TY - JOUR
T1 - An epidemic of hepatitis a in an institution for young children
AU - Tassopoulos, Nicolaos C.
AU - Roumeliotou-karayannis, Anastasia
AU - Sakka, Marina
AU - Ticehurst, John
AU - Mihalik, Kathy
AU - Stephanou, Theodora
AU - Purcell, Robert H.
AU - Papaevangelou, George
N1 - Funding Information:
2National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD. This study was supported by a grant from the Ministry of Health and Welfare of Greece, The authors gratefully acknowledge the assistance of Dr. George Kokolis and the staff of the Children's Institute, Athens, Greece. The authors also appreciate the expertise of Linda Jordan in the preparation of the manuscript.
PY - 1987/2
Y1 - 1987/2
N2 - 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.
AB - 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.
KW - Antigens
KW - Disease outbreaks
KW - Hepatitis A virus
KW - RNA
KW - Viral
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U2 - 10.1093/oxfordjournals.aje.a114530
DO - 10.1093/oxfordjournals.aje.a114530
M3 - Article
C2 - 3028130
AN - SCOPUS:0023154728
SN - 0002-9262
VL - 125
SP - 302
EP - 307
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 2
ER -