Príkazský V, Oleár V, Cernoch A, Safary A, André F E
Institute of Hygiene and Epidemiology, Poprad, Slovakia.
J Med Virol. 1994 Dec;44(4):457-9. doi: 10.1002/jmv.1890440427.
During a large community-wide outbreak of hepatitis A in two adjoining villages in Slovakia with a total of 5,000 inhabitants we administered to schoolchildren the first commercially available vaccine against hepatitis A (HAVRIX, Smith-Kline Beecham Biologicals, Rixensart, Belgium) in an attempt to control the progress of the epidemic. Soon after the start of the vaccination programme, an abrupt decrease in the occurrence of cases in the school was observed. In the village school with 624 schoolchildren, 404 had received a first dose of 360 enzyme-linked immunosorbent assay (ELISA) units (EL.U) and 373 a second dose 1 month later. Subsequent to the start of vaccination there were eight clinical cases of hepatitis A among the 157 children without a history of hepatitis A who remained unvaccinated and only 1 case in the vaccinated school children, giving attack rates of 5.1% and 0.25% in the two groups, respectively. Among the remaining 63 children, one was found seropositive when screened and 62 had a history of hepatitis A at the start of the vaccination programme. These 63 children were not offered vaccine. No cases occurred in that group. During the epidemic, three cases occurred an average of 20 days following its administration among 19 children who received immune globulin (IG). Cases in the whole population of the villages also ceased soon after the vaccination of the children had started. The vaccine was found more effective than postexposure IG in interrupting the epidemic in the whole community.
在斯洛伐克两个相邻村庄爆发的大规模甲型肝炎社区疫情中，两个村庄共有5000名居民，我们给学童接种了第一种上市的甲型肝炎疫苗（HAVRIX，史克必成生物制品公司，比利时里克森萨特），试图控制疫情的发展。疫苗接种计划开始后不久，学校内病例的发生率急剧下降。在有624名学童的乡村学校中，404名儿童接种了第一剂360酶联免疫吸附测定（ELISA）单位（EL.U）的疫苗，1个月后373名儿童接种了第二剂。疫苗接种开始后，在157名无甲型肝炎病史且未接种疫苗的儿童中有8例甲型肝炎临床病例，而接种疫苗的学童中只有1例，两组的发病率分别为5.1%和0.25%。在其余63名儿童中，1名儿童在筛查时血清呈阳性，62名儿童在疫苗接种计划开始时有甲型肝炎病史。这63名儿童未接种疫苗。该组未出现病例。在疫情期间，19名接受免疫球蛋白（IG）的儿童中，平均在接种后20天出现3例病例。儿童开始接种疫苗后不久，村庄全体居民中的病例也停止出现。结果发现，在阻断整个社区的疫情方面，该疫苗比暴露后使用的免疫球蛋白更有效。
