Hanna Jeffrey N, Hills Susan L, Humphreys Jan L
Tropical Public Health Unit Network, Queensland Health, PO Box 1103, Cairns, QLD 4870, Australia.
Med J Aust. 2004 Nov 1;181(9):482-5. doi: 10.5694/j.1326-5377.2004.tb06404.x.
To describe the impact of a hepatitis A vaccination program for Indigenous children in north Queensland.
Enhanced surveillance of all notified cases of hepatitis A in north Queensland from 1996 to 2003.
North Queensland; population, 596 500 people, including about 6900 Indigenous children aged under five years.
Hepatitis A vaccine was provided to Indigenous children in north Queensland from February 1999; two doses were recommended (at 18 months and 2 years of age), as was catch-up vaccination up to the sixth birthday.
In the 4 years 1996-1999, 787 cases of hepatitis A were notified in north Queensland, 237 (30%) of which were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people during this period were 110 and 25 cases per 100 000 persons, respectively. In the first 4 years after introduction of the vaccination program (2000-2003), 66 cases of hepatitis A were notified. Only nine of the 66 (14%) were in Indigenous people. The average annual notification rates in Indigenous and non-Indigenous people in 2000-2003 were 4 and 2.5 cases per 100 000 persons, respectively.
Hepatitis A seems to have been eradicated from Indigenous communities in north Queensland very soon after the vaccination program began. The rapid decline in notifications in non-Indigenous as well as Indigenous people suggests the program quickly interrupted chains of transmission from Indigenous children to the broader community. To our knowledge this is the first evidence that a hepatitis A vaccination program targeting a high-risk population within a community can reduce disease in the broader community. Hepatitis A vaccine should be provided to other high-risk Indigenous children elsewhere in Australia.
描述一项针对昆士兰北部原住民儿童的甲型肝炎疫苗接种计划的影响。
对1996年至2003年昆士兰北部所有报告的甲型肝炎病例进行强化监测。
昆士兰北部；人口596500人，包括约6900名5岁以下的原住民儿童。
1999年2月起向北昆士兰的原住民儿童提供甲型肝炎疫苗；建议接种两剂（18个月和2岁时），并建议在6岁生日前进行补种。
在1996 - 1999年的4年中，昆士兰北部报告了787例甲型肝炎病例，其中237例（30%）为原住民。在此期间，原住民和非原住民的年均报告率分别为每10万人110例和25例。在疫苗接种计划实施后的前4年（2000 - 2003年），报告了66例甲型肝炎病例。66例中只有9例（14%）为原住民。2000 - 2003年原住民和非原住民的年均报告率分别为每10万人4例和2.5例。
在疫苗接种计划开始后不久，昆士兰北部的原住民社区似乎已根除甲型肝炎。非原住民和原住民报告病例数的迅速下降表明该计划迅速中断了从原住民儿童向更广泛社区的传播链。据我们所知，这是第一项表明针对社区内高危人群的甲型肝炎疫苗接种计划可减少更广泛社区疾病的证据。应向澳大利亚其他地区的其他高危原住民儿童提供甲型肝炎疫苗。
