Anglia Health Protection Team; Public Health England; Norfolk, UK.
Hum Vaccin Immunother. 2013 Nov;9(11):2480-2. doi: 10.4161/hv.25719. Epub 2013 Jul 23.
Hepatitis A virus (HAV) is considered one of the most important vaccine-preventable diseases in travelers. HAV spreads from person to person via the fecal-oral route and gives rise to an estimated 1.4 million cases worldwide each year. In developing countries with poor sanitary conditions people tend to be infected during childhood and have few symptoms, whereas in developed countries with good sanitary conditions fewer people develop immunity during childhood. This leads to susceptible populations of adults, who are also more prone to severe complications. Here we describe two confirmed cases of hepatitis A associated with a nursing home. The index case was a care worker who had recently traveled to a high-endemicity country, and the second case was a resident at the nursing home where the index case worked. Both cases had an identical genotype IIIA strain, consistent with a transmission event. Current policy does not include a requirement for hepatitis A vaccine in care workers who travel to high endemicity countries despite the fact that infected care workers can potentially spread the disease to elderly patients and other groups at risk of severe complications from HAV infection. We suggest that employers should consider hepatitis A vaccine upon employment; particularly in care workers who plan to visit areas where HAV is known to be endemic.
甲型肝炎病毒（HAV）被认为是旅行者中最重要的可通过疫苗预防的疾病之一。HAV 通过粪-口途径在人与人之间传播，每年在全球估计有 140 万人感染。在卫生条件差的发展中国家，人们往往在儿童时期感染，症状较少，而在卫生条件较好的发达国家，儿童时期获得免疫力的人较少。这导致了成年人易受感染，而且更容易出现严重的并发症。在这里，我们描述了两例与养老院有关的甲型肝炎确诊病例。首例病例是一名最近前往高流行地区的护理人员，第二例病例是该护理人员工作的养老院的居民。两例病例的基因型均为 IIIA 型，与传播事件一致。尽管感染的护理人员有可能将疾病传播给老年患者和其他易患甲型肝炎感染严重并发症的人群，但现行政策并未要求前往高流行地区的护理人员接种甲型肝炎疫苗。我们建议雇主在雇用护理人员时应考虑接种甲型肝炎疫苗；特别是对于计划前往已知存在甲型肝炎流行地区的护理人员。
