SUBSTANTIAL DECLINE OF NOTIFIED HEPATITIS-B IN MAJOR PARTS OF EUROPE AFTER 1985

A decline in the incidence of notified hepatitis B cases has been obse rved in major parts of Europe since the mid-1980s. Sweden may be taken as an example of a low prevalence area in the north where notificatio ns of acute hepatitis B declined from 6 cases/100,000 inhabitants in 1 985 to only 3/100,000 annually in 1988-91. Choosing W. Germany as an e xample from central Europe, the notification rate of acute hepatitis B declined from 11 cases/100,000 inhabitants in 1984 to 6-8/100,000 in 1988-91. In Italy, a dramatic decline in hepatitis B infections has oc curred since 1985, according to the national hepatitis surveillance sy stem (SEIEVA), from 12 cases/100,000 inhabitants in 1985 to 5/100,000 in 1988-91. A similar trend has also been observed in the USA which se ems to be unrelated to vaccination, since only limited vaccination pro grams have been initiated in high-risk groups. Also in Europe, changed sexual and needle-usage practices in risk groups such as drug addicts and male homosexuals have probably contributed to the observed declin e. In southern Europe, rapidly improving socio-economic conditions and improved medical precautions against hepatitis B have probably also b een important factors.