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- Title
The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies.
- Authors
Alter, M J; Hadler, S C; Margolis, H S; Alexander, W J; Hu, P Y; Judson, F N; Mares, A; Miller, J K; Moyer, L A
- Abstract
To determine trends in the incidence and epidemiology of acute hepatitis B in the United States we conducted intensive surveillance for viral hepatitis in four sentinel counties from October 1, 1981, to September 30, 1988. The overall incidence of hepatitis B remained relatively constant throughout the study period (average, 13.2 cases per 100,000 population), but disease transmission patterns changed significantly. The proportions of hepatitis B cases accounted for by homosexual activity and health care employment decreased 62% and 75%, respectively; the proportions of cases accounted for by parenteral drug use and heterosexual exposure increased 80% and 38%, respectively. The percentage of patients for whom no risk factor was identified (30% to 40%) did not change over time. These patients tended to belong to minority populations, and their socioeconomic level was low. The decline in the number of hepatitis B cases among homosexual men probably results from the modification of high-risk sexual behavior; the decline among health care workers is due mostly to hepatitis B immunization. The current strategy for prevention of hepatitis B, which targets high-risk groups for immunization, has failed to have a significant impact on the incidence of disease.
- Subjects
UNITED States; HEPATITIS B prevention; HEPATITIS B; IMMUNIZATION; PUBLIC health surveillance; SEX distribution; DISEASE incidence; ACUTE diseases
- Publication
JAMA: Journal of the American Medical Association, 1990, Vol 263, Issue 9, p1218
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.263.9.1218