Six years of sentinel surveillance of hepatitis B in general practice in France
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Despite the availability of a safe and efficacious vaccine, new cases of infection by hepatitis B virus (HBV) still occur at a substantial rate. This increases the current prevalence of chronic HBV carriers (10% of newly infected subjects) and in the long run, will raise the incidence of chronic liver disease. The surveillance of viral hepatitis commenced in December 1990 by the French sentinel network for electronic surveillance of communicable diseases. Between 1991 and 1996, a decrease in the annual incidence was observed although it was not significant (p=0.06). The mean number of cases for this period was 12 per 100,000 inhabitants. The sex ratio (M/F) was 1.6 (p<0.01) and the median age, 32 years. Heterosexual transmission was suspected in 25% of cases, homo- bisexual transmission in 10%, use of injected drugs in 19%, percutaneous exposure in 9%, and blood transfusion or hemodialysis in 6%. Although the incidence of HBV infection is decreasing, the prevalence of chronic infection will continue to rise. However, the universal hepatitis B immunisation strategy proposed by WHO will dramatically limit the expansion of the population of chronically infected subjects if high coverage is achieved rapidly.
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- 1.Van Damme P, Kane M, Meheus A. Integration of hepatitis B vaccination into national immunization programmes. Br Med J 1997; 314: 1033-1036.Google Scholar
- 2.Fourquet F, Drucker J. Communicable disease surveillance: The sentinel network. Lancet 1997; 349: 794-795.Google Scholar
- 3.Chauvin P. Constitution and monitoring of an epidemiological surveillance network with sentinel general practitioners. Eur J Epidemiol 1994; 10: 477-479.Google Scholar
- 4.Iwarson S, Jilg W, Stroffolini T. Substantial decline of notified hepatitis B in major parts of Europe after 1985. Scand J Infect Dis 1994; 26: 19-22.Google Scholar
- 5.Alter M, Hadler S, Margolis H, et al. The changing epidemiology of hepatitis B in the United States. JAMA 1990; 263: 1218-1222.Google Scholar
- 6.Centers for Disease Control and Prevention. Protection against viral hepatitis: Recommendations of immunization practices advisory committee (ACIP). MMWR 1990; 39.RR2: 1-26.Google Scholar
- 7.Centers for Disease Control and Prevention. Summary of notifiable diseases, United States, 1994. MMWR 1994; 43: 1-80.Google Scholar
- 8.Devroey D, Van Casteren V, Vranckx R. Clinical acute viral hepatitis encountered by Belgian general practitioners. Int J Infect Dis 1997; 2: 105-109.Google Scholar
- 9.Expertise collective INSERM. Hé patites virales: Dé pi-stage, pré vention, traitement. Editions INSERM, juillet 1997, Paris.Google Scholar
- 10.Benenson A. Control of communicable diseases in man. Washington: American Public Health Association, 1995.Google Scholar
- 11.Direction Gé né rale de la Santé. La politique de vaccination contre l'hé patite B en France. BEH 1997; 51: 227.Google Scholar