Epidemiology of severe hepatitis A in Indigenous Australian children

Aims:  To describe the epidemiology of hepatitis A in Indigenous Australian children. Methods:  Analysis and mapping of national notification and hospitalisation data. Results:  Indigenous Australian children are at far higher risk of clinical hepatitis A than their non-Indigenous counterparts, particularly in the age group 0–4 years. Rates of hospitalisation (15.5 vs. 0.3 per 100 000) and notification (24.4 vs. 1.8 per 100 000) were higher in Indigenous children aged 0–4 years compared with other children in the same age group. In the age group 5–14 years, the rates were 4.4 per 100 000 (Indigenous) versus 0.6 per 100 000 (non-Indigenous) hospitalisations. This excess morbidity falls sharply with age. Rates were the highest in the Northern Territory, South Australia, Western Australia and North Queensland. Conclusions:  Indigenous children are at risk of hepatitis A, particularly early in life. Mapping shows that rates were the highest in jurisdictions with the largest Indigenous populations. This study presents baseline data against which to measure the success of new hepatitis A vaccination programme for Indigenous Australian children which commenced in 2005.