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Immunization strategies to control a community-wide hepatitis A epidemic

Published online by Cambridge University Press:  05 February 2002

K. M. THORBURN
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
R. BOHORQUES
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
P. STEPAK
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
L. L. SMITH
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
C. JOBB
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
J. PALMER SMITH
Affiliation:
Spokane Regional Health District, West 1101 College Avenue, Spokane, WA 99201, USA
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Abstract

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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.

Type
Research Article
Copyright
2001 Cambridge University Press