Recognising and responding to outbreaks of hepatitis A associated with child day-care centres.

Abstract

OBJECTIVES:

To assess the appropriateness of a protocol for recognising and responding to outbreaks of hepatitis A in child day-care centres and to determine if measles-mumps-rubella (MMR) vaccine was given too soon following the administration of normal human immunoglobulin (NIGH) to young children to control the outbreaks.

DESIGN:

Prospective surveillance to recognise cases of hepatitis A associated with, and outbreaks of hepatitis A in, day-care centres.

MAIN OUTCOME MEASURES:

The percentage of initial ('sentinel') cases of hepatitis A associated with day-care centres that were subsequently recognised as also being 'index' cases of outbreaks of hepatitis A in the centres, and the number of children 9-13 months of age when given NIGH who were subsequently given MMR less than three months later.

RESULTS:

Only 18 (16%) of the 114 sentinel day-care associated cases of hepatitis A were also index cases of outbreaks of hepatitis A in their respective centres. A total of 105 cases of hepatitis A were associated with the 18 outbreak centres; NIGH was administered to 928 (78%) of the attendee children, and to 105 (82%) of the susceptible staff, at the 18 centres. Three of the five children 9-13 months of age when given NIGH were given MMR less that three months later.

CONCLUSIONS:

Although outbreaks of hepatitis A were common events in day-care centres in north Queensland during the two-year study period, a single case of hepatitis A associated with a centre was a poor predictor of an outbreak within that centre. Precautions must be taken to ensure that live vaccines are not administered to young children too soon after NIGH.

• Authors: J N Hanna, J L Humphreys, S L Hills, A R Richards, D L Brookes
• Journal: Australian and New Zealand journal of public health (Aust N Z J Public Health) Vol. 25 Issue 6 Pg. 525-8 (Dec 2001) ISSN: 1326-0200 [Print] Australia
• PMID: 11824988 (Publication Type: Journal Article)

Chemical References

• Immunoglobulins
• Measles-Mumps-Rubella Vaccine

Topics

• Adult
• Child Day Care Centers
• Child, Preschool
• Disease Outbreaks (prevention & control)
• Family Characteristics
• Hepatitis A (epidemiology, prevention & control)
• Humans
• Immunization Schedule
• Immunoglobulins (administration & dosage)
• Infant
• Measles-Mumps-Rubella Vaccine (administration & dosage)
• Prospective Studies
• Queensland (epidemiology)
• Sentinel Surveillance