1. Vaccination against hepatitis A during outbreaks starting in schools: what can we learn from experiences in central Italy?
- Author
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Maria Pitta, Maria Grazia Santini, Anita Franzin, Chiara Staderini, Rossella Cecconi, Paolo Bonanni, Barbara Innocenti, Piero Luigi Lai, and Giorgio Garofalo
- Subjects
Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Adolescent ,Asymptomatic ,Disease Outbreaks ,Medicine ,Humans ,Child ,Hepatitis A Vaccines ,Schools ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Public Health, Environmental and Occupational Health ,Outbreak ,Hepatitis A ,Infant ,Day care centre ,medicine.disease ,Vaccination ,Infectious Diseases ,Italy ,Child, Preschool ,Immunology ,Molecular Medicine ,Female ,Viral disease ,medicine.symptom ,business - Abstract
Two outbreaks of hepatitis A started almost simultaneously in a maternal school and in a day care centre located at opposite sides of Florence, Italy, at the end of 2002. Both of them originated from immigrant children, and in both cases, hepatitis A was initially not recognised due to aspecific symptoms. While vaccination of contacts started with delay in the first outbreak, the same intervention was organised and performed in 3 days in the other. The outbreak starting in the maternal school caused 30 notified cases, plus 7 cases diagnosed retrospectively. Nine of them were in a secondary school, where vaccination (in accordance with the Italian national guidelines on hepatitis A (HA) vaccination) had been started only after a secondary case occurred. Only three cases occurred overall in the other outbreak starting in the day care centre, where >80% of infants, children and personnel were immunised. Although few asymptomatic infections probably occurred, no source of contagion existed any longer 2 months after immunisation. A rapid vaccination of school and family contacts of hepatitis A cases after the first case (irrespective of school grade) seems to play an important role to shorten outbreak duration.
- Published
- 2005