Open AccessRecognising and responding to outbreaks of hepatitis A associated with child day‐care centres
Author(s) -
Hanna Jeffrey N.,
Humphreys Jan L.,
Hills Susan L.,
Richards Ann R.,
Brookes Dianne L.
Publication year - 2001
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/j.1467-842x.2001.tb00317.x
Subject(s) - outbreak , medicine , hepatitis a , pediatrics , measles , rubella , hepatitis , measles mumps rubella vaccine , index case , hepatitis a vaccine , demography , virology , vaccination , sociology
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.