Hepatitis A surveillance and vaccine use in China from 1990 through 2007.

Abstract

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.

• Authors: Fuqiang Cui, Stephen C Hadler, Hui Zheng, Fuzhen Wang, Wu Zhenhua, Hu Yuansheng, Xiaohong Gong, Yuansheng Chen, Xiaofeng Liang
• Journal: Journal of epidemiology (J Epidemiol) Vol. 19 Issue 4 Pg. 189-95 ( 2009) ISSN: 1349-9092 [Electronic] Japan
• PMID: 19561383 (Publication Type: Journal Article)

Chemical References

• Hepatitis A Vaccines

Topics

• Adolescent
• Adult
• Age Distribution
• Child
• Child, Preschool
• China (epidemiology)
• Disease Outbreaks (statistics & numerical data)
• Drug Utilization (statistics & numerical data)
• Geography
• Health Transition
• Hepatitis A (diagnosis, epidemiology, prevention & control)
• Hepatitis A Vaccines
• Humans
• Incidence
• Infant
• Infant, Newborn
• Occupations
• Population Surveillance
• Sex Factors