Age-specific Incidence of Hepatitis A 1983-93 0 g-l4years 5 们2鸟y 25-39 years 0 +4y years 19831984198519861987198819891990199119921993 Source: CDC, National Notifiable Diseases Surveillance System
Age-specific Incidence of Hepatitis A 1983-93 Source: CDC, National Notifiable Diseases Surveillance System Year Reported Cases (per 100,000) 19831984198519861987198819891990199119921993 0 5 1 0 1 5 2 0 2 5 5-14 years 15-24 years 25-39 years 0-4 years 40+ years
Global Patterns of Hepatitis a virus Transmission Disease Peak Age Endemicity Rate of Infection Transmission Patterns High Early Person to person; High childhood outbreaks uncommon Moderate High ate Person to person childhood/ food and waterborne young adults outbreaks Low Low Young adults Person to person food and waterborne outbreaks Very low Very low Adults Travelers; outbreaks uncommon
Endemicity Disease Rate Peak Age of Infection Transmission Patterns High Low to High Early childhood Person to person; outbreaks uncommon Moderate High Late childhood/ young adults Person to person; food and waterborne outbreaks Low Low Young adults Person to person; food and waterborne outbreaks Very low Very low Adults Travelers; outbreaks uncommon Global Patterns of Hepatitis A Virus Transmission
诊断( Laboratory Diagnosis a Acute infection is diagnosed by the detection of HAV-Igm in serum by eia a Past Infection i.e. immunity is determined by the detection of hav-Igg by ela
诊断（Laboratory Diagnosis） ◼ Acute infection is diagnosed by the detection of HAV-IgM in serum by EIA. ◼ Past Infection i.e. immunity is determined by the detection of HAV-IgG by EIA
治原则 加强食品卫生管理,水源保护。但HAV感染 以隐性感染和无黄疸型病毒例占多数,故 对传染源较难控制 ■我国已批准将减毒疫苗株H株和L1株投放 市场试用 ■应急预防可用丙种球蛋白 ■基因工程疫苗也正在研究之中
防治原则 ◼ 加强食品卫生管理，水源保护。但HAV感染 以隐性感染和无黄疸型病毒例占多数，故 对传染源较难控制 ◼ 我国已批准将减毒疫苗株H2株和L1株投放 市场试用 ◼ 应急预防可用丙种球蛋白 ◼ 基因工程疫苗也正在研究之中
Hepatitis A Vaccination Strategies Epidemiologic considerations Many cases occur in community-wide outbreaks no risk factor identified for most cases highest attack rates in 5-14 year olds children serve as reservoir of infection Persons at increased risk of infection travelers homosexual men injecting drug users
◼ Many cases occur in community-wide outbreaks ◼ no risk factor identified for most cases ◼ highest attack rates in 5-14 year olds ◼ children serve as reservoir of infection ◼ Persons at increased risk of infection ◼ travelers ◼ homosexual men ◼ injecting drug users Hepatitis A Vaccination Strategies Epidemiologic Considerations