Veille documentaire MTPH

Médecine du travail du personnel hospitalier

The Financial Burden of Public Health Responses to Hepatitis A Cases Among Food Handlers, 2012-2014

Auteur     Rebecca J. Morey
Auteur     Melissa G. Collier
Auteur     Noele P. Nelson
Volume     132
Numéro     4
Pages     443-447
Publication     Public Health Reports (Washington, D.C.: 1974)
ISSN     1468-2877
Date     2017 Jul/Aug
Extra     PMID: 28609202 PMCID: PMC5507430
Abrév. de revue     Public Health Rep
DOI     10.1177/0033354917710947
Catalogue de bibl.     PubMed
Langue     eng
Résumé     When food handlers become ill with hepatitis A virus (HAV) infection, state and local health departments must assess the risk of HAV transmission through prepared food and recommend or provide postexposure prophylaxis (PEP) for those at risk for HAV infection. Providing PEP (eg, hepatitis A [HepA] vaccine or immunoglobulin), however, is costly. To describe the burden of these responses on state and local health departments, we determined the number of public health responses to HAV infections among food handlers by reviewing public internet sources of media articles. We then contacted each health department to collect data on whether PEP was recommended to food handlers or restaurant patrons, the number of PEP doses given, the number of HepA vaccine or immunoglobulin doses given as PEP, and the mean number of health department person-hours required for the response. Of 32 public health responses identified from Twitter, HealthMap, and Google alerts from January 1, 2012, to December 31, 2014, a total of 27 (84%) recommended PEP for other food handlers or restaurant patrons or both. Per public health response, the mean cost per dose of the HepA vaccine or immunoglobulin was $34 139; the mean personnel cost per response was $7329; and the total mean cost of each response was $41 468. PEP is expensive. Less aggressive approaches to PEP, such as limiting PEP to fellow food handlers in nonoutbreak situations, should be considered in the postvaccination era. HepA vaccine for PEP provides long-term immunity and can be used when immunoglobulin is unavailable or cannot be administered within 14 days of exposure to HAV.

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