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Aim To investigate the status of hepatitis A vaccination, knowledge, and health beliefs among university students in Korea and identify factors influencing their hepatitis A vaccination rate. Methods A self-reporting survey was conducted with 367 university students in Korea via descriptive survey. Data were collected on demographics, status of hepatitis A vaccination, knowledge, and health beliefs. Results The hepatitis A vaccination rate was 23.4%. The hepatitis A vaccination rate was significantly higher in those who had a general awareness about the hepatitis A (odds ratio [OR] = 3.56, P = 0.003), those with some overseas travel experience (OR = 2.64, P = 0.025), those perceiving the benefits of hepatitis A vaccination (OR = 1.66, P = 0.023), and those perceiving barriers (inversed) to hepatitis A vaccination (OR = 1.95, P = 0.011). Conclusion To promote hepatitis A vaccination among university students, information and education should be provided to improve their health beliefs. In addition, this demographic should be a major target population for hepatitis A vaccination. This study's results suggest that the development of national promotional campaigns and hepatitis A vaccination programs based on predictors of the vaccination rate are needed.

Aim: The number of hepatitis A cases in Japan as well as in other developed countries has been progressively decreasing during the last several years. There is no universal hepatitis A vaccination program in Japan, and a hepatitis A virus (HAV) epidemic in Japan is not unlikely. In 2011, a hepatitis A outbreak associated with a revolving sushi bar occurred in Chiba, Japan. We aimed to analyze this outbreak. Methods: Twenty-seven patients associated with this outbreak were admitted to the National Hospital Organization Chiba Medical Center. Molecular epidemiologic investigations were conducted. Results: Twenty-six of the 27 patients had gone to the same revolving sushi bar, and then clinical symptoms appeared. HAV RNA was detected by reverse transcription polymerase chain reaction in 23 of the 27 (85.1%) patients whose sera had tested positive for anti-HAV immunoglobulin M. All isolates from this outbreak were clustered within subgenotype IA, displaying 100% sequence homology with each other in 232 bp from all 23 patients. All isolates belong to the IA-1 sublineage, which is endemic to Japan. Conclusion: A revolving sushi bar was associated with a hepatitis A outbreak, and molecular epidemiological investigations proved useful.

Summary. Hepatitis A is a reportable disease in Belarus. Universal hepatitis A vaccination of children aged 6 years in Minsk City began in 2003. This analysis was conducted to evaluate the short-term impact of the program. Hepatitis A incidence data from 1954 to 2006 was compiled. Vaccination effectiveness was estimated by comparing the incidence of reported hepatitis A cases after 4 years of immunization (2006) with the incidence when the vaccination program started (2003). The vaccines used were Avaxim 160™or Avaxim 80™ (95%) and Havrix 720™ (5%). From 2003 through 2006, hepatitis A incidence in vaccinated children under 14 years was 20-fold lower than the incidence in unvaccinated children (0.3 cases/10000 vs 5.98/10000; odds ratio = 0.05, 95% CI: 0.012–0.202), for a vaccination effectiveness of 95%. The decreased incidence of hepatitis A in all age groups in 2006 (by 12 times in preschool children aged 1–5 years, 13 times in children aged 10–14 years and 4–6 times among adults), including those without high coverage by vaccination, suggest a herd effect. Routine vaccination also resulted in a shift of the age pattern of hepatitis A morbidity. The proportion of cases in children under 14 years decreased from 33% to 41% in 2000–2002 to 7% in 2005–2006. We conclude that introduction of universal hepatitis A vaccination in Minsk resulted in sharply reduced incidence in both vaccinated and unvaccinated children. Hepatitis A virus circulation might decrease further by beginning vaccination at a younger age.

Our laboratory demonstrated that seropositivity to hepatitis A virus (HAV) independently predicts risk for coronary artery disease (CAD). As these findings are based only on the presence of HAV-specific antibodies, and not infectious virus, this prompted questions regarding possible effects of HAV vaccines on CAD development. If seropositivity to HAV alone, resulting from HAV vaccination, leads to increased atherogenesis, this raises important issues regarding the benefit of protection against HAV infection vs the risk of developing CAD. This study examines the effect of HAV vaccination on atherosclerosis development in a cholesterol-fed mouse model. Animals either received HAV vaccine, adjuvant, or saline. After 15 weeks, no significant differences were found in lesion area between the groups: HAV vaccine, 13,470 microm2; adjuvant, 16,332 microm2 and saline, 14,356 microm2. Only animals receiving HAV vaccination developed HAV-specific IgG. Thus, in this mouse model, vaccination against HAV does not contribute to the development of atherosclerosis.

Summary. We retrospectively analysed 33 children and adolescents who had been hospitalized in a liver transplant unit within the previous 10 years for acute liver failure (ALF). The patients’ age varied between 2 months and 15 years of age (median 6.2 ± 5.3), and 21 (63%) were male. Thirteen patients (39%) were immunoglobulin-M anti-hepatitis A virus (HAV) sero-positive. Eleven cases (33%) had an undetermined aetiology. The 13 children with HAV ALF were between 17 months and 15.6 years of age (median 5.8 ± 4.6) and eight were male (61.5%). All were on a list for urgent liver transplant. Of these, five (38%) died while waiting for a liver. Only one patient recovered spontaneously. Seven patients received a liver transplant; three died in the immediate postoperative period and one died 45 days after transplant. Three children are alive 1, 2 and 5 years after transplant. We conclude that HAV was the most frequent cause of ALF, which had high mortality even when a liver transplant was possible. The results support universal HAV vaccination in this area.

We report a case of Gianotti-Crosti syndrome in a child following hepatitis A vaccination in order to insist that currently available hepatitis A vaccines are highly immunogenic and that Gianotti-Crosti syndrome is a possible minor adverse reaction.