Abstract
Seven members of staff in a paediatric intensive care unit and two of their relatives developed hepatitis A over a period of five days. A 13 year old boy who was incontinent of faeces prior to his death, was presumed to be the source of infection. Two hundred and sixty seven other members of staff underwent serological testing and were given prophylactic pooled gamma globulin. Twenty three per cent were immune before exposure. Of people born in the United States, those at highest risk of developing the disease are physicians, dentists, nurses and those under the age of 40. Of those born outside the United States, being white and under the age of 30 are the two main risk factors. Data from a questionnaire sent to 19 nurses at risk (six cases, 13 controls) suggested that sharing food with patients or their families, drinking coffee, sharing cigarettes and eating in the nurses' office in the intensive care unit were associated with an increased incidence of hepatitis. Nurses with three or four of these habits were at particular risk. The costs of screening and prophylaxis were US $64.72 per employee, while prophylaxis alone would have cost US $8.42 per employee. Assessing risk factors on the one hand and costs of prophylaxis on the other are important elements in the control of nosocomial infections.
Full text
PDF





Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Carl M., Kantor R. J., Webster H. M., Fields H. A., Maynard J. E. Excretion of hepatitis A virus in the stools of hospitalized hepatitis patients. J Med Virol. 1982;9(2):125–129. doi: 10.1002/jmv.1890090207. [DOI] [PubMed] [Google Scholar]
- EISENSTEIN A. B., AACH R. D., JACOBSOHN W., GOLDMAN A. AN EPIDEMIC OF INFECTIOUS HEPATITIS IN A GENERAL HOSPITAL. PROBABLE TRANSMISSION BY CONTAMINATED ORANGE JUICE. JAMA. 1963 Jul 20;185:171–174. doi: 10.1001/jama.1963.03060030029020. [DOI] [PubMed] [Google Scholar]
- Hollinger F. B., Khan N. C., Oefinger P. E., Yawn D. H., Schmulen A. C., Dreesman G. R., Melnick J. L. Posttransfusion hepatitis type A. JAMA. 1983 Nov 4;250(17):2313–2317. [PubMed] [Google Scholar]
- Kao H. W., Ashcavai M., Redeker A. G. The persistence of hepatitis A IgM antibody after acute clinical hepatitis A. Hepatology. 1984 Sep-Oct;4(5):933–936. doi: 10.1002/hep.1840040525. [DOI] [PubMed] [Google Scholar]
- Klein B. S., Michaels J. A., Rytel M. W., Berg K. G., Davis J. P. Nosocomial hepatitis A. A multinursery outbreak in Wisconsin. JAMA. 1984 Nov 16;252(19):2716–2721. doi: 10.1001/jama.252.19.2716. [DOI] [PubMed] [Google Scholar]
- Krober M. S., Bass J. W., Brown J. D., Lemon S. M., Rupert K. J. Hospital outbreak of hepatitis A: risk factors for spread. Pediatr Infect Dis. 1984 Jul-Aug;3(4):296–299. doi: 10.1097/00006454-198407000-00003. [DOI] [PubMed] [Google Scholar]
- Lemon S. M., Brown C. D., Brooks D. S., Simms T. E., Bancroft W. H. Specific immunoglobulin M response to hepatitis A virus determined by solid-phase radioimmunoassay. Infect Immun. 1980 Jun;28(3):927–936. doi: 10.1128/iai.28.3.927-936.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meyers J. D., Huff J. C., Holmes K. K., Thomas E. D., Bryan J. A. Parenterally transmitted hepatitis A associated with platelet transfusions. Epidemiologic study of an outbreak in a marrow transplantation center. Ann Intern Med. 1974 Aug;81(2):145–151. doi: 10.7326/0003-4819-81-2-145. [DOI] [PubMed] [Google Scholar]
- Meyers J. D., Romm F. J., Tihen W. S., Bryan J. A. Food-borne hepatitis A in a general hospital. Epidemiologic study of an outbreak attributed to sandwiches. JAMA. 1975 Mar 10;231(10):1049–1053. [PubMed] [Google Scholar]
- Mosley J. W., Reisler D. M., Brachott D., Roth D., Weiser J. Comparison of two lots of immune serum globulin for prophylaxis of infectious hepatitis. Am J Epidemiol. 1968 May;87(3):539–550. doi: 10.1093/oxfordjournals.aje.a120845. [DOI] [PubMed] [Google Scholar]
- Noble R. C., Kane M. A., Reeves S. A., Roeckel I. Posttransfusion hepatitis A in a neonatal intensive care unit. JAMA. 1984 Nov 16;252(19):2711–2715. [PubMed] [Google Scholar]
- Orenstein W. A., Wu E., Wilkins J., Robinson K., Francis D. P., Timko N., Wayne R. Hospital-acquired hepatitis a: report of an outbreak. Pediatrics. 1981 Apr;67(4):494–497. [PubMed] [Google Scholar]
- Rakela J., Mosley J. W. Fecal excretion of hepatitis A virus in humans. J Infect Dis. 1977 Jun;135(6):933–938. doi: 10.1093/infdis/135.6.933. [DOI] [PubMed] [Google Scholar]
- Seeberg S., Brandberg A., Hermodsson S., Larsson P., Lundgren S. Hospital outbreak of hepatitis A secondary to blood exchange in a baby. Lancet. 1981 May 23;1(8230):1155–1156. doi: 10.1016/s0140-6736(81)92318-7. [DOI] [PubMed] [Google Scholar]
- Snydman D. R., Dienstag J. L., Stedt B., Brink E. W., Ryan D. M., Fawaz K. A. Use of IgM-hepatitis A antibody testing. Investigating a common-source, food borne outbreak. JAMA. 1981 Feb 27;245(8):827–830. [PubMed] [Google Scholar]
