[Acute XXXX despite regular vaccination against @entity99 and B].

@entity1 @entity648 @entity99
HISTORY AND CLINICAL FINDINGS: A 59-year-old @entity1 , her 55-year-old husband, their daughter, son and the son's girlfriend were admitted with acute icterus 32-34 days after a dinner when they had eaten shellfish. The father had been immunised against @entity99 and B with a combined vaccine (Twinrix(R)) and had completed the full vaccination schedule 47 days prior to this meal. His wife had been incompletely vaccinated with one injection 16 days prior and a second injection 13 days after the dinner. The other three @entity1 of the dinner had not been immunised. The incubation time and clinical picture did not differ between the vaccinated and non-vaccinated @entity1 . INVESTIGATIONS, TREATMENT AND COURSE: All 5 patients were anti-HAV IgM-positive, had high serum aminotransferases and serum @entity648 . All @entity1 had an uneventful recovery. There was no difference in the clinical course between the vaccinated and non-vaccinated @entity1 . CONCLUSION: Combined @entity99 /B vaccination according to the recommended schedule does not guarantee protection in elderly @entity1 . Before travelling in endemic areas, their antibody response after basic @entity99 /B vaccination should be determined.
