The epidemiology of hepatitis A infection in Palestine: a
universal vaccination programme is not yet needed In Palestine,
there has been an increase in the reported incidence of acute
hepatitis A virus (HAV) infection since 1995. Since overt
clinical disease occurs only among adults, questions were raised
whether or not a shift in the epidemiology of HAV has occurred.
This is generally characterized by a decrease in the overall
incidence rate and a shifting in the mean age of infection
towards adolescence and early adulthood. The need for a
vaccination programme is being discussed. To resolve this issue,
we examined the prevalence of anti-HAV in a representative
sample of 396 school children in the Gaza Strip. The prevalence
of anti-HAV was 93·7% (95% CI: 91·3, 96·1%). Stratifying the
prevalence by age showed that 87·8% (95% CI: 78·6, 97%) were HAV
antibody positive by the age of 6. By the age of 14, almost 98%
(95% CI: 92·7, 100%) were HAV antibody positive. This means that
the majority of HAV infection is s