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Contents3 7 Ou t br ea k n ew s

38 Hepa t i t is A vaccines

4 4 In fl uen za

4 4 I nt e rn a ti o na l H ea lt hRegulations

Sommaire37 Le po in t su r l es p idmies

38 Vaccins an t i -hpa t i te A

44 Grippe

3 0 R gl em e nt sa n it a ir einternational

WORLD HEALTHORGANIZATION

Geneva

ORGANISATION M ONDIALEDE LA SANT

Genve

Annua l subscr ip t ion / Abonnement annue lSw. fr. / Fr. s. 230.

6 .5 0 0 1 .2 0 0 0ISSN 00 49-811 4

Prin ted in Switzer land

OUTBREAK NEWS LE POINT SUR LES PIDM IES

Weekly epidemiological recordRelev pidmiologique hebdomadaire

4 FEBRUARY 2000, 7 5th YEAR / 4 FVRIER 2000, 75e

ANN ENo. 5 ,2000,75 , 37-44http: / /www.who. int /wer

2000,75 , 3744 No. 5

1 See No. 15, 1999 , p. 120.

1 Voir N o 15, 1999, p. 120.

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Hepat itis A vaccinesWHO position paper

Summary and conclusion

Public health aspects

Vaccins anti-hpat ite ANote dinformation de l OMS

Rsum et conclusions

Considrations de sant publique

1 Formerly the global programme for vaccines and immunization (GPV). 1Auparavant le Programme mondial des vaccins et vaccinations (GPV).

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RELEVE EPIDEMIOLOGIQ UE HEBDOM ADA IRE, N o 5, 4 FVRIER 2000 39

The results of appropriate epidemiological and cost-benefit studiesshould be carefu lly considered b efo re deciding on nat ional pol icies con-cerning immunization against hepatitis A. As part of this decisionprocess, the public health impact of hepatitis A should be weighedagainst the impact of other vaccine-preventable infections, includingdiseases caused by hepatitis B, Haemophilus influenzaetype b, rubellaand yellow fever.

In highly endemic countries, almost all persons are asymptomaticallyinfected w ith HAV in childhood, which effectively prevent s clinical hep-atit is A in a dolescents and adult s. In th ese count ries, large-scale vacci-nation programm es are not recommended.

In countries of intermediate endemicity where a relatively large pro-portion of the ad ult populat ion is susceptible t o HAV, and w here hepati-tis A represents a significant public health burden, large-scale child-hood vaccination m ay be considered as a supplement t o healt h educa-tion and improved sanitation.

In regions of low endemicity, vaccination against hepatitis A is indi-cated for individuals with increased risk of contracting the infection,such as travellers to areas of intermediat e or high endemicity.

Il convient dexaminer avec attention les rsultats des tudes pid-miologiques, ainsi que les cots et les avantages, avant de dciderdune politique nationale en mat ire de vaccination contre lhpatite A.Au cours de ce processus dcisionnel, on comparera les rpercussionsde lhpatite A sur la sant publique par rapport dautres maladies prvention vaccinale, dont lhpatite B, les infections Haemophilusinfluenzaetype b, la rubole et la fivre jaune.

Dans les pays de forte endmicit, quasiment tous les habitants con-tractent ds lenfance linfection qui reste alors asymptomatique etreprsente une prvention efficace de lhpatite A clinique chezladolescent et ladulte. Les programmes de vaccination grandechelle ne sont donc pas recomm ands dans ces pays.

Dans les pays dendmicit moyenne, o une pr oportion relativementgrande de la population adulte est sensible au HAV et o lhpa-tite A repr sente un f ardeau import ant pour la sant publique, la vacci-nation des enfant s grande chelle pourra tre envisage, en compl-

ment de lducation sanitaire et dune amlioration des systmesdassainissement.

Dans les rgions de faible endmicit, la vaccination contre lhpatite Aest indiqu e pour les personnes exposes un risque accru de cont rac-ter linf ection, par exemp le celles qui se rendent dans les zones de fo rteou moyenne endmicit.

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The pathogen a nd the disease

Lagent pathog ne et la ma ladie

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Protective im mune response

Justification for vaccine control

Hepatitis A vaccines

Rponse im munitaire protectrice

Raison dtre de la vaccination

Vaccins anti-hpat ite A

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General WHO position on new vaccines

Position gnrale de lOMS concernant les nouveaux vaccins

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WHO position on hepatitis A vaccines

Positio n de lOM S sur les vaccins ant i-hpat ite A

2 Document WHO/VSQ/GEN/96.02 avai lab le f rom the VAB documentat ion centre,

World Health Organization, 1211 Geneva 27, Switzerland.

2Document WHO/VSQ/GEN/96.02 disponible auprs du Centre de documentation VAB, Organi-sation m ondiale de la Sant, 1211 Genve 27 , Suisse.

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Influenza

1 See No. 3, 2000, pp. 25-2 8

Grippe

1 Voir N o 3, 2000, pp. 25-28.

INTERNATIONA L HEALTH REGULATIONS / RGLEM ENT SANITAIRE IN TERNATION AL

Notif ications of diseases received from 28 January t o 3 February 2000 / Notif ications de maladies reues du 28 janvier au 3 fv rier 2000

Cholera / Cholra

Africa / Afr ique

Americas / Amriques

Newly infected areas / Zones nouvellement infectes

Cholera / Cholra

Africa / Afr ique

Yellow fever / Fivre jaune

Amer icas /Amer icas /Amer icas /Amer icas /Amer icas / A m r i q u esA m r i q u esA m r i q u esA m r i q u esA m r i q u es

Yellow fever / Fivre jaune