The Taiwan Centers for Disease Control(Taiwan CDC) , the Keelung City Heath Bureau, the Taipei City Public Health Bureau, and the Kaohsiung City Public Health Bureau have recently collaborated on a program called ‘Hepatitis A prevention and immunization plan targeting night market food vendors’, which is being implemented at popular night markets, including Keelung Miaokou night market, Taipei Shilin night market, Raohe Street night market, and Kaohsiung Lioho night market. The plan screens for food vendors who do not have immunity against the disease, they will be issued with a certificate of hepatitis A immunization. The plan is not only implemented to reduce hepatitis A transmission, but also to ensure food safety at the night markets.

So far, the plan is being implemented at 4 night markets located in three counties/cities and has screened 1,290 food vendors. 69.5% of the food vendors have already had immunity against hepatitis A. For the remaining 394 food vendors, Taiwan CDC has arranged for them to receive the hepatitis A vaccine. The hepatitis A vaccine is safe and highly effective. The duration of protection lasts up to 20 years if two doses of the vaccine are administered. The plan has administered the first dose to those who lack immunity this year. The second dose will be administered beginning April, 2009. The public health bureaus will issue the certificate of hepatitis A immunization to those who completed 2 doses of the vaccine. Another purpose of this plan is to build customer confidence in the food served at night market.

Hepatitis A is usually spread when a person ingests fecal matter even in microscopic amounts from contact with objects, food, or drinks contaminated by the feces, or stool, of an infected person. Most adults have immunity if they have been infected in childhood. However, over the past few years, the environmental sanitation in Taiwan has gradually improved. As a result, most children and teenagers in Taiwan do not have the antibody for hepatitis A, making them vulnerable to hepatitis A infection. Hepatitis A is a category II communicable disease in Taiwan. Each year about 200 new hepatitis A virus infections are reported. The incubation period is about 15-50 days. Clinical symptoms include fever, malaise, nausea, abdominal discomfort, and the development jaundice after a few days of infection. The majority of cases recover naturally and then develop lifelong immunity to the infection.

Currently, the routine examination for restaurant cooks and workers has included the test for IgM anti-HAV antibody. Since the night market is a part of nightlife culture in Taiwan, hepatitis A control among food vendors at the night market is extremely important. Therefore, Taiwan CDC has implemented the hepatitis A prevention and immunization plan to ensure food vendors at the night market have immunity against the disease. According to the plan, the public health bureaus cooperate with the night market’s administrative committee to collect blood samples from night market food vendors and screen for people who do not already have immunity against hepatitis A in order to immunize them and provide health education directed towards the prevention of hepatitis A to the people working at the night market. The experience of implementing this plan will be valuable to the other public health bureaus in other cities and counties for the control of hepatitis A in the respective local night markets.