[Protection of Croatian Army draftees and professional soldiers from hepatitis A].

Hepatitis A is an acute infectious disease of viral etiology, with a predominant fecal-oral route of dissemination, and characterized by endemic occurrence or cyclic epidemics in countries of lower socioeconomic development with inappropriate water supply and drain network. In these countries, the youngest age groups are affected, with more than 90% of cases below age 15 and a high rate of subclinical anicteric cases. In industrialized countries, older age groups are involved, occasionally associated with complications and severe clinical course of the disease. In Croatia, the incidence of hepatitis A has been on a steady decline, from 3,103 cases in 1977 to 500 cases in 2000, with a gradual shift towards older age groups. The 75.6% proportion of patients aged 19 recorded before 1980 decreased to 62.6% in the 1991-2000 period. Recent studies indicate the rate of HAV infection in the population aged 30 to be below 20%. Occasional epidemics that occur in some closed populations such as the one recorded in a Croatian Army unit point to the need of preventive measures on entering such populations, in this case enrolling draftees and professional soldiers. The hepatitis A vaccine HAVRIX definitely provides 100% protection from HAV infection and appears to be as efficacious when used during an epidemic, stimulating rapidly and at a high titer the production of antibodies. Compulsory hepatitis A vaccination on enrolling Croatian Army draftees and professional soldiers would eliminate the possible spread of the disease in the army population and occurrence of the disease that requires several week rest and avoiding exertion at long term.