[Current hepatitis B epidemiology in Germany]

Hepatitis B (HB) is the most common occupational hazard for health care workers. On the other hand 90% of the notified HB cases in Germany are observed among the general population (including other high-risk groups like i.v. drug abusers etc.). About 350 million persons all over the world are carriers of the hepatitis B virus (HBV). The availability of effective HB vaccines since 1982 made a control of HB possible. In this communication we report on epidemiological changes due to hepatitis B vaccination in a large university hospital in Germany. Health care workers and non-health care workers occupied at Freiburg university hospital were tested for HBV markers in 1984/85 (n = 4218), 1989/90 (n = 4081) and 1994/95 (n = 4022) during routine occupational health check-ups. Vaccinations were performed using a plasma-derived vaccine (1984/85) or a vaccine obtained by genetic engineering, respectively (1989/90, 1994/95). In 1984/85 prevalence of anti-HBs/HBc in German health care workers (12.4%) was 2.5 times higher than the one in non-health care workers (4.9%), in 1994/95 anti-HBs/HBc prevalence in both groups (4.4 vs. 4.5%) was comparable. On the other hand HBV carriage in persons occupied in professions without blood contact increased from 1984/85 (0.5%) to 1994/95 (1.1%). Therefore, the number of HBV carriers (ca. 1.1 millions) in Germany can be roughly estimated. Our data indicate a high degree of effectiveness of hepatitis B vaccines. Vaccination programme for the general population in accordance with German (STIKO) and WHO recommendations are necessary for the control of HBV infection.