Hepatitis B virus transmission in pre-adolescent schoolchildren in four multi-ethnic areas of England.

The aim of this study was to estimate the amount of childhood hepatitis B virus transmission in children born in the UK, a very low-prevalence country, that is preventable only by universal hepatitis B immunization of infants. Oral fluid specimens were collected from schoolchildren aged 7-11 years in four inner city multi-ethnic areas and tested for the presence of antibody to hepatitis B core antigen (anti-HBc). Those found positive or indeterminate were followed up with testing on serum to confirm their hepatitis B status. The overall prevalence of anti-HBc in children was low [0.26%, 95% confidence interval (CI) 0.14-0.44]. The estimated average annual incidence of hepatitis B was estimated to be 29.26/100 000 children (95% CI 16.00-49.08). The total incidence that is preventable only by a universal infant immunization programme in the UK was estimated to be between 5.00 and 12.49/100 000. The study demonstrates that the extent of horizontal childhood hepatitis B virus transmission is low in children born in the UK and suggests that schools in the UK are an uncommon setting for the transmission of the virus. Targeted hepatitis B testing and immunization of migrants from intermediate- and high-prevalence countries is likely to be a more effective measure to reduce childhood transmission than a universal infant immunization programme.

Provision of services to asylum seekers. Are there lessons from the experience with Kosovan refugees?

Arrangements that were made to receive and support Kosovan refugees in the United Kingdom should be applied to asylum seekers arriving in the country.

Promoting uptake of influenza vaccination among health care workers: a randomized controlled trial.

In a randomized controlled trial, an intensive promotional campaign failed to increase the uptake of vaccination against influenza among health care workers. The uptake of vaccination was low.

Measles surveillance in the English-speaking Caribbean and Suriname: a key strategy in the campaign to eliminate indigenous measles by 1995 - abstract

In 1988, the Caribbean Health Ministers declared the goal of indigenous measles elimination by 1995 in the light of the success of measles vaccination programmes, introduced in 1982, in decreasing disease occurrence. Prior to 1982, measles occurred continuously in larger territories and Caribbean-wide epidemic activity occurred every 3 to 4 years; the last epidemic being in 1989/90. One of the key strategies for measles elimination was a mass immunization campaign conducted in May - June 1991 with a 91.4 per cent vaccination uptake rate among the target population aged 9 months - 15 years. Nine countries achieved coverage rates of > 95 per cent. This was followed by the introduction of an active and sensitive surveillance system on 1st September, 1991 and up to October 31, 1992, 504 suspected cases of measles were reported. However, there were only two (2) confirmed cases (from Barbados - one indiginous and one imported) and 124 compatible cases. Thus, in the 14 months since the launch of the new surveillance system, one case of indigenous measles has been indentified. Logically, the combination of widespread epidemic activity in 1989/90, followed by a very successful mass vaccination campaign in 1991, has enormous potential for breaking all chains of transmission in a population. Continued high-quality surveillance will be necessary to certify elimination but transmission appears to have been interrupted throughout the English-speaking Caribbean. If this is possible in the Caribbean, across a wide variety of territories, then global eradication is one step closer to being a reality (AU)