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Domínguez A, Varela C, Soldevila N, Izquierdo C, Guerrero M, Peñuelas M, Martínez A, Godoy P, Borràs E, Rius C, Torner N, Avellón AM, Castilla J. Hepatitis A Outbreak Characteristics: A Comparison of Regions with Different Vaccination Strategies, Spain 2010-2018. Vaccines (Basel) 2021; 9:1214. [PMID: 34835145 PMCID: PMC8620672 DOI: 10.3390/vaccines9111214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 12/25/2022] Open
Abstract
We compared the cumulative incidence and characteristics of hepatitis A outbreaks in two groups of Spanish autonomous regions according to whether a universal or risk group vaccination strategy was followed. Outbreaks between 2010 and 2018 were analyzed. The cumulative incidence rate of outbreaks was estimated and compared by estimating the rate ratio (RR). The characteristics of the outbreaks and those of the first cases were compared. Adjusted OR (aOR) were calculated using a multivariate logistic regression model. Outbreak incidence was 16.04 per million persons in regions with universal vaccination and 20.76 in those with risk-group vaccination (RR 0.77; 95%CI 0.62-0.94). Imported outbreaks accounted for 65% in regions with universal vaccination and 28.7% in regions with risk-group vaccination (aOR 3.88; 95%CI 2.13-7.09). Adolescents and young adults aged 15-44 years and men who have sex with men were less frequently the first case of the outbreak in regions with a universal vaccination strategy (aOR 0.54; 95%CI 0.32-0.92 and 0.23; 95%CI 0.07-0.82, respectively). The cumulative incidence rate of outbreaks was lower in regions with universal vaccination. In all regions, independently of the vaccination strategy, activities to vaccinate persons belonging to high-risk groups for infection should be emphasized.
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Affiliation(s)
- Angela Domínguez
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
| | - Carmen Varela
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.G.); (M.P.)
| | - Núria Soldevila
- Department of Medicine, Universidad de Barcelona, 08036 Barcelona, Spain;
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
| | | | - María Guerrero
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.G.); (M.P.)
| | - Marina Peñuelas
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain; (M.G.); (M.P.)
| | - Ana Martínez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain;
| | - Pere Godoy
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain;
| | - Eva Borràs
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Agència de Salut Pública de Catalunya, 08005 Barcelona, Spain;
| | - Cristina Rius
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Agència de Salut Pública de Barcelona, 08023 Barcelona, Spain
| | - Núria Torner
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
| | - Ana María Avellón
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28222 Madrid, Spain
| | - Jesús Castilla
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.V.); (A.M.); (P.G.); (E.B.); (C.R.); (N.T.); (A.M.A.); (J.C.)
- Instituto Salud Pública de Navarra-IdiSNA, 31003 Pamplona, Spain
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Herzog C, Van Herck K, Van Damme P. Hepatitis A vaccination and its immunological and epidemiological long-term effects - a review of the evidence. Hum Vaccin Immunother 2021; 17:1496-1519. [PMID: 33325760 PMCID: PMC8078665 DOI: 10.1080/21645515.2020.1819742] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/16/2020] [Accepted: 09/01/2020] [Indexed: 01/11/2023] Open
Abstract
Hepatitis A virus (HAV) infections continue to represent a significant disease burden causing approximately 200 million infections, 30 million symptomatic illnesses and 30,000 deaths each year. Effective and safe hepatitis A vaccines have been available since the early 1990s. Initially developed for individual prophylaxis, HAV vaccines are now increasingly used to control hepatitis A in endemic areas. The human enteral HAV is eradicable in principle, however, HAV eradication is currently not being pursued. Inactivated HAV vaccines are safe and, after two doses, elicit seroprotection in healthy children, adolescents, and young adults for an estimated 30-40 years, if not lifelong, with no need for a later second booster. The long-term effects of the single-dose live-attenuated HAV vaccines are less well documented but available data suggest they are safe and provide long-lasting immunity and protection. A universal mass vaccination strategy (UMV) based on two doses of inactivated vaccine is commonly implemented in endemic countries and eliminates clinical hepatitis A disease in toddlers within a few years. Consequently, older age groups also benefit due to the herd protection effects. Single-dose UMV programs have shown promising outcomes but need to be monitored for many more years in order to document an effective immune memory persistence. In non-endemic countries, prevention efforts need to focus on 'new' risk groups, such as men having sex with men, prisoners, the homeless, and families visiting friends and relatives in endemic countries. This narrative review presents the current evidence regarding the immunological and epidemiological long-term effects of the hepatitis A vaccination and finally discusses emerging issues and areas for research.
