A prevalence study of hepatitis A virus infection in a migrant community: Is hepatitis A vaccine indicated?

• Published in: The Journal of pediatrics Vol. 138; no. 5; pp. 705 - 709
• Main Authors: Dentinger, Catherine M., Heinrich, Nancy L., Bell, Beth P., Fox, LeAnne M., Katz, Dolores J., Culver, David H., Shapiro, Craig N.
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2001; Elsevier
• Subjects: Adolescent; Age Factors; Biological and medical sciences; Child; Child, Preschool; Cross-Sectional Studies; Emigration and Immigration; Epidemiology. Vaccinations; Female; General aspects; Hepatitis A - epidemiology; Hepatitis A - prevention & control; Hepatitis A Vaccines - therapeutic use; Humans; Infectious diseases; Logistic Models; Male; Medical sciences; Mexico - ethnology; Multivariate Analysis; Surveys and Questionnaires; Tropical medicine; United States - epidemiology; Central America; Mexico; America; United States; HAV; Human; Seropositivity; Prevalence; Immigrant; Vaccination; Hepatic disease; Epidemiology; Infection; Viral hepatitis A; Birth place; Viral disease; Adolescent; Digestive diseases; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1067/mpd.2001.112652

Background: The Advisory Committee on Immunization Practices recommends routine hepatitis A vaccination of children living in communities with high rates of hepatitis A. Rates among children living in migrant farm worker families are unknown. Methods: Participants recruited from the 1243 migrant children aged 2 to 18 years in Okeechobee County, Florida, were administered a questionnaire. A blood sample was taken for testing for antibodies to hepatitis A virus (anti-HAV), and hepatitis A vaccine was administered. Results: Of 244 (20%) participating children, 125 (51%) were anti-HAV–positive. Seropositivity increased with age from 34% (2- to 5-year-olds) to 81% (≥14-year-olds) (P <.0001). In multivariate analysis, age (odds ratio [OR] = 1.2/year; 95% CI = 1.1 to 1.3), having a Mexican-born father (OR = 12.2; 95% CI = 2.2 to 227.9), and age on moving to the United States (OR = 1.3/year; 95% CI = 1.0 to 1.6) were independently associated with anti-HAV positivity. Among US-born children aged 2 to 5 years who had never left the United States, 33% were anti-HAV–positive. Conclusions: Anti-HAV prevalence among migrant children in Okeechobee County, including the youngest US-born children, is high, indicating ongoing transmission of HAV. Children in this and other US migrant communities may benefit from hepatitis A vaccination. (J Pediatr 2001;138:705-9)