Information Note
Provisional Legislative Council
Panel on Health Services
Meeting on 9 February 1998
Prevention of Hepatitis A
Introduction
This paper reports on the recent trends of hepatitis A cases in Hong Kong and sets out the relevant preventive measures.
Background
2.Hepatitis A is a food-borne or water-borne disease transmitted through the oral-faecal route. Hong Kong has been enjoying a period of low hepatitis A incidence since 1992. Recently, there have been concerns about the possibility of an increase in the number of hepatitis A cases in 1998, following studies which report a relatively low population immunity towards the disease.
Hepatitis A in Hong Kong
3.Hepatitis A is not an uncommon disease in Hong Kong. In 1988-1991, about 1 100 cases of hepatitis A were notified each year. The number rose to 3 626 in 1992. Since then, the number of hepatitis A cases remained at a low level, ranging from 260 - 870 cases a year, from 1993-1997. Hepatitis A incidents levels in Hong Kong were at historic low during this period.
4.Hepatitis A antibody levels in the local population have been declining over the past two decades. This is the result of improved standard of hygiene and sanitation within the territory, leading to reduced human exposure to the virus, especially among the young age groups. We estimate that at present a substantial number of people aged 30 or below do not have antibodies to hepatitis A.
Recommendations of local advisory bodies
5.Two relevant local advisory bodies appointed by the Director of Health, namely, the Scientific Working Group on Viral Hepatitis Prevention and the Advisory Committee on Immunisation discussed the issue of hepatitis A prevention and the role of vaccination at their meetings on 22 December 1997 and 9 January 1998 respectively. Both committees include medical and health experts from outside the Department of Health. The former committee advises on all issues related to the prevention of viral hepatitis, while the latter advises on local vaccination strategies and programmes.
6.The two advisory bodies examined in detail the scientific evidence and practices in Hong Kong and overseas. The following observations and recommendations were endorsed by the two bodies:
- the timing of a hepatitis A outbreak cannot be accurately predicted solely on the basis of past trends and serological data;
- the most effective method for preventing hepatitis A and other food-borne diseases in the community is observance of good food and personal hygiene. Public education in this aspect should be enhanced and sustained;
- hepatitis A vaccination is an effective means of providing individual protection against the disease. Travellers visiting highly endemic areas are advised to consult general medical practitioners for hepatitis A vaccination; and
- food handlers should be educated to maintain a high standard of food hygiene and be informed about the availability of a vaccine.
Conclusion
7.The Department of Health accepts the recommendations of the two advisory bodies on hepatitis A prevention. Publicity and education activities are being lined up starting early 1998, including campaigns such as exhibitions, school health talks and contributions to newspaper columns. Concurrently, disease surveillance of hepatitis A is being strengthened: cases of hepatitis A will be subject to detailed investigations. These measures will effectively reduce the chance of increasing occurrence of hepatitis A cases.
Department of Health
February 1998