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Affiliation(s)
- Christian Herzog
- Department of Medicine, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Koen Van Herck
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Montagna MT, De Giglio O, Calia C, Pousis C, Triggiano F, Murgolo S, De Ceglie C, Bagordo F, Apollonio F, Diella G, Narracci M, Acquaviva MI, Ferraro GB, Mancini P, Veneri C, Brigida S, Grassi T, De Donno A, Di Iaconi C, Caputo MC, Cavallo RA, La Rosa G, Mascolo G. Microbiological and Chemical Assessment of Wastewater Discharged by Infiltration Trenches in Fractured and Karstified Limestone (SCA.Re.S. Project 2019-2020). Pathogens 2020; 9:pathogens9121010. [PMID: 33266323 PMCID: PMC7759865 DOI: 10.3390/pathogens9121010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/28/2020] [Accepted: 11/29/2020] [Indexed: 01/13/2023] Open
Abstract
This study investigated the environmental contamination of groundwater as a consequence of the discharge of treated wastewater into the soil. The investigation focused on a wastewater treatment plant located in an area fractured by karst in the Salento peninsula (Apulia, Italy). Water samples were collected at four sites (raw wastewater, treated wastewater, infiltration trench, and monitoring well), monthly from May to December 2019 (with the exception of August), and were tested for (1) panel of bacteria; (2) enteric viruses; and (3) chemical substances. A gradual reduction in the concentration of bacteria, viruses and contaminants of emerging concern was observed across the profile of soil fissured by karst. All monitored bacteria were absent from the monitoring well, except for Pseudomonas aeruginosa. Pepper mild mottle virus and adenovirus were detected at all sampling sites. Personal care products and X-ray contrast media showed the greatest decrease in concentration from infiltration trench to the monitoring well, while the highest residual concentrations in the monitoring well were found for anticonvulsants (78.5%), antimicrobials (41.3%), and antipsychotic drugs (38.6%). Our results show that parameters provided by current law may not always be sufficient to evaluate the sanitary risk relating to the discharge of treated wastewater to the soil.
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Affiliation(s)
- Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
- Correspondence: ; Tel.: +39-080-5478476
| | - Carla Calia
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Chrysovalentinos Pousis
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Francesco Triggiano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Sapia Murgolo
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
| | - Cristina De Ceglie
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
| | - Francesco Bagordo
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, via Monteroni, 165, 73100 Lecce, Italy; (F.B.); (T.G.); (A.D.D.)
| | - Francesca Apollonio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy; (M.T.M.); (C.C.); (C.P.); (F.T.); (F.A.); (G.D.)
| | - Marcella Narracci
- National Research Council (CNR), Water Research Institute (IRSA), S.S. di Taranto, via Roma 3, 74123 Taranto, Italy; (M.N.); (M.I.A.); (R.A.C.)
| | - Maria Immacolata Acquaviva
- National Research Council (CNR), Water Research Institute (IRSA), S.S. di Taranto, via Roma 3, 74123 Taranto, Italy; (M.N.); (M.I.A.); (R.A.C.)
| | - Giusy Bonanno Ferraro
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.B.F.); (P.M.); (C.V.); (G.L.R.)
| | - Pamela Mancini
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.B.F.); (P.M.); (C.V.); (G.L.R.)
