Re: Mass vaccination of adults against hepatitis B 'inappropriate'

[EMAIL PROTECTED] (john) wrote:
>Naughty Indians, not singing from the Merck hymn sheet:
>
>http://www.timesofoman.com/newsdetails.asp?newsid=45902
>
> 
>  
> 
>
>ISLAMABAD - The increasing demand for mass vaccination of adults against
>hepatitis B is not based on a scientific and technical appraisal of the
>perceived threat of infection, Executive Director of the National Institute
>of Health (NIH) Dr Athar Saeed Dil has said. 
>
>Globally, adult immunisation is only recommended for high-risk groups
>including injection drug users, healthcare workers who have a high chance
>of needle prick injury and contact with infected blood or body fluids of
>infected persons; household contacts of chronically infected persons,
>commercial sex workers, and persons with multiple sex partners or a
>diagnosis of sexually transmitted disease, he said. 
>
>Dr Dil was asked to comment on the increasing demand from various quarters
>for initiation of mass vaccination for adults against hepatitis B. "Mass
>immunisation of adults is certainly not the answer and is not recommended,"
>he stated. 
>
>Chronic infection occurs in 90 per cent of infants infected at birth, in
30
>per cent children infected at age 1-5 years and only 6 per cent persons
>infected after five years of age. The consequences of hepatitis B infection
>thus depend on age at infection, explained Dr Dil. 
>
>The NIH executive director said it was unusual for those infected later
in
>adult life to become chronic carriers of the virus. The argument,
>therefore, forms the basis of having a mass immunisation programme for
>infants to protect them from this deadly disease. 
>
>According to some experts, and even looking at it hypothetically, adult
>immunisation in the country would cost around Rs10 billion, which is a huge
>amount in comparison with the risk factor. In Pakistan, though there are
no
>nationwide community-based studies to measure the prevalence of hepatitis
B
>virus, the blood screening data of the country shows that the average
>prevalence of hepatitis B stands at 2.5 per cent in blood donors and 7.8
>per cent among health workers. 
>
>The prevalence among commercial sex workers is estimated to be around 11.7
>per cent whereas among those with chronic liver diseases, it stands at 33.5
>per cent. In pregnant women, it is estimated at 3.64 per cent. 
>
>"The current strategy in the country has an overall goal of eliminating
>hepatitis B transmission because most of the serious consequences related
>to the disease occur among persons with chronic hepatitis B infection and
>its consequences, cirrhosis and liver cancer," Dr Dil said. 
>
>Dr Dil said the government has in place, a programme to save the future
>generation of the country from this scourge and for this purpose, universal
>immunisation of all children under one year of age is now a part of
>Pakistan's routine immunisation programme which provides for free
>immunisation against deadly diseases to all children from birth to nine
>months of age. 
>
>The cost of immunising children under one year against hepatitis-B is
>estimated at over Rs347 million. The challenge of arranging resources of
>such magnitude was overcome with the support of the Global Alliance for
>Vaccines and Immunisation to meet the cost. This, Dr Dil said, was a major
>achievement. The public at large needs to be educated on avoiding
>unnecessary use of injections, he said, recommending the following steps:

>
>l Ensure that in case of need for blood transfusion, the blood is screened
>for hepatitis B. 
>
>l Avoid going to roadside dentists since they do not have sterilised
>equipment; insist on a new blade while visiting the barber; do not share
>razors, toothbrushes or any personal care item that might have blood on
it,
>and do not go for body piercing or tattooing from anywhere as the
>instruments used could transmit the infection. 
>
>l Pregnant mothers must be screened for hepatitis B. 
>
>l Persons infected with the disease must not donate blood, organs or tissue.

>concatenated
>l Should restrict oneself to one sexual partner; those associated with
>healthcare must ensure that they follow standard precautions while handling
>needles and other sharps. - Internews



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