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Gerard J. B. Sonder, MD, MSc, Jim E. van Steenbergen, MD, PhD, Lian P. M. J. Bovee, MSc, Paul G. H. Peerbooms, PhD, Roel A. Coutinho, MD, PhD and Anneke van den Hoek, MD, PhD

Gerard J. B. Sonder, Jim E. van Steenbergen, Lian P. M. J. Bovee, Roel A. Coutinho, and Anneke van den Hoek are with the GG&GD, Department of Infectious Diseases, Municipal Health Service, Amsterdam, the Netherlands. Paul G. H. Peerbooms is with GG&GD Municipal Health Laboratory, Amsterdam. Dr. Sonder also is with LCR, National Coordination Center for Travelers Health Advice, Amsterdam. Dr. van Steenbergen also is with LCI, Coordination Communicable Disease Control, Utrecht, the Netherlands. Dr. Coutinho also is with the Academic Medical Center, University of Amsterdam.

Correspondence: Requests for reprints should be sent to G.J.B. Sonder, MD, MSc, GG&GD, Municipal Health Service, PO Box 2200, 1000 CE Amsterdam, the Netherlands (e-mail: gsonder{at}gggd.amsterdam.nl).

Objectives. We evaluated the hepatitis A virus (HAV) control policy (hygienic precautions and passive immunization with immune globulin) for "household contacts" (defined as all people who lived in the same house and who shared the same toilet with the patient, people who took care of an HAV-infected child, and sexual partners of the patient) of acute hepatitis A patients between 1996 and 2000.

Methods. We examined the characteristics and the serological outcomes of household contacts. All susceptible contacts were invited for retesting 6 weeks after they received immune globulin.

Results. Of 1242 contacts of 569 HAV patients, more than 50% (n = 672) were found to be HAV immune. Among the remaining contacts, 161 (28.2%) had a concurrent infection, and 86 of these individuals were symptomatic. The remaining 409 susceptible contacts received immune globulin, with 186 (45%) returning for retesting 6 weeks later (64 [34%] were infected, but only 12 had symptoms).

Conclusions. Immune globulin does not protect all household contacts from HAV infection; however, it attenuates symptoms and effectively reduces further HAV transmission.

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