| | - Carolina Veneri
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.B.F.); (P.M.); (C.V.); (G.L.R.)
| | - Silvia Brigida
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
| | - Tiziana Grassi
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, via Monteroni, 165, 73100 Lecce, Italy; (F.B.); (T.G.); (A.D.D.)
| | - Antonella De Donno
- Laboratory of Hygiene, Department of Biological and Environmental Sciences and Technologies, University of Salento, via Monteroni, 165, 73100 Lecce, Italy; (F.B.); (T.G.); (A.D.D.)
| | - Claudio Di Iaconi
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
| | - Maria Clementina Caputo
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
| | - Rosa Anna Cavallo
- National Research Council (CNR), Water Research Institute (IRSA), S.S. di Taranto, via Roma 3, 74123 Taranto, Italy; (M.N.); (M.I.A.); (R.A.C.)
| | - Giuseppina La Rosa
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.B.F.); (P.M.); (C.V.); (G.L.R.)
| | - Giuseppe Mascolo
- National Research Council (CNR), Water Research Institute (IRSA), via F. De Blasio, 5, 70132 Bari, Italy; (S.M.); (C.D.C.); (S.B.); (C.D.I.); (M.C.C.); (G.M.)
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Zalesskikh AA, Bystrova TN. Sequencing of the VP1-2A Genome Segment for Hepatitis A Subtyping. Sovrem Tekhnologii Med 2020; 12:52-55. [PMID: 34513037 PMCID: PMC8353700 DOI: 10.17691/stm2020.12.1.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Indexed: 12/03/2022] Open
Abstract
The aim of the study was to improve the VP1–2A sequencing method and facilitate the hepatitis A virus genotyping technique.
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Affiliation(s)
- A A Zalesskikh
- Senior Researcher, Laboratory for the Epidemiology of Viral Hepatitis, Blokhina Scientific Research Institute of Epidemiology and Microbiology of Nizhny Novgorod, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), 71 Malaya Yamskaya St., Nizhny Novgorod, 603950, Russia
| | - T N Bystrova
- Professor, Leading Researcher, Laboratory for the Epidemiology of Viral Hepatitis, Blokhina Scientific Research Institute of Epidemiology and Microbiology of Nizhny Novgorod, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), 71 Malaya Yamskaya St., Nizhny Novgorod, 603950, Russia
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Yan BY, Lv JJ, Liu JY, Feng Y, Wu WL, Xu AQ, Zhang L. Changes in seroprevalence of hepatitis A after the implementation of universal childhood vaccination in Shandong Province, China: A comparison between 2006 and 2014. Int J Infect Dis 2019; 82:129-134. [PMID: 30862519 DOI: 10.1016/j.ijid.2019.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 03/02/2019] [Accepted: 03/04/2019] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The hepatitis A vaccine (HepA) has been included in the national expanded program on immunization (EPI) in China since 2008. This study was performed to evaluate the change in dynamics of the seroepidemiology of hepatitis A virus (HAV) before and after the introduction of the program. METHODS The trends in seroepidemiology of anti-HAV antibodies were examined in Shandong Province, China, drawing on two population-based samples of persons aged 1-59 years, one obtained in the year 2006 (n = 6682) and the other in 2014 (n = 5095). RESULTS A dramatic increase in seroprevalence of anti-HAV antibodies from 30.76% (95% confidence interval (CI) 26.24-35.28%) to 77.46% (95% CI 74.04-80.87%) among children aged 1.5-7 years (born after HepA was recommended for routine childhood immunization), as well as an increase from 35.32% (95% CI 29.31-41.33%) to 66.69% (95% CI 55.59-77.80%) in subjects aged 8-14 years, was observed in 2014 when compared with 2006. By contrast, a decline in seroprevalence among subjects aged 15-29 years, as seen particularly in those 20-29 years of age, from 85.72% (95% CI 80.29-91.14%) to 69.24% (95% CI 62.02-76.45%), was found in this study. There was no statistically significant difference in seroprevalence between 2006 and 2014 among the subjects older than 30 years of age. CONCLUSIONS The national HepA routine immunization program has had a positive effect, leading to an increase in anti-HAV seroprevalence among children in Shandong Province, China. More attention should be paid to young adults in the province.
