Hepatitis A among health workers in Paris hospitals

To design a vaccination strategy against hepatitis A among hospital employe es, we carried out a serological survey of hepatitis A virus (HAV) infectio n in 10 university hospitals in the Paris area. Subjects under 60 years of age were consecutively enrolled by occupational health services and tested for IgG to HAV by ELISA. Of the 1,516 subjects recruited, 926 were health w orkers (HW), 322 clerks, and 268 cooks or kitchen employees. Among HW and c lerks the HAV seroprevalence was 53.8% (95% CI: 44.0-65.6), increasing with age and being higher among employees of African or Caribbean origin than t hose from Europe (83.6% vs 45.6%, P < .001). Age correlated closely with th e duration of hospital work, so only age was taken into account for further analysis. The HAV seroprevalences among HW and clerks originating from Eur ope were close (46.8% vs 42.6%) and remained so after adjustment for age. H AV seroprevalences in HW caring for adults and those caring for children we re also similar (45.2% vs 40.1%). Seroprevalence was higher in assistant nu rses than in nurses (51.3% vs. 39.8%, P < .02). Among cooks and kitchen emp loyees, 53.4% were HAV-seropositive. This study shows that hospital employe es need not routinely be vaccinated against HAV; the decision should be tak en by the occupational physician according to the type of work, but should be routine for cooks and kitchen employees. The need for prevaccinal screen ing for anti-HAV should be assessed in the light of employees' geographical origin and age. J. Med. Virol. 58:321-324, 1999. (C) 1999 Wiley-Liss, Inc.