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Active immunisation during an outbreak of hepatitis A in a German day-care centre

A M Hauri1, E Fischer, J Fitzenberger

  • 1Hesse State Health Office, Wolframstr. 33, 35683 Dillenburg, Germany. a.hauri@hlpug.hessen.de

Vaccine
|May 30, 2006
PubMed

Insights

Hepatitis A virus (HAV) vaccination was recommended during a German day-care centre outbreak. Prompt vaccination showed limited impact on disease spread, suggesting a need for earlier intervention strategies.

Area of Science:

  • Epidemiology
  • Public Health
  • Vaccinology

Background:

  • An outbreak of Hepatitis A virus (HAV) occurred in a German day-care centre (DCC) involving 100 children.
  • HAV vaccination was recommended for children, employees, and household members following the outbreak's identification.

Purpose of the Study:

  • To evaluate Hepatitis A virus (HAV) vaccine uptake among day-care centre attendees, staff, and their families.
  • To identify potential risk factors associated with HAV infection during the outbreak.
  • To assess the effectiveness of vaccination and human normal immunoglobulin (HNIG) in controlling the outbreak.

Main Methods:

  • A retrospective cohort study was conducted to analyze vaccination rates and disease incidence.
  • Data collected included clinical hepatitis cases, asymptomatic HAV infections, vaccination status, and HNIG administration.
  • Comparison of illness rates in vaccinated versus unvaccinated individuals and in households with and without immunoprophylaxis.

Main Results:

  • Vaccine uptake was 66.7% for DCC children, 15.8% for household members, and 100% for employees.
  • Despite prompt vaccination recommendations, cases of HAV infection occurred in both vaccinated and unvaccinated individuals.
  • Lower illness rates were observed in children who received HNIG compared to those who did not.
  • Households where the DCC child received HAV vaccine and/or HNIG had a 5.6% case definition fulfillment rate, while households of non-immunized children had none.

Conclusions:

  • While most vaccinations were administered promptly after the recommendation, they may not have been timely enough to significantly alter the outbreak's trajectory.
  • The findings suggest that the timing of vaccination and immunoprophylaxis is critical for effective control of Hepatitis A virus outbreaks in day-care settings.

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