engleski

Viral hepatitis A onboard of a ship – risk for crew disabling

Background: Hepatitis A is rare disease today. Improved sanitation and hygienic condition are considered as main reasons of that decline in the risk for the hepatitis A in developed countries. Those changes in the pattern of the disease indicated to lose of natural immunisation during childhood, and consecuentely it affects more adults than children during recent years. However, merchant and cruise ships with crew of mixed nationality are at increased risk for spreading of the hepatitis A. Subjects and methods: Hepatitis A cases was notified to Croatian national institute of public health. Incidence of hepatitis A was compared between periods1970-74 and 2004-04. The crew of a merchant ship was epidemiologicaly investigated in 2006 for risk of hepatitis A outbreake. Results: Hepatitis A reported cases declined from 42900 to 1946 in Croatia and from 1731 to 29 in Rijeka. The difference of the incidence between children and adults was statistically significant for Rijeka (p=0, 0008), but not for the rest of Croatia. Non-immune crew members of the ship are considered at high risk for transmission of the hepatitis A due to close interpersonal contats by anal-oral ruote. Discussion: The infection can be imported onboard of a ship by infected crew member or passenger. High attack rate among adults with more severe clinical presentation than in children can cause spread of the infection and disabling of the crew and functionality of the ship. In our example the disease were not spread to the non-immune crew member, most probbably due to excellent hygienic conditions onboard the ship. The vaccination of the non-immunized seafarers must be considered as the necessary prophylactic measure in the future.

adults; children; hepatitis A; incidence; risk; ship; waccination; working disability

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