Vaccination against hepatitis A during outbreaks starting in schools: what can we learn from experiences in central Italy?

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.

Cite this paper

@article{Bonanni2005VaccinationAH, title={Vaccination against hepatitis A during outbreaks starting in schools: what can we learn from experiences in central Italy?}, author={Paolo Bonanni and Anita Franzin and Chiara Staderini and Maria da Luz Pitta and Giorgio Garofalo and Rossella Cecconi and Maria Grazia Santini and Piero Luigi Lai and Barbara Innocenti}, journal={Vaccine}, year={2005}, volume={23 17-18}, pages={2176-80} }