Prevention and control of hepatitis A

Until recently, protection against hepatitis A has depended on high standards of public health and hygiene, bolstered by selective passive immunisation of those at high risk of infection using human normal immunoglobulin (HNIG). The scope for prophylaxis changed in April 1992 with the introduction of a hepatitis A vaccine (Havrix--SmithKline Beecham), which offers active immunisation and so longer and more effective protection than HNIG. In this article we discuss the epidemiology of hepatitis A and the methods of prevention and control of the infection. We also appraise the vaccine and consider how it should be used.