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Affiliation(s)
- Bing-Yu Yan
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jing-Jing Lv
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Jia-Ye Liu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yi Feng
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Wen-Long Wu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China
| | - Ai-Qiang Xu
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Li Zhang
- Academy of Preventive Medicine, Shandong University, Jinan, China; Shandong Provincial Key Laboratory of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, China.
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Hong SS, Choi UY, Ma SH, Lee SY, Han SB, Kim KH, Kang JH, Kim JH. Comparison of the immunogenicity and safety of 3 inactivated hepatitis A vaccines in Korean children aged 12 to 18 months: An open-label, randomized, prospective, multicenter study. Medicine (Baltimore) 2019; 98:e14364. [PMID: 30732169 PMCID: PMC6380807 DOI: 10.1097/md.0000000000014364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Several approved inactivated hepatitis A (HA) vaccines are available in Korea. These have been shown to be immunogenic and safe in European children; however, their immunogenicity and safety have not been investigated among Korean children. We aimed to compare the immunogenicity and safety of the most commonly used HA vaccines in ethnic Korean children aged 12 to 18 months.In this open-label, randomized, prospective, multicenter study, 108 children were enrolled and randomized to receive a pediatric form of Avaxim, Epaxal, or Havrix. The 2nd dose was administered after an interval of 6 months. Anti-HA virus (HAV) immunoglobulin (Ig) G was measured to assess geometric mean concentrations (GMCs) and seropositvity rates (≥20 mIU/mL anti-HAV IgG). To assess safety, local solicited adverse events (AEs), systemic solicited AEs, unsolicited AEs, and serious AEs (SAEs) were graded.Among the 108 participants enrolled, 37, 34, and 37 received Avaxim, Epaxal, and Havrix, respectively. After administration of 2 doses, the seropositivity rates in the Avaxim, Epaxal, and Havrix groups were all 100% (95% confidence intervals [CIs]: 99.0-100, 98.9-100, and 99.0-100, respectively; P < .001). The anti-HAV GMCs in the Avaxim, Epaxal, and Havrix groups were 5868.4 (95% CI: 4237.2-8126.6), 1962.1 (95% CI: 1298.0-2965.9), and 2232.9 mIU/mL (95% CI: 1428.4-3490.4), respectively, after administration of 2 doses (P < .001). There were no significant differences in the proportions of participants reporting local solicited AEs, systemic solicited AEs, unsolicited AEs, and SAEs among the 3 vaccine groups after the 1st and 2nd doses. All local solicited and unsolicited AEs were grade 1 or 2. Grade 3 systemic solicited AE occurred in 5.4% and 2.9% of the participants in the Havrix group after the 1st and 2nd doses, respectively. SAEs after the 1st and 2nd doses were reported in 2 participants and 1 participant, respectively, but none was assessed as being related to vaccination.The results indicate that these vaccines were safe and immunogenic in ethnic Korean children. The results have contributed to the establishing of an HA vaccination policy in Korea and will be informative to countries that plan to initiate vaccination programs against HAV.
