§ Mr. BarronTo ask the Secretary of State for Health what was the incidence in the United Kingdom of(a) hepatitis B and (b) haemophilus influenzae type B— Hib—meningitis (i) at the time of the introduction of Hib vaccination to the immunisation schedule, (ii) in each of the five years before that introduction and (iii) at the latest available date. [38465]
§ Mr. HoramHaemophilus influenzae type B vaccine was introduced into the United Kingdom childhood immunisation programme in October 1992. Comparable and complete information for the periods specified is available only for England and Wales. This information is in the table.
Laboratory reports for England and Wales to the public health laboratory service1 Year Bacteraemia and meningitis of Haemophilus influenzae type B Hepatitis B 1987 n/a 785 1988 n/a 641 1989 655 583 1990 658 618 1991 667 572 1992 627 531 1995 2239 2612 1 Laboratory reports are made to the public health laboratory service under a voluntary and confidential reporting system. 2 Provisional.
§ Mr. BarronTo ask the Secretary of State for Health what is his policy on the World Health Organisation's recommendation on the integration of hepatitis B into national vaccination programmes by 1997; and if he will make a statement. [38486]
§ Mr. HoramThe Department's current policy is to recommend immunisation against hepatitis B for those groups at increased risk of infection because of their life style, occupation or other factors such as close contact with a case or carrier. This policy, including the risk groups for whom immunisation is recommended, is kept under review.
§ Mr. BarronTo ask the Secretary of State for Health what percentage of health authorities screened pregnant women for hepatitis B in each of the last three years; and if he will make a statement. [38460]
§ Mr. HoramThe public health laboratory service carried out a survey of English and Welsh district health authorities' hepatitis B ante-natal screening policies in September 1991. In England, there was a response rate of 81 per cent. All the health authorities responding carried out ante-natal screening for hepatitis B. Seventy-seven per cent. of those which responded had a selective screening policy, 21 per cent. had a universal screening policy and 2 per cent. had a mixed policy of selective and universal screening depending on the individual screening centre.
§ Mr. BarronTo ask the Secretary of State for Health which(a) EU and (b) Group of Seven member countries have introduced national policies for routine vaccination of (i) infants and (ii) adolescents against hepatitis B; and if he will rank them according to the prevalence of hepatitis B, with rates of incidence. [38471]
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§ Mr. HoramMember states are asked to report the number of cases of certain infectious disease to the World Health Organisation European regional office. These include cases of acute hepatitis B. It should be noted that methods of surveillance, case definitions and completeness of reporting vary between European member states and that caution should be observed when making comparisons. The WHO European office does not hold data of the seroprevalence of chronic hepatitis B infection in member states.
The number of cases of acute hepatitis B reported to the WHO European office by European Union member states in 1994, the latest for year for which most complete data are available, are given in the table. The incidence of acute hepatitis B per 100,000 for EU member states who have provided data to WHO has been calculated using population figures as at 1 January 1994 taken from EUROSTAT (Demographic Statistics).
Country Number of cases of acute hepatitis B Population in millions Incidence per 100,000 Austria 241 8.0 3.0 Belgium 51 10.1 0.5 Denmark 127 5.2 2.4 France — 57.8 — Finland 192 5.1 3.8 Germany 5,166 81.3 6.4 Greece 222 10.4 2.1 Ireland — 3.6 — Italy 2,733 57.1 4.8 Luxembourg 72 0.4 18.0 Netherlands 213 15.3 1.4 Portugal 1,114 9.9 11.3 Spain — 39.1 — Sweden 264 8.7 3.0 United Kingdom 1535 [58.3] 1— 1 This figure includes only cases from England. Using a 1994 population for England of 48.7 millions the rate of acute cases of hepatitis B in England for that year was 1.1 per 100,000. Seroprevalence rates for chronic hepatitis B infection in other countries are not held centrally.
We understand that in Europe, Italy and France have implemented national policies to immunise infants and adolescents, Spain and Portugal have implemented policies for adolescents; and Belgium has recently begun to introduce a policy for infant and adolescent immunisation.
