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American Journal of Epidemiology Vol. 125, No. 2: 302-307
Copyright © 1987 by The Johns Hopkins University School of Hygiene and Public Health

research-article

AN EPIDEMIC OF HEPATITIS A IN AN INSTITUTION FOR YOUNG CHILDREN

NICOLAOS C. TASSOPOULOS1,2, ANASTASIA ROUMELIOTOU-KARAYANNIS1, MARINA SAKKA1, JOHN TICEHURST2, KATHY MIHALIK2, THEODORA STEPHANOU1, ROBERT H. PURCELL2 and GEORGE PAPAEVANGELOU1

1National Center for Viral Hepatitis, Athens School of Hygiene Athens 11521, Greece
2National Institute of Allergy and Infectious Diseases, National Institutes of Health Bethesda, MD

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.

antigens; viral; disease outbreaks; hepatitis A virus; RNA


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