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

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doi:10.1016/j.vaccine.2004.07.035
Copyright © 2004 Elsevier Ltd All rights reserved.

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

L. Saglioccaa, E. Biancob, , , P. Amorosoc, M. Quartod, I. Richichib, M.E. Tostib, N. Carannantec, M. Chironnad, P. Chiriacòe, G. Di Barif, P. Lopalcod, F. Restag, T. Santantonioh, G. Tantimonacoi and A. Meleb

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

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

Abstract

Although the secondary transmission of hepatitis A virus (HAV) infection is preventable through vaccination, it is not known whether the vaccination of household contacts is feasible. To this end, we conducted a prospective cohort study among the household contacts, 40 years of age or less, of all persons infected with primary HAV infection (index cases) and admitted to eight hospitals in southern Italy within 7 days of onset. Household contacts were vaccinated, and serum samples were taken at vaccination and after 14 and 45 days. Secondary cases were defined as those with IgM seroconversion occurring at least two weeks after enrolment. Coprimary cases were those assumed to have had the same exposure as the index case. Susceptible cases were those who were negative for both IgG and IgM. A total of 495 household contacts participated (acceptance rate of 65%); 65% were vaccinated within 4 days of admission of the index case and 95% within 7 days. At enrolment, 196 (39.6%) household contacts were immune (IgG-positive serum). During follow-up, 19 (3.8%) were IgM-positive: 13 (2.6%) were coprimary cases and 6 (1.2%; 95% CI: 0.2–3.2) secondary cases (5 identified at 14 days from vaccination and 1 at 45 days). Of the 241 susceptible cases, 192 (79.7%) had developed IgG antibodies at 14 days and only 3 (1.2%) did not develop IgG antibodies at 45 days. The 65% acceptance rate and the finding that 95% of the participating household contacts were vaccinated within 7 days of the index case's hospitalization indicate that timely vaccination is indeed feasible. The necessity of returning for the collection of blood samples probably decreased the acceptance rate.
Keywords: Hepatitis A virus; HAV vaccination; Household contacts

Corresponding author. Tel.: +39 06 49904164; fax: +39 06 49904170.

| |

| | This Document | |
| |

| | | Abstract | |
| | | Full Text + Links | |
| | | PDF (77 K) | |
| |

| |
| | Actions | |
| |

| | | E-mail Article | |
| |

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