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American Journal of Epidemiology Vol. 106, No. 6: 493-501
Copyright © 1977 by The Johns Hopkins University School of Hygiene and Public Health

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VIRAL HEPATITIS: ENZYME ASSAYS AND SEROLOGIC PROCEDURES IN THE STUDY OF AN EPIDEMIC1

JORGE RAKELA, EILEEN NUGENT and JAMES W. MOSLEY

1From the Department of Medicine, University of Southern California School of Medicine, 2826 South Hope Street, Los Angeles, CA 90007 and the Hepatic Epidemiology Laboratory, Liver Unit, Rancho Los Amigos County Hospital.

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Rakela, J., E. Nugent and J. W. Mosley (USC School of Medicine, Los Angeles, CA 90007). Viral hepatitis: enzyme assays and serologic procedures in the study of an epidemic. Am J Epidemiol 106:493–501, 1977.

An epidemic of viral hepatitis beginning in late 1975 in a residence for multiply handicapped children, recognized very early in its course, was investigated prospectively to permit comparison of enzymatic and serologic tests. Thirty-three residents of the institution and 46 full- and part-time employees were studied by the immune adherence hemagglutination procedure for antibody (anti-HAV) to hepatitis A virus (HAV). Of these, 31 residents and 37 staff members were susceptible at the beginning of the epidemic. Nineteen and six, respectively, had anti-HAV seroconversion indicating HAV infection. Thus, 12 children (39%) and 31 staff members (81%) of presumed susceptibies did not have serologic evidence of infection. The subclinical/clinical ratio for the children was 1.1: 1; for personnel, it was 1: 1. Serum alanine aminotransferase (ALT) levels compatible with viral hepatitis occurred in 21 persons (84%) who had anti-HAV seroconversion; conversely, there were 10 persons who had ALT abnormality without detectable anti-HAV in late specimens among the total of 68 susceptibles. There was no evidence the latter could be attributed to hepatitis B virus infection; therefore, they may represent the endemic occurrence of non-A, non-B agent(s).

alanine aminotransferase; epidemics; hepatitis; hepatitis A virus; mental retardation


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