Active immunisation during an outbreak of hepatitis A in a German day-care centre

• Published in: Vaccine Vol. 24; no. 29; pp. 5684 - 5689
• Main Authors: Hauri, A.M., Fischer, E., Fitzenberger, J., Uphoff, H., Koenig, C.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 17-07-2006; Elsevier; Elsevier Limited
• Subjects: Applied microbiology; Biological and medical sciences; Child; Child Day Care Centers - statistics & numerical data; Child, Preschool; Children & youth; Cohort Studies; Day-care centre; Disease Outbreaks; Employees; Families & family life; Family Characteristics; Fundamental and applied biological sciences. Psychology; Hepatitis; Hepatitis A; Hepatitis A - epidemiology; Hepatitis A - prevention & control; Hepatitis A Antibodies - blood; Hepatitis A Vaccines - administration & dosage; Hepatitis A Vaccines - immunology; Hepatitis A virus; Hepatitis A Virus, Human - immunology; Holidays & special occasions; Households; Human viral diseases; Humans; Immunisation; Immunization; Infections; Infectious diseases; Laboratories; Medical sciences; Microbiology; Outbreak; Outbreaks; Postexposure prophylaxis; Public health; Questionnaires; Retrospective Studies; Risk factors; Urine; Vaccination - methods; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Viral diseases; Viral hepatitis; Germany; Day-care centre; Outbreak; Hepatitis A; Postexposure prophylaxis; Immunisation; Chemoprophylaxis; Immunization; Hepatic disease; Vaccine; Infection; Viral hepatitis A; Viral disease; Digestive diseases
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2006.04.053

During an outbreak in a German day-care centre (DCC) caring for 100 children HAV vaccination was recommended for children, employees and household members of cases. A retrospective cohort study was done to evaluate vaccine uptake and identify possible risk factors for disease. Between 19 December 2004 and 30 January 2005 eight DCC children and seven household members fulfilled the case definition, i.e. had clinical hepatitis (14) or were diagnosed with asymptomatic HAV infection (1). Following the recommendation to vaccinate, given on 23 December 2004, 66.7% (46/69) of DCC children, 15.8% (29/184) of household members and 5/5 of employees were vaccinated, and three vaccinated children and two not vaccinated children fell ill. One of 11 children who received human normal immunoglobulin (HNIG) and four of 58 children who did not receive HNIG fell ill. In households in which the DCC child received HAV vaccine and/or HNIG, seven (5.6%) of 125 household members fulfilled the case definition. In households of non-immunised children none of the 59 household members fell ill. We conclude that, although most vaccinations were administered promptly, they may not have been timely enough to impact the course of the outbreak.