AN EPIDEMIC OF HEPATITIS A IN AN INSTITUTION FOR YOUNG CHILDREN

A common-source epidemic of hepatitis A occurred in an Athenian institution boarding 38 children (mean age 4.8 years). All children were examined, and blood was drawn from each at the onset of the study and repeatedly during the next three months. Only one child (2.6%) was initially immune to hepati...

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Bibliographic Details
Published in:American journal of epidemiology 1987-02, Vol.125 (2), p.302-307
Main Authors: TASSOPOULOS, NICOLAOS C., ROUMELIOTOU-KARAYANNIS, ANASTASIA, SAKKA, MARINA, TICEHURST, JOHN, MIHALIK, KATHY, STEPHANOU, THEODORA, PURCELL, ROBERT H., PAPAEVANGELOU, GEORGE
Format: Article
Language:English
Subjects:
antigens
Biological and medical sciences
Child
Child, Preschool
Disease Outbreaks
Epidemiologic Methods
Female
Greece
Hepatitis A - epidemiology
Hepatitis A - immunology
hepatitis A virus
Hepatovirus - isolation & purification
Human viral diseases
Humans
Infectious diseases
Institutionalization
Male
Medical sciences
RNA
Seasons
viral
Viral diseases
Viral hepatitis
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Summary:A common-source epidemic of hepatitis A occurred in an Athenian institution boarding 38 children (mean age 4.8 years). All children were examined, and blood was drawn from each at the onset of the study and repeatedly during the next three months. Only one child (2.6%) was initially immune to hepatitis A virus as a result of prior infection. The attack rate (62.2%) and the ratio of icteric to anicteric cases (1:1.3) were high despite the administration of immunoglobulin (IG). Assays for anti-HAV IgM and a rising titer of anti-HAV IgG identified 19 (82.6%) and 22 (95.7%) of the 23 hepatitis A infections, respectively. One case (4.3%) was detected only by the presence of hepatitis A virus antigen and hepatitis A virus RNA in a focal specimen, but these assays were otherwise marginally useful in this study. Nevertheless, the use of all available tests for the detection of hepatitis A virus is mandatory for the most accurate estimation of an epidemic of hepatitis A. Prompt administration of immunoglobulln had no effect on the number of clinical cases that were in the late incubation period, but it may have diminished the clinical expression of the infection and thus made diagnosis of infection more difficult.
ISSN:0002-9262
1476-6256
DOI:10.1093/oxfordjournals.aje.a114530