James Thea L, Aschkenasy Miriam, Eliseo Laura J, Olshaker Jonathan, Mehta Supriya D
Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
J Emerg Med. 2009 May;36(4):412-6. doi: 10.1016/j.jemermed.2007.10.001. Epub 2008 Mar 24.
In 2004, a hepatitis A outbreak occurred in Boston, Massachusetts with an incident rate of 14.8 per 100,000, compared to 4.2 in 2003. The majority of cases had risk factors of homelessness, injection drug use, or incarceration. In September 2004, the Boston Public Health Commission began an immunization campaign partnering with health centers, detoxification centers, homeless shelters, and our Emergency Department (ED) to increase the number of hepatitis A vaccinations and stem the epidemic. The ED rapidly developed (within days) a vaccination protocol. Hepatitis A vaccinations were offered to patients over age 21 years who were homeless, substance users, or incarcerated. From October 2004 through January 2005, the ED vaccinated 122 patients notable for 64% male, 61% homeless, 28% substance users, and 11% incarcerated. No reported vaccination reactions occurred. There was a 51% decrease in the number of cases of Hepatitis A in Boston in the first 4 months of 2005. As a partner, the ED helped stem the epidemic by rapidly providing vaccinations to those most vulnerable. This project provides a model for future collaborations between EDs and local, state, and federal organizations to address epidemics.
2004年，马萨诸塞州波士顿市发生甲型肝炎疫情，发病率为每10万人中有14.8例，而2003年为4.2例。大多数病例有无家可归、注射吸毒或监禁等风险因素。2004年9月，波士顿公共卫生委员会发起了一项免疫运动，与健康中心、戒毒中心、无家可归者收容所和我们的急诊科合作，以增加甲型肝炎疫苗接种数量并遏制疫情。急诊科迅速（在数天内）制定了疫苗接种方案。为年龄在21岁以上、无家可归、吸毒或被监禁的患者提供甲型肝炎疫苗接种。从2004年10月到2005年1月，急诊科为122名患者接种了疫苗，这些患者的特点是64%为男性，61%无家可归，28%吸毒，11%被监禁。未报告有疫苗接种反应。2005年的前4个月，波士顿甲型肝炎病例数减少了51%。作为合作伙伴，急诊科通过迅速为最脆弱人群提供疫苗接种，帮助遏制了疫情。该项目为急诊科与地方、州和联邦组织未来合作应对疫情提供了一个模式。
