Hepatitis A Surveillance and Vaccine Use in China From 1990 Through 2007

被引:49
作者
Cui, Fuqiang [1 ]
Hadler, Stephen C. [2 ]
Zheng, Hui [1 ]
Wang, Fuzhen [1 ]
Wu Zhenhua [1 ]
Hu Yuansheng [1 ]
Gong, Xiaohong [1 ]
Chen, Yuansheng [1 ]
Liang, Xiaofeng [1 ]
机构
[1] Chinese Ctr Dis Control & Prevent, Beijing 100050, Peoples R China
[2] WHO Representat Off China, Beijing, Peoples R China
关键词
hepatitis A; epidemiology; surveillance; vaccine; IMMUNOGENICITY; IMMUNIZATION; H2-STRAIN; EFFICACY; OUTBREAK; CHILDREN; PROGRAM; SAFETY; ISRAEL; WATER;
D O I
10.2188/jea.JE20080087
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Hepatitis A vaccines have been highly effective in preventing hepatitis A. To investigate the epidemiology of hepatitis A in China after hepatitis A vaccine became available, we reviewed reported cases of hepatitis A and the use of hepatitis A vaccine in China during the period from 1990 through 2007. Methods: Data from the National Notifiable Disease Reporting System from 1990 to 2007 and the Emergency Events Reporting System from 2004 to 2007 were reviewed and epidemiologic characteristics analyzed. Hepatitis A vaccine distribution between 1992 and 2007 was also reviewed. Results: The incidence of hepatitis A has declined by 90% since 1990, from 56 to 5.9 per 10(5)/year. Declines in age-specific incidence were seen in all age groups, most dramatically among children younger than 10 years. Disease incidence still varies Substantially: poorer western provinces have had the highest incidences since 2000. In high-incidence provinces, children younger than 10 years continue to have a high disease incidence. Only 50% of cases were laboratory-confirmed, and only 3% occurred in reported local outbreaks. Over 156 million doses of hepatitis A vaccine have been distributed since 1992, and use has continued to increase since 2003. Conclusions: Incidence of hepatitis A has decreased in all age groups, likely due to changing socioeconomic conditions and increasing hepatitis A vaccine use. Nevertheless, western populations remain at high risk, with transmission predominantly occurring among children. The epidemiology of hepatitis A transmission is not well understood. Improved Surveillance with better laboratory confirmation is needed to monitor the impact of universal hepatitis A vaccination of young children; this strategy began to be implemented in 2008.
引用
收藏
页码:189 / 195
页数:7
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