EXPERIENCE OF HEPATITIS-A VACCINATION DURING AN OUTBREAK IN A NURSERY-SCHOOL OF TUSCANY, ITALY

An outbreak of hepatitis A started in late October 1996 in a nursery s chool in Tuscany, Italy. A programme of hepatitis A vaccination withou t the use of immunoglobulin started at the beginning of December 1996 and included 33 children, 21 household contacts and 6 adults working i n the school. Overall, II cases occurred in children attending the sch ool (attack rate 27 %) and 10 among their household contacts (attack r ate 9 %). The latter also included parents, and, in two cases, grandmo thers. The data indicate that susceptibility to HAV has increased over recent decades in central Italy. Past and recent experience shows tha t the usual duration of hepatitis A epidemics in the absence of immune prophylaxis is longer than that described here. The use of hepatitis A vaccine probably contributed to the early extinction of the outbreak , because no further cases were notified in the area after 7 February 1997.