FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 321:1301-1305 November 9, 1989 Number 19 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

Since 1975 nearly 1 million persons have entered the United States from Southeast Asia, where infection with hepatitis B virus (HBV) is hyperendemic. To evaluate the prevalence and patterns of transmission of HBV infection among the children of refugees from Southeast Asia, we studied 196 refugee families with 257 children born in the United States. Of 31 children born in the United States to mothers with infectious disease, 17 (55 percent) had been infected with HBV. Of 226 children whose mothers did not have infectious disease, 15 had HBV infection--a prevalence of 6.6 percent (95 percent confidence interval, 4.1 to 10.7). The risk of infection was greatest (26 percent) among children living in households with children with infectious disease (relative risk, 5.5; confidence interval, 2.3 to 13.4). Exposure to fathers or other adults with infectious disease was not significantly associated with infection. Of children from households with no persons with infectious disease, 3.9 percent (confidence interval, 1.7 to 8.8) were infected. Nearly half (46 percent) the cases of HBV infection among the U.S.-born children of refugees were not attributable to perinatal transmission from a mother with infectious disease. We conclude that child-to-child transmission may be occurring within and between households. Current recommendations to immunize the newborns of mothers with infectious disease are not sufficient to protect all U.S.-born children of Southeast Asian refugees from HBV infection early in life, when the risk of chronic sequelae and premature death is highest. We recommend that the HBV vaccination policy be expanded to include all newborns of Southeast Asian immigrants.

Source Information

Division of Reproductive Health, Centers for Disease Control, Atlanta, GA 30333.

This article has been cited by other articles:

• Plancoulaine, S, Mohamed, M K, Arafa, N, Bakr, I, Rekacewicz, C, Tregouet, D-A, Obach, D, El Daly, M, Thiers, V, Feray, C, Abdel-Hamid, M, Abel, L, Fontanet, A (2008). Dissection of familial correlations in hepatitis C virus (HCV) seroprevalence suggests intrafamilial viral transmission and genetic predisposition to infection. Gut 57: 1268-1274 [Abstract] [Full Text]  
• Shepard, C. W., Simard, E. P., Finelli, L., Fiore, A. E., Bell, B. P. (2006). Hepatitis B Virus Infection: Epidemiology and Vaccination. Epidemiol Rev 28: 112-125 [Abstract] [Full Text]  
• (2004). Acute Hepatitis B Among Children and Adolescents--United States, 1990-2002. JAMA 292: 2967-2968 [Full Text]  
• Stauffer, W. M., Maroushek, S., Kamat, D. (2003). Medical Screening of Immigrant Children. CLIN PEDIATR 42: 763-773  
• HIPGRAVE, D. B., VAN, N. T., HUONG, V. M., LONG, H. T., DAT, D. T., TRUNG, T. N., JOLLEY, D., MAYNARD, J. E., BIGGS, B.-A. (2003). HEPATITIS B INFECTION IN RURAL VIETNAM AND THE IMPLICATIONS FOR A NATIONAL PROGRAM OF INFANT IMMUNIZATION. Am J Trop Med Hyg 69: 288-294 [Abstract] [Full Text]  
• Armstrong, G. L., Mast, E. E., Wojczynski, M., Margolis, H. S. (2001). Childhood Hepatitis B Virus Infections in the United States Before Hepatitis B Immunization. Pediatrics 108: 1123-1128 [Abstract] [Full Text]  
• Lauderdale, D. S., Salant, T., Han, K. L., Tran, P. L. (2001). Life-Course Predictors of Ultrasonic Heel Measurement in a Cross-sectional Study of Immigrant Women from Southeast Asia. Am J Epidemiol 153: 581-586 [Abstract] [Full Text]  
• Mahoney, F. J. (1999). Update on Diagnosis, Management, and Prevention of Hepatitis B Virus Infection. Clin. Microbiol. Rev. 12: 351-366 [Abstract] [Full Text]  
• Committee on Community Health Services, (1997). Health Care for Children of Immigrant Families. Pediatrics 100: 153-156 [Abstract] [Full Text]  
• Margolis, H. S., Coleman, P. J., Brown, R. E., Mast, E. E., Sheingold, S. H., Arevalo, J. A. (1995). Prevention of Hepatitis B Virus Transmission by Immunization: An Economic Analysis of Current Recommendations. JAMA 274: 1201-1208 [Abstract]  
• Meropol, S. B. (1995). Health Status of Pediatric Refugees in Buffalo, NY. Arch Pediatr Adolesc Med 149: 887-892 [Abstract]  
• Kwan-Gett, T. S. C., Whitaker, R. C., Kemper, K. J. (1994). A Cost-effectiveness Analysis of Prevaccination Testing for Hepatitis B in Adolescents and Preadolescents. Arch Pediatr Adolesc Med 148: 915-920 [Abstract]  
• Niu, M. T., Targonski, P. V., Stoll, B. J., Albert, G. P., Margolis, H. S. (1992). Prevention of Perinatal Transmission of the Hepatitis B Virus: Outcome of Infants in a Community Prevention Program. Arch Pediatr Adolesc Med 146: 793-796 [Abstract]  
• Mevorach, D., Eliakim, R., Brezis, M. (1992). Hepatitis B--An Occupational Risk for Butchers?. ANN INTERN MED 116: 428-428 [Abstract]  
• Silverman, N. S., Darby, M. J., Ronkin, S. L., Wapner, R. J. (1991). Hepatitis B Prevalence in an Unregistered Prenatal Population: Implications for Neonatal Therapy. JAMA 266: 2852-2855 [Abstract]