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[Hepatitis A in Estonia (1990-1999)]
V T Tefanova1, T G Tallo, L S Priĭmiagi
1Institute of Experimental and Clinical Medicine, Tallinn.
Zhurnal Mikrobiologii, Epidemiologii I Immunobiologii
|June 5, 2002
Summary
Viral hepatitis A (VHA) epidemiology in Estonia shifted from children to adults, with decreased cases. Everyday contact remains the primary transmission route, but vaccination is key for prevention.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Estonia experienced significant changes in viral hepatitis A (VHA) epidemiology between 1990-1999.
- A notable decrease in VHA morbidity occurred, alongside a shift in the age structure of affected individuals from preschool children to older age groups.
Purpose of the Study:
- To analyze the epidemiological changes in VHA in Estonia during the 1990s.
- To identify transmission routes and risk factors associated with VHA, particularly during a regional outbreak.
Main Methods:
- Retrospective analysis of VHA case data from 1990-1999.
- Investigation of a VHA outbreak in North Estonia in 1998, focusing on transmission routes and patient demographics.
Main Results:
- VHA morbidity decreased significantly, with rates dropping from 78.4 to 7.7 per 100,000 population between 1990 and 1996.
- Everyday contact was the primary transmission route, though risk factors were often unclear (>80% of cases).
- A 1998 outbreak disproportionately affected young adults (15-29 years), coinciding with high rates of parenteral hepatitis B and C and drug addiction, suggesting potential parenteral VHA transmission in this group.
Conclusions:
- VHA epidemiology in Estonia has shifted, with a declining incidence and an aging patient population.
- While everyday contact is the main VHA transmission route, the 1998 outbreak highlighted potential parenteral transmission among injection drug users.
- Vaccination is identified as the most effective strategy for VHA prophylaxis.