ABSTRACT
An ongoing outbreak of scabies in and outside a nursing home in Amsterdam is described. Despite standard treatment with lindane and ivermectin, many recurrences were observed which suggested resistance to these drugs. After treatment with 5% permethrine, the patients were finally cured.
Subject(s)
Disease Outbreaks/prevention & control , Disease Outbreaks/statistics & numerical data , Hexachlorocyclohexane/administration & dosage , Ivermectin/administration & dosage , Permethrin/administration & dosage , Scabies/epidemiology , Scabies/prevention & control , Drug Resistance , Humans , Incidence , Insecticides/administration & dosage , Netherlands/epidemiology , Nursing Homes/statistics & numerical data , Population Surveillance , Risk Assessment/methods , Risk Factors , Treatment Failure , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the impact and effectiveness of risk-group vaccination against hepatitis A targeted at migrant children living in a country with low endemicity of hepatitis A. METHODS: Retrospective population based data analysis. Routinely collected data on hepatitis A incidence in migrant children and other risk groups in Amsterdam from 1 January 1992 to 2004 were analyzed and related to exposure, immunity and vaccination coverage in migrant children. RESULTS: The overall hepatitis A incidence in Amsterdam declined after a pediatric vaccine was introduced in 1997. This decline was seen in migrant children traveling to hepatitis A-endemic countries, contacts with hepatitis A patients, primary school students, injecting drug users, and persons with unknown source of infection, but not in men who have sex with men (MSM) or in travelers to endemic countries other than migrant children. CONCLUSION: The hepatitis A vaccination campaigns are effective: they reduce both import and secondary HAV cases. The campaigns could be more efficient and cost-effective if the hepatitis B vaccinations currently given to these groups were replaced by a combined hepatitis A and B vaccine. This would increase the hepatitis A vaccination coverage considerably and further reduce the hepatitis A incidence.
