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. 1992 Aug;109(1):167–173.

An outbreak of hepatitis A in Gloucester, UK.

F A Majeed 1, J M Stuart 1, K A Cartwright 1, R Room 1, J R Gilkes 1, M C Smith 1, B E Watson 1
PMCID: PMC2272227  PMID: 1499670

Abstract

During an outbreak of hepatitis A that occurred in Gloucester, UK between September 1989 and January 1991, 162 clinical cases were identified through notifications and laboratory reports, a monthly attack rate of 1.05 per 10,000 residents. The highest attack rate was seen in 5-14-year-olds. There were significant correlations between hepatitis A attack rates in the electoral wards of Gloucester and with the Jarman UPA 8 scores for the wards and with overcrowding, unemployment, under 5-year-olds and ethnic minority. The use of human normal immune globulin prophylaxis (HNIG) for household contacts was unsuccessful in ending the outbreak, partly because only one third of cases reported a household contact with recent hepatitis A. Our experience does not support the use of HNIG in stopping community-wide outbreaks of hepatitis A. Two public health campaigns were mounted during the outbreak; both were followed by a fall in the number of cases. Greater priority should be given to the implementation and evaluation of public health campaigns in future community-wide outbreaks of hepatitis A.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appleton H. Foodborne viruses. Lancet. 1990 Dec 1;336(8727):1362–1364. doi: 10.1016/0140-6736(90)92905-w. [DOI] [PubMed] [Google Scholar]
  2. Benenson M. W., Takafuji E. T., Bancroft W. H., Lemon S. M., Callahan M. C., Leach D. A. A military community outbreak of hepatitis type A related to transmission in a child care facility. Am J Epidemiol. 1980 Oct;112(4):471–481. doi: 10.1093/oxfordjournals.aje.a113016. [DOI] [PubMed] [Google Scholar]
  3. Carl M., Francis D. P., Maynard J. E. Food-borne hepatitis A: recommendations for control. J Infect Dis. 1983 Dec;148(6):1133–1135. doi: 10.1093/infdis/148.6.1133. [DOI] [PubMed] [Google Scholar]
  4. Centers for Disease Control (CDC) Hepatitis A among drug abusers. MMWR Morb Mortal Wkly Rep. 1988 May 20;37(19):297-300, 305. [PubMed] [Google Scholar]
  5. Crusberg T. C., Burke W. M., Reynolds J. T., Morse L. E., Reilly J., Hoffman A. H. The reappearance of a classical epidemic of infectious hepatitis in Worcester, Massachusetts. Am J Epidemiol. 1978 Jun;107(6):545–551. doi: 10.1093/oxfordjournals.aje.a112574. [DOI] [PubMed] [Google Scholar]
  6. Forbes A., Williams R. Changing epidemiology and clinical aspects of hepatitis A. Br Med Bull. 1990 Apr;46(2):303–318. doi: 10.1093/oxfordjournals.bmb.a072400. [DOI] [PubMed] [Google Scholar]
  7. Green M. S., Dotan K. Efficacy of immune serum globulin in an outbreak of hepatitis A virus infection in adults. J Infect. 1988 Nov;17(3):265–270. doi: 10.1016/s0163-4453(88)96666-2. [DOI] [PubMed] [Google Scholar]
  8. Hadler S. C., Webster H. M., Erben J. J., Swanson J. E., Maynard J. E. Hepatitis A in day-care centers. A community-wide assessment. N Engl J Med. 1980 May 29;302(22):1222–1227. doi: 10.1056/NEJM198005293022203. [DOI] [PubMed] [Google Scholar]
  9. Hall W. T., Madden D. L., Mundon F. K., Brandt D. E., Clarke N. A. Protective effect of immune serum globulin (ISG) against hepatitis A infection in a natural epidemic. Am J Epidemiol. 1977 Jul;106(1):72–75. doi: 10.1093/oxfordjournals.aje.a112435. [DOI] [PubMed] [Google Scholar]
