Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009;19(4):189-95.
doi: 10.2188/jea.je20080087. Epub 2009 Jun 27.

Hepatitis A surveillance and vaccine use in China from 1990 through 2007

Fuqiang Cui  1 , Stephen C Hadler, Hui Zheng, Fuzhen Wang, Wu Zhenhua, Hu Yuansheng, Xiaohong Gong, Yuansheng Chen, Xiaofeng Liang
Affiliations

Hepatitis A surveillance and vaccine use in China from 1990 through 2007

Fuqiang Cui et al. J Epidemiol. 2009.

Abstract

Background: Hepatitis A vaccines have been highly effective in preventing hepatitis A. To investigate the epidemiology of hepatitis A in China after hepatitis A vaccine became available, we reviewed reported cases of hepatitis A and the use of hepatitis A vaccine in China during the period from 1990 through 2007.

Methods: Data from the National Notifiable Disease Reporting System from 1990 to 2007 and the Emergency Events Reporting System from 2004 to 2007 were reviewed and epidemiologic characteristics analyzed. Hepatitis A vaccine distribution between 1992 and 2007 was also reviewed.

Results: The incidence of hepatitis A has declined by 90% since 1990, from 56 to 5.9 per 10(5)/year. Declines in age-specific incidence were seen in all age groups, most dramatically among children younger than 10 years. Disease incidence still varies substantially: poorer western provinces have had the highest incidences since 2000. In high-incidence provinces, children younger than 10 years continue to have a high disease incidence. Only 50% of cases were laboratory-confirmed, and only 3% occurred in reported local outbreaks. Over 156 million doses of hepatitis A vaccine have been distributed since 1992, and use has continued to increase since 2003.

Conclusions: Incidence of hepatitis A has decreased in all age groups, likely due to changing socioeconomic conditions and increasing hepatitis A vaccine use. Nevertheless, western populations remain at high risk, with transmission predominantly occurring among children. The epidemiology of hepatitis A transmission is not well understood. Improved surveillance with better laboratory confirmation is needed to monitor the impact of universal hepatitis A vaccination of young children; this strategy began to be implemented in 2008.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Incidence of hepatitis A by age group: 1991–2007. Source: NNDRS.
Figure 2.
Figure 2.. Incidence of hepatitis A by province: 1990–2007. Source: NNDRS.
Figure 3.
Figure 3.. Age-specific incidence of hepatitis A in areas of high, intermediate, and low incidence: 2004–2007. Source: NNDRS.
Figure 4.
Figure 4.. Hepatitis A vaccine distributed by year: 1992–2007. Source: China Domestic Biologic Companies
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. WHO, Weekly Epidemiological Record. Hepatitis A vaccines, WHO position paper, 2000, 75, 37–44.
    1. Hadler SC. Global impact of hepatitis A virus infection—Changing patterns. In Hollinger FB, Lemon SM, Margolis H (eds) Viral Hepatitis And Liver Disease. Williams and Wilkens, Baltimore, MD 1991.
    1. Barzaga BN Hepatitis A shifting epidemiology in South-east Asia and China . Vaccine. 2000;18S1:S61–4 10.1016/S0264-410X(99)00467-3 - DOI - PubMed
    1. Jacobsen KH , Koopman JS. The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns . Int J Epidemiol. 2005. Jun;34(3):600–9 Epub 2005 Apr 14 10.1093/ije/dyi062 - DOI - PubMed
    1. Mausezahl D , Cheng F , Zhang SQ , Tanner M. Hepatitis A in a Chinese urban population: the spectrum of social and behavioral risk factors . Int J Epidemiol. 1996;25:1271–9 10.1093/ije/25.6.1271 - DOI - PubMed

MeSH terms

Substances