For the three non-European members of the Group of Seven, we understand that the United States has introduced a universal infant programme, Canada has mainly a universal adolescent policy but with some provinces favouring infant immunisation and Japan has not implemented a universal programme having a selective immunisation policy with particular focus on prevention of perinatal transmission through screening in pregnancy.
§ Mr. BarronTo ask the Secretary of State for Health what assessment he has made of the extent to which Government policy has reduced the incidence of hepatitis B; and what new measures he plans to reduce such incidence. [38470]
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§ Mr. HoramReports of acute hepatitis B to the public health laboratory service have fallen from a peak of just under 2,000 reports in England in 1984 to 612 reports in 1995—provisional figure. This decrease occurred in most groups at increased risk of infection.
This may be linked to the modification of risk behaviours in response to Government initiatives to promote safer sexual practices and recognised techniques for reducing the risks associated with injecting drug misuse, such as needle and syringe exchange schemes, in the light of HIV-AIDS, as well as our immunisation policy targeted at those at increased risk of infection.
These initiatives will continue and hepatitis B immunisation policy will be kept under review.
§ Mr. BarronTo ask the Secretary of State for Health what is the hepatitis B vaccination coverage rate for(a) GPs, (b) nurses, (c) police, (d) homosexual males, (e) drug abusers and (f) babies born to carrier mothers. [38461]
§ Mr. BarronTo ask the Secretary of State for Health how many and what proportion of hepatitis B cases in each of the last three years fell within the definition of at risk categories in each(a) health authority and (b) region. [38485]
§ Mr. HoramConfirmed cases of acute hepatitis B infection are reported by laboratories to the public health laboratory service under a voluntary and confidential surveillance system. The information requested, which is available only by regional health authority, is given in the table.
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Regional Health Authority Total reports of acute hepatitis B infection Number of reports with information about the patient Number of cases identified from information given as falling with defined risk groups Percentage of reports with information about the patient which fall within defined risk groups 1993 Northern 15 10 10 100 Yorkshire 49 29 29 100 Trent 25 18 17 94 East Anglia 19 14 12 86 North-west Thames 64 46 45 98 North-east Thames 74 48 45 94 South-east Thames 67 49 44 90 South-west Thames 29 19 18 95 Wessex 23 19 18 95 Oxford 25 21 20 95 South Western 47 45 44 98 West Midlands 47 27 26 96 Mersey 56 53 42 79 North Western 68 50 45 90 Total 607 448 415 94
Regional Health Authority Total reports of r acute hepatitis B infection Number of reports with information about the patient Number of cases identified from information given as falling with defined risk groups Percentage of reports with information about the patient which fall within defined risk groups 1994 Northern 17 12 12 100 Yorkshire 66 55 55 100 Trent 49 31 28 90 East Anglia 19 14 12 86 North-west Thames 35 24 23 96 North-east Thames 41 27 26 96 South-east Thames 71 60 56 93 South-west Thames 29 20 19 95 Wessex 28 20 18 90 Oxford 24 19 15 79 South Western 50 46 45 98 West Midlands 45 8 7 88 Mersey 59 47 40 85 North Western 69 44 41 93 Total 601 427 397 92 1995 Northern 21 9 9 100 Yorkshire 102 67 67 100 Trent 49 38 38 100 East Anglia 23 9 8 89 North-west Thames 26 11 11 100 North-east Thames 27 15 13 87 South-east Thames 62 40 37 93 South-west Thames 32 20 20 100 Wessex 21 19 16 84 Oxford 35 23 21 91 South Western 21 18 14 78 West Midlands 40 18 15 83 Mersey 80 65 60 92 North Western 45 21 20 95 Total 584 373 349 92 1. The public health laboratory service reporting system records reports under the following risk groups: injecting drug users; sex between men; sex between men and women; sexual contact unspecified; children of hepatitis B carrier mothers; family/household contacts; medical treatments; occupational exposure; and institutional exposure.
2. Approximately two thirds of reports received by PHLS provide information relating to risk groups.