The diverse patterns of hepatitis a epidemiology in the United States - Implications for vaccination strategies
The diverse patterns of hepatitis a epidemiology in the United States - Implications for vaccination strategies
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DOI：
10.1086/314518
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发表时间：
1998-12-01
影响因子：
6.4
通讯作者：
Margolis, HS
中科院分区：
文献类型：
--
作者：
Bell, BP;Shapiro, CN;Margolis, HS
甲型肝炎是美国最常见的疫苗可预防疾病。这项研究的哨兵县：科罗拉多州的丹佛县、华盛顿州的皮尔斯县、阿拉巴马州的杰斐逊县和佛罗里达州的皮内拉斯县，研究了1983-1995年期间甲型肝炎的发病率和危险因素。在4897例血清学确诊病例中，611例(13%)住院，9例(0.2%)死亡。平均发病率为14.7/10万(根据县和年份的不同，范围为0.6-100.7/10万)。报告的感染源频率因县而异，但总体上最大的单一群体(52%)没有报告感染源。在丹佛县(1991年至1993年)和皮尔斯县(1987年至)3年的全社区疫情期间，发病率分别增加了4倍和13倍，并且在所有年龄、种族/民族和风险群体中都有所增加。在社区范围的暴发期间，甲型肝炎并不局限于特定的风险群体；全国范围内发病率的持续下降更有可能来自常规的儿童疫苗接种，而不是对高危群体进行有针对性的接种。
Hepatitis A is the most frequently reported vaccine-preventable disease in the United States. Hepatitis A incidence and risk factors during 1983-1995 were examined among cases reported to the study's Sentinel Counties: Denver County, Colorado; Pierce County Washington; Jefferson County, Alabama; and Pinellas County, Florida. Of 4897 serologically confirmed cases, 611 patients (13%) were hospitalized and 9 (0.2%) died. The average incidence was 14.7/100,000 (range, 0.6-100.7/100,000, depending on county and year). The frequency of reported sources of infection varied by county, but the largest single group overall (52%) did not report a source. During 3-year communitywide outbreaks in Denver (1991-1993) and Pierce (1987-1989) Counties, rates increased 4- and 13-fold, respectively, and increased in all age, racial/ethnic, and risk groups. During communitywide outbreaks, hepatitis A is not limited to specific risk groups; sustained nationwide reductions in incidence are more likely to result from routine childhood vaccination than from targeted vaccination of high-risk groups.