Hepatitis A surveillance in England--how many cases are not reported and does it really matter?

Epidemiol Infect. 2006 Dec;134(6):1299-302. doi: 10.1017/S0950268806006194. Epub 2006 May 10.


Underreporting of hepatitis A infection in England may be high and a number of outbreaks have occurred undetected by routine surveillance. We evaluated surveillance of hepatitis A cases by employing capture-recapture analysis on data from two distinct outbreaks of hepatitis A. The overall reporting of cases of hepatitis A was 81.7% (95% CI 55.3-95) in the first outbreak in North East England and reporting through Lab Base was 65.7% (95% CI 42.8-76.4). In the second outbreak in the East Midlands the overall reporting of hepatitis A cases was 27.8% (95% CI 19-38.7) and through Lab Base 16.6% (95% CI 11.4-23.1). Underreporting of hepatitis A cases is high. Public health interventions exist to prevent and control outbreaks of hepatitis A. The lack of reliable data on incidence and prevalence hampers effective public health management of this disease.

MeSH terms

  • Disease Notification / standards*
  • Disease Outbreaks
  • England / epidemiology
  • Health Services Research
  • Hepatitis A / epidemiology*
  • Hepatitis A / transmission
  • Humans
  • Linear Models
  • Population Surveillance*
  • Public Health Informatics / standards*