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..._. . /' * 6 November. 1 !

Kids don't spread hepatitis

N O evidence for horizontal transmission of hepatitis li hits been found in a study of nearly 3000 Sydney school children The siudy, conducted in 5U schools. counters the notion thai universal vac cination of infants against hepatitis II could be a costcffcciivc publie health measure. Speaking at the 18th annual posi graduale meeting of The Children's Hospital, Camperdown in Sydney. staff specialist Dr Margaret Uurgcss said the study suggested mass uinuu nisation of adolescents could have more impact on the incidence uf hepa litis li because it would he dune at a time when the risk of infection was greater. "To make an informed decision about the value of mass vaccination wc need to know what the risk is of horizontal iransmission outside the home," she said. Led by Dr Burgess, lhe research team compared lhe prevalence of hepatitis U in schools where less than 5% of students were from high risk groups, will those where more than 20% of llic children were from high risk groups. low risk child was dciincd as while, and born in Australia, New Zea and, northern Europe or the US. 'High risk' children were migrants or born to migrants from areas such as Vicmam, Thailand, Cambodia or South America where hepatitis 1 is 3 known (o be highly endemic. Dr Burgess said more than 20% of high risk children were positive for hepatitis 1 markers, and a third of 3 these were chronic carriers of the virus. Markers for hepatitis infection wer; found in only 0.2% of low risk children, irrespective of their association with high risk children at school. This emphasised the imporiancc of targeting hepatitis ti vaccination lo children and infanls of high risk adults, she said. The US, Italy and New Zealand arc already advocating universal hepatitis U immunisation of infants, even though they arc low endemic conn tries.

Duration
Dr Burgess said the duration of protection provided by the vaccine was not known. booster dose for high risk individuals was recommended 3 5 years after vaccination. Therefore, high risk children needed lo be boosted prior to school entry, she said. "If wc vaccinate all infants wc will be vaccinating at a lime when they arc ai little risk of infection. "And ill adolescence they will need

a booster dose witch the risk of infection is more real." she said Dr Buigcss said hepatitis 1 vaccina3 tion of adolescents would be more effective and was a practical option, as Australia already had a routine rubella immunisation program for this age group. However, administering a full course of three shots to teenagers could be difficult, she said. Dr Burgess also expressed concern about reports of rare but serious adverse reactions associated with llic recombinant DNA hepatitis U vaccine, occurring about six weeks aflcr vaccination. These have included four reput is in Australia to the end uf 1991) une case of Guillain Uarrc syndrome, iwo cases of optic neuritis and a progressive dcinycliuaiing condition. Samantha Overv

Universal i u r e uj nfajib risiimi hepatitis U may noi be a eosftef/evtii e /mtilie h,-lilil i' , In ihr >esitin / .SiJici un,h

HIC attacked for issuing data sheets

D I A G N O S T I C r e f e r r a l data sheets the I lenltli Insurance Coin mission scili to about 15,IKK) (Jl's last week, have been criticised by the . (Jl's should act in patients' hest interests in deciding about tesis, the said. Il said Australia's medical niolcsiiiiii