The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

4035.0: Tuesday, November 18, 2003 - 9:45 AM

Abstract #68104

Where justice and jaundice meet: Hepatitis A vaccination in jails as a strategy to reach high-risk adults

Sirenda Vong, MD, MSc1, Anthony Fiore, MD, MPH1, Daniel Haight, MD2, Frances Pinero, RN2, Kathy Boaz, MPH1, Tracy Badsgard, MPH1, Carmela Mancini, MPH3, Nancy Borgsmiller, RN2, Bill Tynan, MD3, Steven Wiersma, MD, MPH3, and Beth Bell, MD, MPH1. (1) Division of Viral Hepatitis, NCID, Centers for Disease Control and Prevention, MS G-37, 1600 Clifton Road, Atlanta, GA 30333, (2) Polk County Health Department, 1290 Golfview Avenue, 4th Floor, Bartow, FL 33830, (3) Bureau of Epidemiology, Florida Department of Health, 4052 Bald Cypress Way, Bin A-12, Tallahassee, FL 32399

Background: Illicit drug use (DU) is an important risk factor for hepatitis A, but implementing vaccination programs among drug users is difficult. During January 2001-August 2002, 403 hepatitis A cases were reported in Polk County, Florida. Most case-patients reported DU or an arrest history. Methods: To assess the county jail as a potential vaccination venue and determine the prevalence of and risk factors for hepatitis A virus (HAV) infection, we conducted a serologic survey among a sample of inmates. The jail admits approximately 80 inmates/day and has an average daily census of 1,500. Results: We interviewed and tested 275 inmates. The median age was 31 years (range: 18-58), 70% were male, 64% white, and 11% Hispanic. A history of past DU was reported by 81%; 41% used methamphetamine. Previous HAV infection was found in 94 (34%). HAV-infected inmates were more likely to be methamphetamine users (47% vs. 27%, adjusted OR [aOR]: 2.26, 95% confidence interval [CI]: 1.14 4.54), females (45% vs. 29%, aOR: 2.36, 95% CI: 1.29 4.38), Hispanics (61% vs. 30%, aOR: 7.10, 95% CI: 2.58 19.61), and aged > 35 years (44% vs. 25%, aOR: 2.63, 95% CI: 1.33 5.56). Among inmates who reported DU, 53% were susceptible to HAV. Conclusion: The high proportion of illicit drug users and those susceptible to HAV infection among jail inmates indicates that implementing vaccination programs in jails could be an important component of a community-based strategy to control hepatitis A outbreaks among illicit drug users.

Learning Objectives:

Keywords: Hepatitis A, Drug Use

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.

Results From Outbreak Investigations: Implications for Public Health Practice

The 131st Annual Meeting (November 15-19, 2003) of APHA