 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Edgar P. Simard, MPH(c), AM Wasley, ScD, Lyn Finelli, DrPH, and Beth Bell, MD, MPH. National Center for Infectious Diseases, Division of Viral Hepatitis, Centers for Disease Control and Prevention, 1600 Clifton Road, MS G-37, Atlanta, GA 30333, 4043715451, eos4@cdc.gov
Background: Hepatitis A (HA) is one of the most frequently reported vaccine-preventable diseases in the United States (U.S.). Vaccination is recommended for persons at increased risk for infection (e.g., travelers, men who have sex with men) and for children in states with consistently elevated HA rates, which are mostly in the west.
Methods: HA cases reported by state health departments were analyzed to assess trends in incidence and demographic and risk factor characteristics following implementation of vaccine recommendations. Rates were calculated using U.S. Census Bureau population estimates.
Results: During 1990-2002, the national HA rate declined 77% (12.6/100,000 to 2.9/100,000). The western region of the country experienced the largest decline of 86% vs. 69.1% elsewhere. HA incidence among persons <20 years old declined 87.9% vs. 67.5% among older ages. Rates declined among all racial/ethnic groups; the largest decline (95.7%) was in American Indians/Alaska Natives. The male/female ratio increased from 1.3-1.7. During 1990-2001, the proportion of case patients <20 years old declined from 41.5%-24.3%, while the proportion who were adults increased from 58.5%-75.7%. Of adults, 25% reported a risk history for which vaccination is indicated.
Conclusion: HA incidence in the U.S. declined to a historic low. The largest declines occurred in geographic areas and age and racial groups with the highest vaccination rates, suggesting that routine childhood vaccination is contributing to reducing HA rates. Continued monitoring is needed to determine if low rates are sustained and attributable to vaccination. However, vaccination efforts for adults need to be strengthened.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.