Immunization strategies to control a community-wide hepatitis A epidemic

One fifth of 527 cases of hepatitis A occurred in self-identified injection drug users during a community-wide epidemic in Spokane County (Washington) in 1997–8. We hypothesized that an immunization campaign targeted at illicit drug users could control the epidemic. Starting in May 1998, hepatitis A...

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Bibliographic Details
Published in:Epidemiology and infection 2001-12, Vol.127 (3), p.461-467
Main Authors: THORBURN, K. M., BOHORQUES, R., STEPAK, P., SMITH, L. L., JOBB, C., PALMER SMITH, J.
Format: Article
Language:English
Subjects:
Adult
Animal viral diseases
Biological and medical sciences
Disease Outbreaks - prevention & control
Disease prevention
Drug use
Epidemics
Female
Food
Food Handling
Foodborne illnesses
Fundamental and applied biological sciences. Psychology
Hepatitis A
Hepatitis A - epidemiology
Hepatitis A - prevention & control
Hepatitis A Vaccines
Hepatitis A virus
Homeless people
Human viral diseases
Humans
Illicit drugs
Immunization
Immunoglobulins
Infections
Infectious diseases
Injections
Male
Medical sciences
Microbiology
Prisoners
Project evaluation
Restaurants
Risk Factors
Seasons
Substance Abuse, Intravenous
Vaccination
Vaccines
Viral diseases
Viral hepatitis
Washington - epidemiology
Workers
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Summary:One fifth of 527 cases of hepatitis A occurred in self-identified injection drug users during a community-wide epidemic in Spokane County (Washington) in 1997–8. We hypothesized that an immunization campaign targeted at illicit drug users could control the epidemic. Starting in May 1998, hepatitis A vaccine was provided to individuals in jails and other sites frequented by illicit drug users. Volunteers at vaccination sites were surveyed about risk. Serial convenience samples of jail inmates who denied previous vaccination were anonymously tested for hepatitis A virus (HAV) immunoglobulin G (IgG). From May to December 1998, 2765 high-risk individuals were vaccinated against hepatitis A. The proportion of HAV IgG seropositive inmates increased from 30% to more than 50%. Our findings suggest that vaccination along with naturally occurring infection increased the rate of hepatitis A immunity among illicit drug users during the final months of the epidemic. This supports the hypothesis that targeted immunization of high risk groups may shorten the natural history of a community-wide epidemic.
ISSN:0950-2688
1469-4409
DOI:10.1017/S0950268801006008