8/3/2019 Kids Don't Spread Hep B - Burgess

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'.> ' Ui \i\t\N ' u r j (_/"7 :rtft > . . . .' : ..._. . /' *6 N o v e m b e r . 1 !Kids don't spread hepatitis

N O ev i dence for hor i zonta l t ra ns-mission of hepatitis l i hits beenfoun d in a stud y of nearly 3000Sy dney school chi l dren

The siudy, conducted in 5U schools.counters the notion thai universal vaccination of infants against hepatitis IIcould be a costcffcci ivc publie healthmeasure.

Speaking at the 18th annual posigraduale meeting of The Children'sHospital, Camperdown in Sydney.staff specialist Dr Margaret Uurgcsssaid the study suggested mass uinuunisation of adolescents could havemore impact on the incidence uf hepalitis li because it would he dune at atime when the risk of infection wasgreater.

"To make an informed decisionabout the value of mass vaccination wcneed to know what the risk is ofhorizontal iransmission outside the

HIC attackedfor issuingdata sheetsD I A G NO S T I C r e f e r r a l d a t asheets the I l enl t l i Insura nce C oi nm i ssi on sci l i to a bout 15,IKK) ( Jl ' slast week, have been cr i t i ci sed bythe .

(Jl's should act in patients' hestinterests in deciding about tesis, the said.Il said Australia's medical niolcsiiiiii

home," she said.Led by Dr Burgess, lhe research

team compared lhe prevalence of hepa-titis U in schools where less than 5%of students were from highrisk groups,wil l those where more than 20% ofl l ic chi ldren were from highriskgroups. low risk child was dciincd as

while, and born in Austral ia, NewZea and, northern Europe or the US.

'Highrisk' children were migrants orborn to migrants from areas such asVi cm a m , Tha i l a nd, C a m bodi a orSouth Amer ica where h epatitis 13 isknown (o be highly endemic.

Dr Burgess said more than 20% ofhighrisk children were positive forhepatitis 13 markers, and a th ird ofthese were chronic carriers of the virus.

Markers for hepatitis infectionwer; found in only 0.2% of low riskchi ld re n, irrespective of their associa-tion with highrisk children at school.

This emphasised the imporiancc oftargeting hepatitis ti vaccination lochildren and infanls of highrisk adults,she said.The US, Italy and New Zealand arc

already advocating universal hepatitisU immunisation of infants, eventhough they arc low endemic conntries.Duration

Dr Burgess said the duration of pro-tection provided by the vaccine wasnot known. booster dose for highrisk in-

dividuals was recommended 35 yearsafter vaccination. Therefore, highriskchildren needed lo be boosted prior toschool entry, she said.

"I f wc vaccinate all infants wc willbe vaccinating at a lime when they arcai l i tt le r isk of infection.

"And ill adolescence they will need

a booster dose witch the risk of infec-tion is more real." she said

Dr Buigcss said hepatitis 13 vaccina-tion of adolescents would be moreeffective and was a practical option, asAustralia already had a routine rubel-la immuni sation program for this agegroup.

However, administering a fu ll courseof three shots to teenagers could bed if f icu lt , she said.

Dr Burgess also expressed concernabout reports of rare but seriousadverse reactions associated with l l icrecombinant DNA hepatitis U vaccine,occurring about six weeks aflcrvaccination.

These have included four reput is inAus tral ia to the end uf 1991) une caseof Guil lainUarrc syndrome, iw o casesof optic neuritis and a progressivedci ny cl i ua i i ng condi t i on.

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