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題名 | B型肝炎疫苗接種世代發生急性B型肝炎感染個案之預後調查 |
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作者 | 劉嘉玲; 黃志傑; 林思鳳; 楊志元; 蘇韋如; 劉定萍; | 書刊名 | 疫情報導 |
卷期 | 30:14 2014.07.22[民103.07.22] |
頁次 | 頁276-284 |
分類號 | 412.41 |
關鍵詞 | 急性B型肝炎; 疫苗接種世代; 預後; |
語文 | 中文(Chinese) |
中文摘要 | 臺灣自 1986年 7月起,全面實施新生兒 B型肝炎預防注射,本調查回溯性追蹤B型肝炎疫苗接種世代,罹患急性 B型肝炎之流行病學特徵及預後,作為未來 B型肝炎防治政策制定之參考。自疾病管制局(現已改制為疾病管制署)傳染病個案通報系統選定 2008年 1月 1日至 2012年 3月 31日間研判為急性 B型肝炎確定病例且篩選其出生日期為 1986年 7月 1日以後出生者共 75例,以自願性方式收案並接受 B型肝炎血清標記現況檢測及問卷調查,同時亦檢測個案家中成員 B型肝炎帶原現況。參加本研究共有 37例(37/75,49.3%)個案,其中至少接種 3劑之 B型肝炎疫苗者占 81.1%(30/37),疫苗接種不完整或無接種紀錄者其出生年介於 1987至 1990年之間。9例(9/37,24.3%)個案之家人有 B型肝炎帶原的病史,手足間未有同時為 B型肝炎帶原者。發病年齡層以 15-24歲居多(N=32),其中伴侶為 B型肝炎帶原者占 6例;未滿 1歲為感染次多族群(N=3),其母親均為 B型肝炎帶原者。B型肝炎血清標記追蹤顯示,21例(21/37,56.8%)B型肝炎表面抗原消失且 B型肝炎表面抗體出現;12例(12/37,32.4%)僅 B型肝炎表面抗原消失但未產生 B型肝炎表面抗體;有 3例(3/37,8.1%)為 B型肝炎帶原者,發病年齡分別為 8個月、6歲及 19歲;另有 1例個案為急性 B型肝炎併發猛爆性肝炎死亡。本調查顯示並非所有 B型肝炎疫苗接種世代的急性 B型肝炎個案的預後都走向 B型肝炎表面抗原消失且 B型肝炎表面抗體出現,而急性 B型肝炎的防治,除一部分原因與疫苗無法完全阻斷周產期 B型肝炎母嬰傳染外,15-24歲年齡層之罹病風險仍然存在,此族群之肝炎防治策略仍需持續努力,以期達到消除 B型肝炎之理想目標。 |
英文摘要 | Since Taiwan revised the notification criteria of acute viral hepatitis A on February 4, 2010, the caseload of confirmed acute viral hepatitis A had been significantly reduced. Nevertheless, the number of confirmed cases has appeared an elevated trend since March 2013. To figure out the risk factors and the epidemiology of indigenous cases of acute viral hepatitis A in Taiwan, this study utilized the Notifiable Infectious Diseases Statistics System to analyze the data of indigenous confirmed cases of acute viral hepatitis A in Taiwan from 2010 to 2013. It revealed that the incidence of indigenous confirmed cases of acute viral hepatitis A was 0.3-0.4 per 100,000 population with a male to female sex ratio of 1.11-1.9. The dominant age group was the 20-44 year-old adults. Food stalls accounted for the highest rate of the eating places within the maximum incubation period, and 26% -42% was attributed to raw food consumption. In order to enhance the efficacy on acute viral hepatitis A prevention, Taiwan CDC organized a task force in response to outbreaks of hepatitis A and held regular meetings for case investigation. Furthermore, test results of PCR and genotyping were also adopted which were helpful for clarifying the suspect spreading source in a short time to block the spreading and to reduce the risk of acute viral hepatitis A occurred in Taiwan. |
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