Hepatitis A and B in children and adolescents - what can we learn from Puglia (Italy) and Catalonia (Spain)?

Viral hepatitis remains a major contributor to the global disease burden. M ass immunisation strategies against hepatitis B have been adopted by more t han 90 developing and industrialised countries. Countries with low hepatiti s A endemicity are experiencing cyclical outbreaks and an epidemiological s hift, with larger numbers of individuals at risk of infection at an older a ge, resulting in increased morbidity. The high cost of outbreaks in these c ountries has made immunisation strategies cost-effective. The development o f a vaccine against hepatitis A and a combined vaccine against hepatitis A and hepatitis B offers potentially exciting opportunities for a preventativ e approach in areas of both low and high endemicity. Existing mass immunisa tion programmes against hepatitis B will facilitate the adoption of joint s trategies illustrated by the examples of Puglia (Italy) and Catalonia (Spai n). (C) 2000 Elsevier Science Ltd. ALI rights reserved.