The investigation of a 'cluster' of hepatitis B in teenagers from an Indigenous community in North Queensland

Background: In early 1999, five teenagers from the same indigenous communit y were notified as having hepatitis B. Hepatitis B vaccine should have been offered to this cohort of teenagers in a 'catch-up' program during the lat e 1980s when they were of preschool age. Objectives: To determine the vaccination status of residents of the communi ty born between 1981 and 1985 (inclusive) and to ascertain the prevalence o f markers of hepatitis B infection and carriage in the incompletely vaccina ted teenagers in this cohort. Methods: Community health records were examined to identify all residents i n the study cohort. Immunisation records were obtained from local hospital records and from a statewide computerised vaccination database. Serological tests for markers of hepatitis B infection and carriage were performed on blood samples from the incompletely vaccinated teenagers. Results: Only 44% of 235 teenagers who had their vaccination status assesse d were fully vaccinated. One hundred and eleven (47%) of the cohort had not received any hepatitis B vaccine. Over 90% of the incompletely vaccinated had been infected with the hepatitis B virus and 26% of these were hepatiti s B carriers. Conclusions: Despite the availability of an effective hepatitis B vaccine a nd the recommendation for a catch-up program, the pre-school aged cohort of children at the community were not effectively targeted for vaccination. H epatitis B remains a consequential infection in Indigenous communities in N orth Queensland. Implications: Initiatives to control hepatitis B need to be enhanced within existing maternal and child health, sexual health, alcohol and drug and ch ronic disease management programs.