  10. Jarman B. Underprivileged areas: validation and distribution of scores. Br Med J (Clin Res Ed) 1984 Dec 8;289(6458):1587–1592. doi: 10.1136/bmj.289.6458.1587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lednar W. M., Lemon S. M., Kirkpatrick J. W., Redfield R. R., Fields M. L., Kelley P. W. Frequency of illness associated with epidemic hepatitis A virus infections in adults. Am J Epidemiol. 1985 Aug;122(2):226–233. doi: 10.1093/oxfordjournals.aje.a114093. [DOI] [PubMed] [Google Scholar]
  12. Lemon S. M. Type A viral hepatitis. New developments in an old disease. N Engl J Med. 1985 Oct 24;313(17):1059–1067. doi: 10.1056/NEJM198510243131706. [DOI] [PubMed] [Google Scholar]
  13. Matthew E. B., Dietzman D. E., Madden D. L., Newman S. J., Sever J. L., Nagler B., Bouton S. M., Rostafinski M. A major epidmeic of infectious hepatitis in an institution for the mentally retarded. Am J Epidemiol. 1973 Sep;98(3):199–215. doi: 10.1093/oxfordjournals.aje.a121549. [DOI] [PubMed] [Google Scholar]
  14. McIntyre N. Clinical presentation of acute viral hepatitis. Br Med Bull. 1990 Apr;46(2):533–547. doi: 10.1093/oxfordjournals.bmb.a072414. [DOI] [PubMed] [Google Scholar]
  15. Moore P., Oakeshott P., Logan J., Law J., Harris D. M. Prophylaxis against hepatitis A for travel. BMJ. 1990 Mar 17;300(6726):723–724. doi: 10.1136/bmj.300.6726.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Nikolić P., Nikolić S., Debeljković N., Rakela J., Edwards V. M., Mosley J. W. A virologically studied epidemic of type A hepatitis in a school for the mentally retarded. Am J Epidemiol. 1981 Aug;114(2):260–266. doi: 10.1093/oxfordjournals.aje.a113190. [DOI] [PubMed] [Google Scholar]
  17. O'Mahony M. C., Gooch C. D., Smyth D. A., Thrussell A. J., Bartlett C. L., Noah N. D. Epidemic hepatitis A from cockles. Lancet. 1983 Mar 5;1(8323):518–520. doi: 10.1016/s0140-6736(83)92203-1. [DOI] [PubMed] [Google Scholar]
  18. Parry J. V., Farrington C. P., Perry K. R., Waight P. A., Mortimer P. P., Miller E. Rational programme for screening travellers for antibodies to hepatitis A virus. Lancet. 1988 Jun 25;1(8600):1447–1449. doi: 10.1016/s0140-6736(88)92250-7. [DOI] [PubMed] [Google Scholar]
  19. Pavia A. T., Nielsen L., Armington L., Thurman D. J., Tierney E., Nichols C. R. A community-wide outbreak of hepatitis A in a religious community: impact of mass administration of immune globulin. Am J Epidemiol. 1990 Jun;131(6):1085–1093. doi: 10.1093/oxfordjournals.aje.a115601. [DOI] [PubMed] [Google Scholar]
  20. Regan C. M., Syed Q., Corkery A. Hepatitis A vaccine. BMJ. 1991 Aug 17;303(6799):414–414. doi: 10.1136/bmj.303.6799.414-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Shaw F. E., Jr, Sudman J. H., Smith S. M., Williams D. L., Kapell L. A., Hadler S. C., Halpin T. J., Maynard J. E. A Community-wide epidemic of hepatitis A in Ohio. Am J Epidemiol. 1986 Jun;123(6):1057–1065. doi: 10.1093/oxfordjournals.aje.a114334. [DOI] [PubMed] [Google Scholar]
  22. Stuart J. M., Majeed F. A., Cartwright K. A., Room R., Parry J. V., Perry K. R., Begg N. T. Salivary antibody testing in a school outbreak of hepatitis A. Epidemiol Infect. 1992 Aug;109(1):161–166. [PMC free article] [PubMed] [Google Scholar]
  23. Tilzey A. J., Banatvala J. E. Hepatitis A. BMJ. 1991 Jun 29;302(6792):1552–1553. doi: 10.1136/bmj.302.6792.1552. [DOI] [PMC free article] [PubMed] [Google Scholar]

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