Vaccination policy against hepatitis A in Italy

In Italy, improved sanitation and living conditions have led to a decline i n the rate of hepatitis A infection among children generating an increasing proportion of adults susceptible to this virus. Shellfish consumption is a major source of infection while person to person transmission is important in the spread of infection and in the maintenance of outbreaks. Thus preve ntion of secondary HAV infection is a crucial point. A randomised controlle d trial of hepatitis A vaccine in household contacts of people with sporadi c HAV infection in Italy has shown a protective efficacy of 82% (CI 20-96%) . The two secondary infections in the vaccine group were symptomless. sugge sting that the disease expression may be weaker in vaccinated subjects. (C) 2001 Elsevier Science Ltd. All rights reserved.