Hepatitis transmission among the Sioux Indians of South Dakota.

Abstract

Hepatitis A continues to occur in cyclical communitywide epidemics on the Indian reservations of South Dakota. In June 1985 a population-based serosurvey for viral hepatitis involving 120 households was conducted at the Pine Ridge and Rosebud Sioux Indian reservations in South Dakota. The serosurvey was performed shortly after a large hepatitis A epidemic on the Pine Ridge reservation in 1983-84, and immediately before a large hepatitis A epidemic on the Rosebud reservation in 1985-86. The overall seroprevalence for antibodies to hepatitis A virus (anti-HAV) was 76.2 percent (Pine Ridge reservation 80.5 percent, Rosebud reservation 72.0 percent, relative risk = 1.12, 95 percent confidence interval = 1.01, 1.24). For age groups 0 to 4 years, 54.2 percent and

Effect of maternal antibody on immunogenicity of hepatitis A vaccine in infants

“…7-10 Toddlers often have asymptomatic infection and are the source of silent transmission to susceptible persons and maintenance of the virus in a community over time. 3 Therefore, sustained vaccination of children, preferably as part of the early childhood immunization schedule, will be required to prevent HAV transmission and the reintroduction of disease into communities.…”

“…Serologic studies in this and neighboring populations showed a high prevalence of hepatitis A virus (HAV) infection among adults. 3 Eligible participants were infants born to mothers who received well-child care at the Rapid City Indian Health Service (Sioux San) Hospital. Infants were excluded if they received IG, immunosuppressive therapy, blood, or blood products; were immune-compromised; were born to hepatitis B surface antigen-positive mothers; or were diagnosed with a severe developmental disability or progressive or unstable neurologic disorder.…”

“…1,2 Historically, the highest rates of hepatitis A have been among American Indians/Alaska Natives and Hispanics, and American Indian reservations and some Hispanic communities have regularly had epidemics persisting for several years. 1,3 In these communities, the highest disease rates are observed among children, because most adults, including women of childbearing age, have antibody to hepatitis A virus (anti-HAV) from infection acquired during childhood. 3 Hepatitis A vaccination has been shown to produce protective levels of anti-HAV rapidly, [4][5][6] to protect >95% of vaccinated persons from disease, 7,8 and to interrupt disease transmission.…”

“…1,3 In these communities, the highest disease rates are observed among children, because most adults, including women of childbearing age, have antibody to hepatitis A virus (anti-HAV) from infection acquired during childhood. 3 Hepatitis A vaccination has been shown to produce protective levels of anti-HAV rapidly, [4][5][6] to protect >95% of vaccinated persons from disease, 7,8 and to interrupt disease transmission. 1,9,10 Recently, routine hepatitis A vaccination has been recommended for children older than 2 years living in states and communities with disease rates that have exceeded the national average over the period of the past decade.…”

Viral hepatitis in minorities

“…In another study, the incidence of chronic active hepatitis was 193 per 100,000 in men, and that of cirrhosis 107 per 100,000 over 7815 carrier-years [50]. Research examining prevalence in mainland Native Americans is scant, with little data on natural history or treatment outcomes [51].…”