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Mr. Barron: To 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. Horam: Haemophilus 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 service(54)

YearBacteraemia and meningitis of Haemophilus influenzae type BHepatitis B

(54) Laboratory reports are made to the public health laboratory service under a voluntary and confidential reporting system.

(55) Provisional.

Mr. Barron: To 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. Horam: The 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. Barron: To 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. Horam: The 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. Barron: To 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. Horam: Member 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).

CountryNumber of cases of acute hepatitis BPopulation in millionsIncidence per 100,000
United Kingdom(56)535[58.3](56)--

(56) 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. Barron: To 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. Horam: Reports 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. Barron: To 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. Horam: The information requested is not collected centrally.

Mr. Barron : To 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. Horam: Confirmed 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.

Regional Health Authority Total reports of acute hepatitis B infectionNumber of reports with information about the patientNumber of cases identified from information given as falling with defined risk groupsPercentage of reports with information about the patient which fall within defined risk groups
East Anglia19141286
North-west Thames64464598
North-east Thames74484594
South-east Thames67494490
South-west Thames29191895
South Western47454498
West Midlands47272696
North Western68504590
East Anglia19141286
North-west Thames35242396
North-east Thames41272696
South-east Thames71605693
South-west Thames29201995
South Western50464598
West Midlands458788
North Western69444193
East Anglia239889
North-west Thames261111100
North-east Thames27151387
South-east Thames62403793
South-west Thames322020100
South Western21181478
West Midlands40181583
North Western45212095

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.

22 Jul 1996 : Column: 121

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