Article

The changing epidemiology of hepatitis A in children and the consideration of active immunization in Korea.

Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Medical Journal (impact factor: 1.14). 03/2000; 41(1):34-9. pp.34-9
Source: PubMed

ABSTRACT Currently, Korea is a low endemicity country for HAV, especially in children. However, recent reports of hepatitis A outbreaks show that there has been a shift of disease incidence to adolescents and young adults, with 2 cases of acute liver failure in one reported outbreak. We need to study the immune status for HAV in order to provide information for the establishment of preventive measures and possible consequences of HAV in Korea. A total of 334 infants, children and adolescents less than 20 years of age living in rural areas of Kyonggi Province, Korea were evaluated for anti-HAV immune status in 1996. Five hundred and eighty-four primary school children living in the same area were separately evaluated for the natural seroconversion rate between 1993 and follow-up samples taken in 1996. Anti-HAV IgG antibody was measured by enzyme immunoassay (HAVAB EIA kit, Abbott Laboratories, Chicago, Illinois, USA). In comparison with previous reports of seroprevalence rates, our data confirmed a dramatic drop in seroprevalence rates among children and adolescents under 20 years of age living in rural areas, from over 63.8% two decades ago to 4.6% in 1996. Natural acquisition of HAV antibody in primary school children rarely occurs, registering only 0.5% during three years. Several outbreaks in young adults during 1996-1998 suggested that immunity against HAV in this population is so low that massive outbreaks are unavoidable. Teenagers and young adults, especially soldiers, who are likely to be exposed to contaminated food or water, would also have a greater risk of hepatitis A. Immunizing children with HAV vaccine as a routine schedule should also be considered in Korea in the future, particularly if the disease burden could be estimated and the cost-effectiveness of the vaccine could be proved.

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Keywords

Abbott Laboratories
 
acute liver failure
 
Anti-HAV IgG antibody
 
anti-HAV immune status
 
disease burden
 
disease incidence
 
dramatic drop
 
enzyme immunoassay
 
follow-up samples
 
HAVAB EIA kit
 
hepatitis A. Immunizing children
 
low endemicity country
 
massive outbreaks
 
Natural acquisition
 
natural seroconversion rate
 
outbreaks
 
primary school children
 
reported outbreak
 
routine schedule
 
seroprevalence rates