8e943bb7f66fd08500932d99285d748d pmc_34835145.pdf b35bc1cd1720f2950650b46ab9bbdcf82a56afca pmc_34835145.pdf 2748b3f1d36b0a06a94679f0e9dba4a995dda5b027103853e3d749fe812c277d pmc_34835145.pdf Title: Hepatitis A Outbreak Characteristics: A Comparison of Regions with Different Vaccination Strategies, Spain 2010–2018 Subject: We compared the cumulative incidence and characteristics of hepatitis A outbreaks in two groups of Spanish autonomous regions according to whether a universal or risk group vaccination strategy was followed. Outbreaks between 2010 and 2018 were analyzed. The cumulative incidence rate of outbreaks was estimated and compared by estimating the rate ratio (RR). The characteristics of the outbreaks and those of the first cases were compared. Adjusted OR (aOR) were calculated using a multivariate logistic regression model. Outbreak incidence was 16.04 per million persons in regions with universal vaccination and 20.76 in those with risk-group vaccination (RR 0.77;95%CI 0.62–0.94). Imported outbreaks accounted for 65% in regions with universal vaccination and 28.7% in regions with risk-group vaccination (aOR 3.88; 95%CI 2.13–7.09). Adolescents and young adults aged 15–44 years and men who have sex with men were less frequently the first case of the outbreak in regions with a universal vaccination strategy (aOR 0.54; 95%CI 0.32–0.92 and 0.23; 95%CI 0.07–0.82, respectively). The cumulative incidence rate of outbreaks was lower in regions with universal vaccination. In all regions, independently of the vaccination strategy, activities to vaccinate persons belonging to high-risk groups for infection should be emphasized. Keywords: Hepatitis A; outbreak; transmission; vaccination strategy; risk groups Author: Angela Domínguez, Carmen Varela, Núria Soldevila, Conchita Izquierdo, María Guerrero, Marina Peñuelas, Ana Martínez, Pere Godoy, Eva Borràs, Cristina Rius, Núria Torner, Ana María Avellón, Jesús Castilla and PREVICET Working Group on Viral Hepatitis Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Nov 25 11:28:55 2021 CET ModDate: Thu Nov 25 11:32:29 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 892904 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- SDIDBK+VnURWPalladioL Type 1 Custom yes yes no 10 0 OWWVBT+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 FZKSEX+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 KTSFTP+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 UURBZW+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 55 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 59 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 63 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 75 0 JBDGLK+URWPalladioL-BoldItal Type 1 Custom yes yes no 82 0 UJUUJI+PazoMath Type 1 Builtin yes yes no 104 0 HNCFYK+VnURWPalladioL-Italic Type 1 Custom yes yes no 117 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-22 02:32:17 CET RepresentationInformation: pmc_34835145.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-01-10 08:10:15 CET Size: 892904 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 282 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Outbreak and Case Reporting Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Variables Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Hepatitis A Outbreak Characteristics: A Comparison of Regions with Different Vaccination Strategies, Spain 2010 2018 Author: Angela Domínguez, Carmen Varela, Núria Soldevila, Conchita Izquierdo, María Guerrero, Marina Peñuelas, Ana Martínez, Pere Godoy, Eva Borràs, Cristina Rius, Núria Torner, Ana María Avellón, Jesús Castilla and PREVICET Working Group on Viral Hepatitis Subject: We compared the cumulative incidence and characteristics of hepatitis A outbreaks in two groups of Spanish autonomous regions according to whether a universal or risk group vaccination strategy was followed. Outbreaks between 2010 and 2018 were analyzed. The cumulative incidence rate of outbreaks was estimated and compared by estimating the rate ratio (RR). The characteristics of the outbreaks and those of the first cases were compared. Adjusted OR (aOR) were calculated using a multivariate logistic regression model. Outbreak incidence was 16.04 per million persons in regions with universal vaccination and 20.76 in those with risk-group vaccination (RR 0.77;95%CI 0.62 0.94). Imported outbreaks accounted for 65% in regions with universal vaccination and 28.7% in regions with risk-group vaccination (aOR 3.88; 95%CI 2.13 7.09). Adolescents and young adults aged 15 44 years and men who have sex with men were less frequently the first case of the outbreak in regions with a universal vaccination strategy (aOR 0.54; 95%CI 0.32 0.92 and 0.23; 95%CI 0.07 0.82, respectively). The cumulative incidence rate of outbreaks was lower in regions with universal vaccination. In all regions, independently of the vaccination strategy, activities to vaccinate persons belonging to high-risk groups for infection should be emphasized. 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