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Affiliation(s)
- Seung Soo Hong
- Department of Pediatrics, Graduate School of Medical Science
| | - Ui Yoon Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Sang Hyuk Ma
- Department of Pediatrics, Changwon Fatima Hospital, Changwon
| | - Soo Young Lee
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Seung Beom Han
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Kyung-Hyo Kim
- Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jin Han Kang
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
| | - Jong-Hyun Kim
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul
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Godoy P, Carmona G, Manzanares S, Jane M, Borràs E, Camps N, Álvarez J, Barrabeig I, Sala MR, Rius C, Minguell S, Carol M, Ferras J, Domínguez A. Trends and risk factors of hepatitis A in Catalonia after the introduction of a hepatitis A+B vaccination programme. J Viral Hepat 2018; 25:1001-1007. [PMID: 29603832 DOI: 10.1111/jvh.12900] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 01/23/2018] [Indexed: 01/26/2023]
Abstract
At the end of 1998, universal hepatitis A+B vaccination of 12 year olds was introduced in Catalonia. The aim was to examine trends in hepatitis A during 2005-2015 and assess risk factors by age group. We carried out an observational epidemiological study of the incidence and risk factors of hepatitis A reported to the surveillance system. Information on exposure was recorded for each case for the 2-6 weeks before symptom onset. Spearman's coefficient was used to evaluate the trends of rates. The chi-square test was used to compare categorical. We studied 2621 hepatitis A cases; the age mean was 26.6 years (SD=18.2), and >50% of cases were in the 20-49 years age group. The incidence decreased from 3.28/100 000 in 2005 to 1.50/100 000 in 2015. The rate for women decreased over time (P = .008), but the reduction was not significant in men (P = .234). Men consistently had higher rates than women with the biggest difference being in the 20-34 years age group (rate 8.8 vs 2.8). The greatest risk factor was travel to an endemic country (42.1%) in the 0-19 years age group and male-to-male sexual contact (18.6%) in the 20-49 years age group. The case fatality rate in adults aged >49 years was 0.4%. In conclusion, the vaccination programme of preadolescents resulted in a reduction in hepatitis A cases. However, a significant amount of cases still appear in immigrants and men who have sex with men. Hepatitis A in adults is an emerging health problem that will require new strategies.
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Affiliation(s)
- P Godoy
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institut de Recerca Biomédica de Lleida. IRBLleida, Lleida, Spain
| | - G Carmona
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - S Manzanares
- Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - M Jane
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - E Borràs
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - N Camps
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - J Álvarez
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - I Barrabeig
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - M-R Sala
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - C Rius
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - S Minguell
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - M Carol
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - J Ferras
- Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
| | - A Domínguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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The effectiveness and limitation of the national childhood hepatitis A vaccination program in the Republic of Korea: Findings from the Korean National Health and Nutrition Examination Survey (KNHANES), 2015. PLoS One 2017; 12:e0189210. [PMID: 29220416 PMCID: PMC5722338 DOI: 10.1371/journal.pone.0189210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/21/2017] [Indexed: 01/17/2023] Open
Abstract
Background Vaccination for hepatitis A virus (HAV) has been implemented as one of the national vaccination programs despite the epidemiological transition of HAV in the Republic of Korea. While the national HAV vaccination program is largely associated with the shift of socioeconomic trend in the country, concerns have been raised on the effectiveness of the HAV immunization. The objective of this study was to examine the epidemiological trend of HAV and assess the effectiveness of the nationwide HAV vaccination policy based on a nationally representative sample of the Korean population collected in 2015. Methods We analyzed anti-HAV of 5,856 respondents aged ≥10 years collected from Korean National Health and Nutrition Examination Survey (KNHANES) data in 2015. We estimated age-adjusted anti-HAV prevalence by sociodemographic and other characteristics. We evaluated the factors associated with anti-HAV positivity among each age group (10–19, 20–29, 30–45 and over 45 years old). Results The prevalence of anti-HAV among adults aged ≥10 years was 72.5% (95% confidence interval, CI, 73.7–71.4) in 2015. The lowest age-specific prevalence was among adults aged 20–29 years with 11.9% (95% CI 9.3–15.1%). The prevalence of anti-HAV among those aged 10–14 and 15–19 years was 59.7% (95% CI 52.7–66.4) and 24.0% (95% CI 19.5–29.3), respectively. The prevalence of anti-HAV among adults aged between 30 and 44 years rapidly increased from below 20% to above 90%. The prevalence of anti-HAV among adults aged ≥45 years was 97.8% (95% CI 96.0–97.6). Factors significantly associated with anti-HAV positivity among those aged 10–19 years old were young age, higher house income and high influenza vaccination rate. Compared to the respondents aged 10–19 years (those who were subject to the national childhood vaccine recommendation), those aged 20–29 years (those who were not subject to the recommendation) had low adjusted odds ratio (OR, 0.52 95% CI 0.34–.81 P-value = 0.004) for anti-HAV positivity. Conclusions The age-adjusted anti-HAV prevalence showed a U-shaped association, implying the high dependence of anti-HAV prevalence on age and the epidemiological shift. The inclusion of the hepatitis A vaccine into the national immunization recommendation was effective shown by the increase of immunity in the general population. However, the vaccination rate was low in the low-income group. Young adults aged 20–39 years may benefit from inclusion in the HAV vaccination program due to the significantly low vaccination rate.
