[Hepatitis A epidemic in Heerlen in late 1996, importance of immunization in immigrant children]

Description of a local epidemic of hepatitis A in 1996 in Heerlen, the Netherlands.

Descriptive.

Regional Health Service Oostelijk Zuid-Limburg, Heerlen, the Netherlands.

Semistructured questions were asked by telephone of patients, patients' parents, general practitioners, the day-care centre manager and the head of the primary school, to collect information about cases.

In the last four months of 1996, 41 persons (23 children and 18 adolescents and adults) were infected in a city of some 50,000 inhabitants. The primary case was most likely a three-year-old boy from Moroccan parents, who prior to his disease had visited his family in Morocco and although non-immune had not been immunised. From the boy's family the virus spread to a day-care centre and a primary school. In this epidemic patients of 15 different general practitioners were affected. An intervention with hepatitis A immunoglobulin in the day-care centre and primary school and immunoglobulin prophylaxis in affected families was effective in halting the epidemic.

Special attention is needed for immunisation of children of travelling immigrant parents. Immunoglobulin prophylaxis in affected families and notification of cases to the regional health institute by general practitioners may prevent cases. Serological notification by the regional laboratory as well as notification of infectious diseases by day-care centres and schools will add to the regional infection surveillance and control.