100.000 (p = 0.022) post-vaccine introduction. Incidence rate reduction was higher among children aged 1-4 years old, with an annual reduction of 67.6% in the post-vaccination period against a 7.7% annual reduction in the pre-vaccination period (p < 0.001). Between 2015 and 2018, the vaccination program prevented 14,468 hepatitis A cases. Conclusion: Our study highlighted the positive impact of a recommended one-dose inactivated hepatitis A vaccine for 1–4-years-old in controlling hepatitis A at national level.

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Section: Discussionmentioning

confidence: 99%

The Impact of an Inactivated Hepatitis A Vaccine with One Dose in Brazil: A Retrospective Time-Series

et al. 2021

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“…Worldwide spread of the same strains among the homosexual community highlights the prevalence of international networking in this population and the role of travel in virus dissemination. It also demonstrates the great susceptibility and the low rate of vaccination among MSM; it is estimated to be 25-45% despite the long-lasting recommendations [68][69][70]. More and more MSM have been using HIV pre-exposure prophylaxis (PrEP) to prevent HIV infection since 2016.…”

Section: Men Who Have Sex With Men (Msm)mentioning

confidence: 99%

Hepatitis A: Epidemiology, High-Risk Groups, Prevention and Research on Antiviral Treatment

Migueres

Lhomme

Izopet

2021

Viruses

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The hepatitis A virus (HAV) is a leading cause of acute viral hepatitis worldwide. It is transmitted mainly by direct contact with patients who have been infected or by ingesting contaminated water or food. The virus is endemic in low-income countries where sanitary and sociodemographic conditions are poor. Paradoxically, improving sanitary conditions in these countries, which reduces the incidence of HAV infections, can lead to more severe disease in susceptible adults. The populations of developed countries are highly susceptible to HAV, and large outbreaks can occur when the virus is spread by globalization and by increased travel and movement of foodstuffs. Most of these outbreaks occur among high-risk groups: travellers, men who have sex with men, people who use substances, and people facing homelessness. Hepatitis A infections can be prevented by vaccination; safe and effective vaccines have been available for decades. Several countries have successfully introduced universal mass vaccination for children, but high-risk groups in high-income countries remain insufficiently protected. The development of HAV antivirals may be important to control HAV outbreaks in developed countries where a universal vaccination programme is not recommended.

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“…These populations can be difficult to engage, and vaccinating these high-risk individuals needs to be a public health priority (at least in developed countries). MSM have been linked to outbreaks of cases in developed countries, with epidemiological and laboratory investigations linking genotypes between countries[ 17 ]. It is important that high-risk groups such as MSM are identified and offered vaccination to prevent outbreaks in susceptible communities where there is lack of herd immunity[ 18 ].…”

Section: Hepatitis a Virusmentioning

confidence: 99%

“…Improving uptake of HAV vaccination in the MSM population is a remaining challenge. Targeting these at risk populations by methods such as social media and dating apps have been shown to improve vaccination uptake[ 17 ]. Patients with chronic liver disease should also be offered HAV vaccination due to their risk of more severe infection, however doing so has not entered widespread clinical practice[ 19 ].…”

Section: Hepatitis a Virusmentioning

confidence: 99%

Viral hepatitis in 2021: The challenges remaining and how we should tackle them

Dunn¹,

Wetten²,

McPherson³

et al. 2022

WJG

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Viral hepatitis results in 1.4 million deaths annually. The World Health Organization (WHO) set an ambitious target to eliminate viral hepatitis by 2030, but significant challenges remain. These include inequalities in access to healthcare, reaching at risk populations and providing access to screening and effective treatment. Stigma around viral hepatitis persists and must be addressed. The WHO goal of global elimination by 2030 is a worthy aim, but remains ambitious and the coronavirus 2019 pandemic undoubtedly has set back progress. This review article will focus on hepatitis A to E, highlighting problems that have been resolved in the field over the past decade, those that remain to be resolved and suggest directions for future problem solving and research.

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Hepatitis A outbreak among MSM in Berlin due to low vaccination coverage: Epidemiology, management, and successful interventions

Cited by 16 publications

References 19 publications

The Impact of an Inactivated Hepatitis A Vaccine with One Dose in Brazil: A Retrospective Time-Series

The Impact of an Inactivated Hepatitis A Vaccine with One Dose in Brazil: A Retrospective Time-Series

Hepatitis A: Epidemiology, High-Risk Groups, Prevention and Research on Antiviral Treatment

Viral hepatitis in 2021: The challenges remaining and how we should tackle them

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