Hépatite A: vaccination généralisée ou ciblée ? (French)

Hepatitis A vaccination: high-risk patients and travellers or universal immunisation. (English)

Heavy and various hygienic measures are the basis of Hepatitis A prevention but are difficult to reach. Also in a large part of South and East hemispheres, Hepatitis A remains endemic. In western countries, with the high heterogeneity of life and hygienic conditions, transmission of Hepatitis A is frequent by water, contaminated foods and familial contacts. High level of asymptomatic forms with absence of clinical symptoms but contagious is an important factor of dissemination, mainly in children. There is no specific treatment and liver graft is not rare even in vaccination era. French recommendations are focused on patients with chronic liver diseases and travellers going to an endemic area. The usual mode of contamination in France is a traveller, mainly a child with an asymptomatic infection, coming from an endemic area without vaccination. More than 25% of families staying in France have close contacts with their family members living in endemic areas. Also, as in a great number of western countries, the only possibility is to recommend universal Hepatitis A vaccination in France. [ABSTRACT FROM AUTHOR]

La prévention de l'hépatite A repose avant tout sur des mesures sanitaires évidentes mais indispensables. Elle est endémique dans les pays du Sud, mais du fait du caractère très hétérogène des conditions d'hygiène dans les pays occidentaux, la transmission de l'hépatite A, par voie hydrique et plus rarement manuportée est loin d'être inhabituelle. La grande particularité de l'hépatite A est la proportion considérable de formes asymptomatiques mais toujours contagieuses, particulièrement chez l'enfant. La vaccination actuellement recommandée en France est très mal pratiquée dans le principal groupe ciblé. Plus de 25 % des résidents français ont un lien familial fort avec des habitants de zones endémiques. Le mode de contamination habituel est le retour de voyage, particulièrement des enfants, avec une forme pauci-symptomatique mais contagieuse qui répand le virus. Il est donc indispensable de rapidement recommander en France la vaccination généralisée contre l'hépatite A chez les jeunes enfants et de ne plus se contenter de vacciner seulement les groupes à risque. [ABSTRACT FROM AUTHOR]

Copyright of Médecine Thérapeutique: Pédiatrie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)