EPIDEMIOLOGY OF HEPATITIS-A IN VALENCIA, SPAIN - PUBLIC-HEALTH IMPLICATIONS

Between July 1988 and July 1989, sera from 1223 persons resident in th e Valencia area of Spain were tested for antibodies against the hepati tis A virus, Sixty-five per cent of serum samples were positive for an ti-HAV (95% confidence interval = 62.4-67.6), The prevalence of anti-H AV increased significantly with age (odds ratio > 50 years = 69.8; 95% confidence interval = 26.5-183.4) and previous history of hepatitis A (odds ratio = 2.1; 95% confidence interval = 1.4-3.2), Prevalence dec reased with higher educational level (odds ratio, university studies = 0.2; 95% confidence interval = 0.1-0.5), Overall, there has been a re duction of anti-HAV prevalence reflecting the decreasing exposure of t he Spanish population to hepatitis A virus in recent years, particular ly in the younger generations. The age of infection has increased, inc reasing the probability of future epidemics in groups previously prote cted by immunity acquired in early childhood, This new epidemiological pattern has strong public health implications, and universal childhoo d vaccination together with measures directed to improve sanitation ma y be the best public health strategy to protect the population.