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Hepatitis

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)

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	(55)39	(55)612

(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).

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	(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 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
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.

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