Reported rates of acute hepatitis B cases by gender and age group in 2013.

<p>Reported rates of acute hepatitis B cases by gender and age group in 2013.</p

Trends of Acute Hepatitis B Notification Rates in Eastern China from 2005 to 2013

<div><p>Zhejiang Province was a high endemicity for hepatitis B disease in the 1990's. A number of measures implemented since then have begun to control and prevent hepatitis B. In 1992, hepatitis B vaccine came on the market. In 2002, hepatitis B vaccine was included in the national Expanded Programme on Immunization (EPI). Between 2007 and 2010, catch-up vaccination was implemented for children under 15. Since 2010, vaccination guidelines for high-risk groups have also been adopted. This study evaluated the impact of these control and prevention strategies on acute hepatitis B notification rates from 2005 through 2013. Data from the National Notifiable Disease Reporting System (NNDRS) revealed a steady downward trend in notification rates of acute hepatitis B. The most dramatic decline occurred among pre-adults, highlighting the benefits of EPI's policy of universal vaccination for children. However, the highest notification rates occurred among young adults of lower socio-economic status. These findings indicate the strong need to vaccinate young adults at risk for HBV infection as well as to collect risk-factor information in the NNDRS for monitoring and following up persons with acute hepatitis B.</p></div

Reported rates of acute hepatitis B cases by age group and timely vaccination rates, 2005–2013.

<p>Reported rates of acute hepatitis B cases by age group and timely vaccination rates, 2005–2013.</p

Reported rates of acute hepatitis B cases by region, 2005–2012.

<p>Reported rates of acute hepatitis B cases by region, 2005–2012.</p

Reported rates of acute hepatitis B cases, 2005–2013.

<p>Reported rates of acute hepatitis B cases, 2005–2013.</p

Reported rates of acute hepatitis B cases by gender, 2005–2013.

<p>Reported rates of acute hepatitis B cases by gender, 2005–2013.</p

Cumulative ratios of reported acute hepatitis B cases by occupation and age group, 2005–2013.

<p>Cumulative ratios of reported acute hepatitis B cases by occupation and age group, 2005–2013.</p

Percentages of hepatitis A cases by occupation.

<p>Percentages of hepatitis A cases by occupation.</p

Changing Epidemiological Characteristics of Hepatitis A in Zhejiang Province, China: Increased Susceptibility in Adults

<div><p>Background</p><p>Hepatitis A is a common acute hepatitis caused by hepatitis A virus (HAV). Annually, it affects 1.4 million people worldwide. Between 1991 and 1994, HAV infections were highly endemic in Zhejiang Province (China), with 78,720 reported HAV infections per year. Hepatitis A vaccine came on the market in 1995 and was implemented for voluntary immunization. Since 2008, hepatitis A vaccine has been integrated into the national childhood routine immunization program.</p><p>Objective</p><p>To understand the current epidemiological profile of hepatitis A in Zhejiang Province since hepatitis A vaccine has been available for nearly two decades.</p><p>Methods</p><p>This study used the 2005–2014 National Notifiable Diseases Reporting System data to evaluate the incidence rate of notified hepatitis A cases in Zhejiang Province.</p><p>Results</p><p>The overall trend of incidence rate of notified hepatitis A cases significantly decreased from 2005 to 2014 (P< 0.001). During the study period, the reported incidence rate in individuals aged ≤19 years declined to the historically lowest record in 2014. Compared with individuals aged ≤19 years, those aged ≥20 years showed the highest incidence rate (P< 0.001). Majority of HAV infected cases were Laborers, accounting for approximately 70% of reported cases.</p><p>Conclusions</p><p>Childhood immunization strategy with hepatitis A vaccine seemed to be effective in decreasing notified hepatitis A incidence rate in individuals aged ≤19 years. Those aged ≥20 years were observed to be the most susceptible population. The vast majority of hepatitis A cases were notified among Laborers. Therefore, we strongly suggest that future preventive and control measures should focus more on adults, particularly Laborers, in addition to the current childhood hepatitis A vaccination programme.</p></div

Dose of Hepatitis A vaccines used and new-born population by year.

<p>Dose of Hepatitis A vaccines used and new-born population by year.</p