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Factors associated to duration of hepatitis A outbreaks: implications for control
Torner Gràcia, Núria; Broner, Sonia; Martinez, Ana; Tortajada, Cecilia; Garcia de Olalla, Patricia; Barrabeig i Fabregat, Irene; Sala, Maria Rosa; Camps, Neus; Minguell, Sofia; Álvarez, Josep; Ferrús, Gloria; Torra, Roser; Godoy i García, Pere; Domínguez García, Àngela
Even though hepatitis A mass vaccination effectiveness is high, outbreaks continue to occur. The aim of this study was to investigate the association between duration and characteristics of hepatitis A outbreaks. Hepatitis A (HA) outbreaks reported between 1991 and 2007 were studied. An outbreak was defined as $2 epidemiologically-linked cases with $1 case laboratory-confirmed by detection of HA immunoglobulin M (IgM) antibodies. Relationships between explanatory variables and outbreak duration were assessed by logistic regression. During the study period, 268 outbreaks (rate 2.45 per million persons-year) and 1396 cases (rate 1.28 per 105 persons-year) were reported. Factors associated with shorter duration were time to intervention (OR = 0.96; 95% CI: 0.94–0.98) and school setting (OR = 0.39; 95% CI: 0.16–0.92). In person-to-person transmission outbreaks only time to intervention was associated with shorter outbreak duration (OR = 0.96; 95% CI: 0.95–0.98). The only variables associated with shorter outbreak duration were early administration of IG or vaccine and a school setting. Timely reporting HA outbreaks was associated with outbreak duration. Making confirmed HA infections statutory reportable for clinical laboratories could diminish outbreak duration.
cc-by, (c) Torner et al., 2012
Public Library of Science

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