[comment on Hepatitis B - United States of America (California) Liver Cancer]

Changes in vaccination policy may not solve California’s “liver cancer epidemic.” In the United States as a whole, rates of Hepatitis B were had already declined significantly before the demonstration of effective vaccine uptake [1,2] See graph :

Vaccination of infected Asian immigrants cannot alter disease progression or public health risk among Asian immigrants who were already infected before arriving to California. The focus must be on testing and counseling of pregnant carriers and high-risk contact groups in this community. In any case, possible effects of increased vaccination on rates of liver cancer might not be apparent for several years, given the natural lag period from infection to tumor.

(See the Graph tool tutorial at www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011 publication. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Hepatitis B: Global Status, 2011. 327 pp, 405 graphs, 1517 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-b-global-status/

Note cited by ProMED

The incidence of viral hepatitis in Bulgaria has actually decreased in recent years [1-3] See graph:

Nevertheless, disease rates in Bulgaria remain slightly higher than those in neighboring countries.

Graphs are generated using an interactive online system – see GIDEON Graphs

References:
1. Berger SA. Infectious Diseases of Bulgaria, 2011. 68 pp, 101 graphs, 967 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-bulgaria/
2. Berger SA. Hepatitis A: Global Status, 2011. 163 pp, 180 graphs, 1073 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/
3. Berger SA. Hepatitis B: Global Status, 2011. 327 pp, 405 graphs, 1517 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-b-global-status/

Note reproduced in ProMED

Rates of hepatitis B in Tajikistan and surrounding countries have declined considerably since the 1990′s, and are similar to those reported in the United States. Interestingly, this trend began a decade before the introduction of universal Hepatitis B vaccination in the region. [1,2]

References:
1. Berger SA. Infectious Diseases of Tajikistan, 2011. 340 pp, 80 graphs, 87 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-tajikistan/2. Berger SA. Hepatitis B: Global Status, 2011. 327 pp, 405 graphs, 1517 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-b-global-status/

Cited in ProMED
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Featured in ProMED

Recent reports of hepatitis B and C in Sindh underscore a general trend toward high hepatitis rates in Pakistan. The following serosurvey data regarding Hepatitis A-G are abstracted from GIDEON (primary references available on request).

Hepatitis A seroprevalence:
94% of children by age 5 (Karachi, 1994 publication)
100% of children ages 14 to 15 (Karachi, 2002 to 2004)
40.57% of persons with clinical suspicion of acute hepatitis (2003 to 2004)

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