Hepatitis: Tegnell A

Bossi P, Tegnell A, Baka A, Van Loock F, Hendriks J, Werner A, Maidhof H, Gouvras G, Anonymous00206. · Task Force on Biological and Chemical Agent Threats, Public Health Directorate, European Commission, Luxembourg. · Euro Surveill. · Pubmed #15677840 links to  free full text

Abstract: Q fever is a zoonotic disease caused by Coxiella burnetii. Its interest as a potential biological weapon stems from the fact that an aerosol of very few organisms could infect humans. Another route of transmission of C. burnetii could be through adding it to the food supply. Nevertheless, C. burnetii is considered to be one of the less suitable candidate agents for use in a bioterrorist attack; the incubation is long, many infections are inapparent and the mortality is low. In the case of an intentional release of C. burnetii by a terrorist, clinical presentation would be similar to naturally occurring disease. It may be asymptomatic, acute, normally accompanied by pneumonia or hepatitis, or chronic, usually manifested as endocarditis. Most cases of acute Q fever are asymptomatic and resolve spontaneously without specific treatment. Nevertheless, treatment can shorten the duration of illness and decrease the risk of complications such as endocarditis. Post-exposure prophylaxis is recommended after the exposure in the case of a bioterrorist attack.

Dannetun E, Tegnell A, Giesecke J. · Department of Communicable Disease Control, Landstinget i Ostergötland, Linköping, Sweden. · BMC Public Health. · Pubmed #17511891 links to  free full text

Abstract: BACKGROUND: The World Health Organisation, WHO, recommends that most countries should vaccinate all children against hepatitis B. Sweden has chosen not to do so, but the issue is reassessed regularly. The objective of this survey was to assess knowledge and attitudes towards hepatitis B vaccine for children among parents living in Sweden, and to compare distribution of responses and response rate between parents answering a postal questionnaire and those responding via the Internet. METHODS: A population-based cross-sectional survey, where the sampling frame consisted of all parents to a child born 2002 living in Sweden. Two independent samples of 1001 parents in each sample were drawn. All parents were contacted by postal mail. The parents in the first sample were invited to participate by answering a paper questionnaire. The parents in the second sample were given an individual user name along with a password, and asked to log on to the Internet to answer an identical electronic questionnaire. RESULTS: A total of 1229 questionnaires were analysed. The overall response rate for paper questionnaires was 55%, and 15% for the web version. Knowledge of the disease hepatitis B was overall high (90%). A higher degree of knowledge was seen among parents with education beyond high school (p = 0.001). This group of parents also had a higher tendency to reply via the Internet (p = 0.001). The willingness to accept hepatitis B vaccine for their child was correlated to the acceptance of the present childhood vaccination programme (p = 0.001). CONCLUSION: The results reveal a high level of knowledge of the disease and a positive attitude to having their children vaccinated. This study also displays that the conventional postal method of surveying still delivers a higher response rate than a web-based survey.

Dannetun E, Tegnell A, Torner A, Giesecke J. · Department of Communicable Disease Control, Landstinget i Ostergötland, Linköping, Sweden. · J Hosp Infect. · Pubmed #16621139 No free full text.

Abstract: The aim of this study was to assess how well the guidelines on vaccination against hepatitis B had been implemented among healthcare workers (HCWs) at risk for blood exposure. A point-prevalence survey was conducted in six departments of a university hospital in Sweden: the emergency room, intensive care unit, postoperative unit, surgical theatre, department of anaesthesiology and the laboratory for blood chemistry. All HCWs who worked in these departments during the 24h of the survey were asked to complete a questionnaire. In total, 369 questionnaires were analysed. Seventy-nine percent (293/369) of HCWs had received at least one dose of vaccine, but only 40% (147/369) reported that they were fully vaccinated and 21% (76/369) had not been vaccinated at all. The majority of unvaccinated HCWs (72/76, 95%) stated that they would accept vaccination if offered. The main barrier to better compliance with the guidelines is not lack of acceptance among the employees but the failure of the employer to ensure that policies are implemented.