ScienceDirect - Vaccine : Feasibility of vaccination = in preventing secondary cases of hepatitis A virus infection

Feasibility of vaccination in preventing secondary cases of hepatitis = A virus=20 infection

L. Sagliocca^a,=20 E. Bianco^b^,=20^,, P. Amoroso^c,=20 M. Quarto^d,=20 I. Richichi^b,=20 M.E. Tosti^b,=20 N. Carannante^c,=20 M. Chironna^d,=20 P. Chiriac=C3=B2^e,=20 G. Di Bari^f,=20 P. Lopalco^d,=20 F. Resta^g,=20 T. Santantonio^h,=20 G. Tantimonacoⁱ=20 and A. Mele^b=20

^aA.O.G. Rummo, Benevento, = Italy
^bCentro Nazionale di = Epidemiologia,=20 Sorveglianza e Promozione della Salute, Istituto Superiore di = Sanit=C3=A0, Viale=20 Regina Elena, 299, 00161 Roma, Italy
^cDipartimento di Malattie Infettive, Ospedale = Cotugno,=20 Napoli, Italy
^dSezione di Igiene = DIMIMP,=20 Universit=C3=A0 di Bari, Italy
^eU.O. = Malattie=20 Infettive, Ospedale A. Perrino, Brindisi, Italy
^fU.O. Malattie Infettive, Ospedale Pediatrico = Giovanni=20 XXIII, Bari, Italy
^gU.O. Malattie = Infettive,=20 Ospedale SS. Annunziata, Taranto, Italy
^hClinica=20 di Malattie Infettive Universit=C3=A0 di Bari, Italy
ⁱU.O. Malattie Infettive, Policlinico di = Foggia, Italy=20

Received 26 February 2004; accepted 26 July 2004. = Available=20 online 1 September 2004.

Abstract

Although the secondary transmission of hepatitis A virus (HAV) = infection is=20 preventable through vaccination, it is not known whether the vaccination = of=20 household contacts is feasible. To this end, we conducted a prospective = cohort=20 study among the household contacts, 40 years of age or less, of all = persons=20 infected with primary HAV infection (index cases) and admitted to eight=20 hospitals in southern Italy within 7 days of onset. Household contacts = were=20 vaccinated, and serum samples were taken at vaccination and after 14 and = 45=20 days. Secondary cases were defined as those with IgM seroconversion = occurring at=20 least two weeks after enrolment. Coprimary cases were those assumed to = have had=20 the same exposure as the index case. Susceptible cases were those who = were=20 negative for both IgG and IgM. A total of 495 household contacts = participated=20 (acceptance rate of 65%); 65% were vaccinated within 4 days of admission = of the=20 index case and 95% within 7 days. At enrolment, 196 (39.6%) household = contacts=20 were immune (IgG-positive serum). During follow-up, 19 (3.8%) were = IgM-positive:=20 13 (2.6%) were coprimary cases and 6 (1.2%; 95% CI: 0.2=E2=80=933.2) = secondary cases (5=20 identified at 14 days from vaccination and 1 at 45 days). Of the 241 = susceptible=20 cases, 192 (79.7%) had developed IgG antibodies at 14 days and only 3 = (1.2%) did=20 not develop IgG antibodies at 45 days. The 65% acceptance rate and the = finding=20 that 95% of the participating household contacts were vaccinated within = 7 days=20 of the index case's hospitalization indicate that timely vaccination is = indeed=20 feasible. The necessity of returning for the collection of blood samples = probably decreased the acceptance rate.=20

Keywords: Hepatitis A virus; HAV vaccination; = Household=20 contacts
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Corresponding author. Tel.: +39 06 49904164; fax: = +39 06=20 49904170.



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Volume=20 23, Issue 7 , 4 January 2005, Pages 910-914=20

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Copyright =C2=A9 = 2005 Elsevier = B.V. All rights=20 reserved. ScienceDirect=C2=AE is a registered trademark of = Elsevier=20 B.V.



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			Full=20 Text + Links
			PDF=20 (77 K)



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			E-mail=20 Article