Epidemiology and eradication strategy for hepatitis B in Europe. The European Regional Study Group

In Europe, only approximately 1% of the general population are chronic carriers of the hepatitis B surface antigen (HBsAg) but hepatitis B is unevenly distributed in the region. Based on the prevalence of HBsAg, the region may be divided into three hepatitis B epidemiological patterns: the UK and the Scandinavian countries (less than 0.1%); most countries in Western Europe (0.1-0.5%); and countries situated along the Mediterranean Sea and in Eastern Europe (1-5%). Existing screening and vaccination programmes depend on such factors as the carrier rate of the indigenous population and the influx of immigrants from highly endemic areas. Vaccination of health care workers is, in general, advised but not required. The accent has been placed, in most countries, on the screening of pregnant women for the presence of HBsAg and the vaccination of newborns of carrier mothers. Education programmes are needed to enhance awareness of general practitioners regarding these risk groups. The institution of mass vaccination will depend upon the cost of vaccine, although the cost factor is less important in Europe than in developing countries.