Naslov
Virusni hepatitis A – kako spriječiti epidemije
(Viral hepatitis A – how to prevent outbreaks)

Autori
Nemeth Blažić, Tatjana ; Kosanović Ličina, Mirjana L. ; Kurečić Filipović, Sanja ; Kaić, Bernard

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, ostalo, stručni

Skup
1. hrvatski kongres o upalnim bolestima jetre s međunarodnim sudjelovanjem - IHEPCRO2020

Mjesto i datum
Zagreb, Hrvatska, 12.11.2020. - 14.11.2020

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
hepatitis A, epidemija, Hrvatska
(hepatitis A, epidemic, Croatia)

Sažetak
Background Hepatitis A (HAV) is highly transmissible acute liver infection which is rarely fatal (case- fatality ratio is 0.1–0.3 % up to 1.8 % in adults), but it can cause fulminant hepatitis which is often fatal. The disease is often asymptomatic or mild, particularly in children under five years, and it is more severe in adults. HAV is transmitted primarily by the faecal-oral route and through contaminated water and food but it can be spread via oral-anal sex. It can occur sporadically or in outbreaks. The risk groups that have been associated with illness outbreaks include household contacts, day-care centres or schools, people who use drugs, men having sex with men (MSM) and homeless people. Aims: To give an overview of epidemiological situation of HAV in Croatia and Europe with special focus on recent years and anti-epidemic measures. Methods A descriptive analysis of data from the National Register of Infectious Disease (Croatian Institute of Public Health) as well as from epidemic reports for the period 2008-2019, and data from international reports (ECDC) was performed, with special focus on epidemic in 2017- 2018. Results The incidence of HAV has decreased significantly in the last 50 years, in the last 10 years the incidence is satisfactorily low with a small annual number of patients (4-20), which was significantly contributed by improved living conditions and successful preventive measures in maintaining personal and communal hygiene and sanitation. From January to August 2017, there was a fourfold increase in HAV reports in most (19) EU / EEA countries compared to the last few years (2017: 11.212 reports, 2012-2015: an average of 2594 reports per year). In Croatia it was also recorded a sixfold increase in the number of reports of HAV in 2017 compared to previous years (2017: 47, 2012-2016: an average of 7 reports per year). Epidemiological data have shown that in epidemics in Europe and Croatia there has been an increase in the number of patients in the subgroup of men who have sex with men (MSM). Due to the increased number of cases of HAV in European countries during 2016 and 2017, an increased number of HAV patients was recorded in Croatia as well. The main public health control measures for HAV are: adequate sanitation and housing, personal hygiene practices education, particularly hand hygiene, and pre-exposure immunisation of individuals in populations at increased risk. Protection during sexual intercourse is advised to prevent oral-anal transmission. Isolation of the patient, interviewing, risk assessment of cases and determining the possible source of infection and surveillance of contacts are carried out. For exposed contacts, post-exposure vaccination and immunoglobulin administration is recommended. Conclusion Despite the sporadic cases of HAV in the last ten years, mostly acquired abroad, the existence of continuously epidemiological surveillance, as well as individual assessment of each person diagnosed with HAV, the cluster of HAV can be detected early. In addition to interviewing the infected person, the management of close, epidemiologically significant contacts, includes a detailed epidemiological interview, immunization status checking, as well as the recommendation and implementation of anti-epidemic measures. HAV vaccination as an anti-epidemic measure is effective but must be available (HZZO subvention issue) and applied in a timely manner (time frame). Given the large reservoir of non-immune individuals in Croatia, as well as the characteristics of the causative agent (low infectious dose) as well as recent epidemiological trends (large migrant wave, lower hygienic conditions in some parts of Europe) and the emergence of grouping and "new" transmission routes (sexual contacts, MSM population), it is necessary to make recommendations / guidelines on pre-exposure prophylaxis of the population at increased risk.

Izvorni jezik
Hrvatski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

Napomena
Link na najavu kongresa: https://bfm.hr/ihepcro2020/
i web stranicu kongresa:
http://www.ihepcro.com/en/home/

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