Risk of exposure to hepatitis A virus among day-care workers in Israel: implications for preventive measures.

Hepatitis A is an important infectious disease in Israel. The high incidence of hepatitis A, the declining prevalence of antibodies against hepatitis A virus throughout the past decade, and the availability of an active immunization for hepatitis A have engendered the identification of occupations in which workers are at increased risk of acquiring the disease. A prevalence study for hepatitis A antibodies was conducted during the first half of 1998 in a random sample of 37 day-care centers in different parts of Israel.

Cost-utility analysis of hepatitis A prevention among health-care workers in Israel.

This study was conducted to evaluate the efficiency of different strategies of preventing hepatitis A (HA) among physicians, nurses, and paramedical staff by means of cost-effectiveness analysis. The strategies compared were passive immunization during a hepatitis A outbreak, systematic mass vaccination of all workers, and screening for antibodies to HA virus followed by vaccination of nonimmune employees. To predict the prevented number of HA cases, an epidemiological model was incorporated based on our previous nationwide study on clinical HA cases, seroepidemiological survey, and other scientific medical literature.