Bahrain is to stop compulsorily immunising schoolchildren against the viral diseases mumps, measles and rubella (MMR) from this year.

Instead they will be vaccinated against Hepatitis A.

Health Ministry head of disease control Dr Muna Al Mousawi, said World Health Organisation (WHO) recommendations now no longer list the single dose MMR as a vaccine that must be given.

'Acting on those recommendations, we are withdrawing it from our public health programme,' she said.

Until now, the vaccine was being compulsorily administered to schoolchildren in grade seven, in both private and government schools, as a booster to vaccines given in infancy.

'Hepatitis A is an acute, usually self-limiting disease of the liver caused by hepatitis A virus (HAV),' said Dr Al Mousawi.

'It is transmitted from person to person, primarily by the faecal-oral route. The incidence of hepatitis A is closely related to socio-economic development and sero-epidemiological studies show that prevalence of anti-HAV antibodies in the general population varies from 15 per cent to close to 100 per cent in different parts of the world.'

She said Bahrain was not one of the endemic regions for HAV but an estimated 1.5 million clinical cases of HAV occur worldwide each year.

'In youngsters, HAV infection is usually asymptomatic, whereas symptomatic disease occurs more commonly among adults,' said Dr Al Mousawi.

She said Hepatitis A may represent a substantial medical and economic burden.

'Currently, four inactivated vaccines against HAV are internationally available,' said Dr Al Mousawi.

'All four vaccines are safe and effective, with long-lasting protection. None of the vaccines are licensed for children less than one year of age.'

She said the risk of developing symptomatic illness following HAV infection is directly correlated to age.

'In children below six years, HAV infection is usually asymptomatic, with only 10 per cent developing jaundice,' said Dr Al Mousawi.

'Among older children and adults, infection usually causes clinical disease, with jaundice occurring in more than 70 per cent of cases.'

She said although Hepatitis A was mostly self-limiting and rarely fatal, the disease may represent a substantial economic burden, particularly in countries with low and intermediate incidence rates.

'In the US, a region of relatively low Hepatitis A endemicity, calculations based on surveillance data from 1989 indicated annual medical and work-loss costs of approximately $200 million (BD75.6 million).' TradeArabia News Service