Jilg W
Institute for Medical Microbiology and Hygiene, University of Regensburg, Germany.
Vaccine. 1993;11 Suppl 1:S6-8. doi: 10.1016/0264-410x(93)90150-v.
In the industrialized countries of Europe, North America and Australia, the incidence and prevalence of hepatitis A decreased significantly during recent decades. In the high-endemicity areas of Africa, Asia and South America, hepatitis A is still transmitted during infancy or early childhood and usually leads to asymptomatic infection or only mild disease. The majority of infections in developed countries, however, now occur in young adults of whom 70-80% develop more severe icteric disease. Main risk groups in the latter regions are travellers to less-developed areas and drug addicts; an occupational risk of hepatitis A virus infection exists for individuals working in paediatric wards, in day-care centres, in medical laboratories/kitchens as well as for sewage workers. These individuals comprise the target group for active hepatitis A vaccination. Consequent use of these vaccines should not only prevent an often severe disease but also save significant costs.
在欧洲、北美和澳大利亚的工业化国家，近几十年来甲型肝炎的发病率和流行率显著下降。在非洲、亚洲和南美洲的高流行地区，甲型肝炎仍在婴儿期或幼儿期传播，通常导致无症状感染或仅引起轻微疾病。然而，发达国家的大多数感染现在发生在年轻人中，其中70-80%会发展为更严重的黄疸型疾病。后一类地区的主要风险群体是前往欠发达地区的旅行者和吸毒者；在儿科病房、日托中心、医学实验室/厨房工作的人员以及污水工人存在感染甲型肝炎病毒的职业风险。这些人构成了甲型肝炎主动免疫接种的目标群体。合理使用这些疫苗不仅可以预防一种往往很严重的疾病，还能节省大量成本。