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De Giglio O, Caggiano G, Bagordo F, Barbuti G, Brigida S, Lugoli F, Grassi T, La Rosa G, Lucentini L, Uricchio VF, De Donno A, Montagna MT. Enteric Viruses and Fecal Bacteria Indicators to Assess Groundwater Quality and Suitability for Irrigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060558. [PMID: 28538682 PMCID: PMC5486244 DOI: 10.3390/ijerph14060558] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/20/2017] [Accepted: 05/22/2017] [Indexed: 11/18/2022]
Abstract
According to Italian Ministerial Decree No. 185 of 12 June 2003, water is considered suitable for irrigation if levels of fecal bacteria (i.e., Escherichia coli and Salmonella) are within certain parameters. The detection of other microorganisms is not required. The aim of this study is to determine the bacteriological quality of groundwater used for irrigation and the occurrence of enteric viruses (Norovirus, Enterovirus, Rotavirus, Hepatovirus A), and to compare the presence of viruses with the fecal bacteria indicators. A total of 182 wells was analyzed. Widespread fecal contamination of Apulian aquifers was detected (141 wells; 77.5%) by the presence of fecal bacteria (i.e., E. coli, Salmonella, total coliforms, and enterococci). Considering bacteria included in Ministerial Decree No. 185, the water from 35 (19.2%) wells was unsuitable for irrigation purposes. Among 147 wells with water considered suitable, Norovirus, Rotavirus, and Enterovirus were detected in 23 (15.6%) wells. No Hepatovirus A was isolated. Consequently, 58 wells (31.9%) posed a potential infectious risk for irrigation use. This study revealed the inadequacy of fecal bacteria indicators to predict the occurrence of viruses in groundwater and it is the first in Italy to describe the presence of human rotaviruses in well water used for irrigation.
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Affiliation(s)
- Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Giuseppina Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Francesco Bagordo
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Via per Monteroni, Campus Ecotekne, Monteroni di Lecce, 73047 Lecce, Italy.
| | - Giovanna Barbuti
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
| | - Silvia Brigida
- Water Research Institute, National Research Council, Viale Francesco de Blasio 5, 70132 Bari, Italy.
| | - Federica Lugoli
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Via per Monteroni, Campus Ecotekne, Monteroni di Lecce, 73047 Lecce, Italy.
| | - Tiziana Grassi
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Via per Monteroni, Campus Ecotekne, Monteroni di Lecce, 73047 Lecce, Italy.
| | - Giuseppina La Rosa
- National Institute of Health, Department of Environment and Health, Viale Regina Elena 299, 00100 Rome, Italy.
| | - Luca Lucentini
- National Institute of Health, Department of Environment and Health, Viale Regina Elena 299, 00100 Rome, Italy.
| | - Vito Felice Uricchio
- Water Research Institute, National Research Council, Viale Francesco de Blasio 5, 70132 Bari, Italy.
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Via per Monteroni, Campus Ecotekne, Monteroni di Lecce, 73047 Lecce, Italy.
| | - Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Piazza G. Cesare 11, 70124 Bari, Italy.
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