| セッション情報 |
Enteric Viral Hepatitis i)Epidemiology of Hepatitis A and E
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| タイトル |
IF4a-1 A Comparison of Viral Hepatitis A (HAV) and E (HEV) in the United States and Asia
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| 演者 |
Kenrad E. Nelson（Johns Hopkins UniversityUSA） |
| 共同演者 |
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| 抄録 |
Acute HEV in the USA decreased 93．70／o from 1990 （14／100000） to 2009 （O．6／100000）． HAV vaccine wasrecom血ended for high risk persons（1996）all chilldren in high incidence areas（1999）and all children at1－2 years of age （2006）Routine vaccination of children provided herd irnmunity to adults in whom HAVinfection rates also declined ・dramatically． Clinical HAV is heterogeneous in most low income countries inAsia due to asymptomatic HAV in young children providing immunity to adolescents and adultsbut clini－cal HAV is emerging in older persons in many urban areas in middle－income counuies in Asia whose SEstatus has increased ； 300000 cases were reported in a Shanghai shellfish outbreak in 1991． Clinical HEV israre in the USAinvolving mostly travellers to endemic areas． Howeverrecently 27 autochthonous caseswere reported． NeverthelessHEV seroprevalence in the national representative NHANES sample of18625 persons was 21．00／o． lncreased risk （OR ＝ 1．4） for anti－HEV lgG was found in persons with frequentconsumption of organ meats． HEV gt3 is common in US swine populations and HEV RNA has been foundin commercial pig livers． Pig farmers are at higher risk of infection． ln Asia 1arge epidemics occur annuallyduring monsoons from waterborne gt l HEV in NepallndiaBangladesh and Pakistan． Pregnant womenhave higher mortalitye．g． 200／o． Sporadic endemic cases occur from zoonotic HEV gt4 infection in coun－tries throughout Asia． Person－to－person transmission of HEV is rarely documentedEffective HEV vac一cines have bee／n developed and tested in Nepal and China． |
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