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Studies on the agent of infectious hepatitis. III. The effect of skin tests for infectious hepatitis on the incidence of the disease in a closed institution.

At the onset of an epidemic in a closed institution about one-fourth of the inmates were skin-tested. During the year following the skin test, 5 cases of hepatitis with jaundice were recorded among 320 skin-tested individuals with unknown histories, one in the 144 skin test-positive, and 4 in the 176 skin test-negative subjects. In contrast 112 cases occurred among the 825 non-skin-tested individuals. Thus, the incidence of jaundice in the skin-tested group was 1.6 per cent as against 13.6 per cent in the non-skin-tested individuals. Possible explanations for this observation have been discussed.

Female↗

Thirty years of experience with infectious hepatitis prevention in the Israel Defence Forces.

Infectious hepatitis is endemic to Israel. Large outbreaks of infectious hepatitis were common in the Israel Defence Forces (IDF) before 1970, at which time post-exposure prophylaxis with immune serum globulin was introduced. It caused a decrease in the incidence of infectious hepatitis from 10-14/1,000 to 3/1,000. A further reduction in incidence was achieved after 1978 when a policy of pre-exposure prophylaxis was established. The number of yearly outbreaks and cases per outbreak also declined as a result of this policy. Worldwide studies have shown that a policy of pre-exposure prophylaxis and/or post-exposure prophylaxis with immune serum globulin is effective in reducing the incidence of infectious hepatitis. The experience of the IDF is that a combination of both pre-exposure and post-exposure prophylaxis is more efficacious. This policy should be worthwhile in other areas where infectious hepatitis is endemic.

Adult↗

Infectious hepatitis in dialysis patients.

Infectious hepatitis is a major problem for patients with end-stage renal disease and for staff caring for these patients. Initially hepatitis B was the major cause of hepatitis in dialysis patients and staff. Patients had a tendency to develop chronic hepatitis or become chronic carriers of the virus while staff either developed typical acute hepatitis or a primary antibody response. The discovery of the hepatitis B surface antigen (HBsAg), the screening of transfused blood for HBsAg, and the institution of infection control measures including isolation techniques have resulted in a remarkable decrease in the incidence of this disease. Nonetheless, the problem of infectious hepatitis continues as non-A, non-B hepatitis has become more commonplace among dialysis patients. Unfortunately, no viral markers have been discovered, and blood products remain the major vehicle of transmission. The institution of infection control measures similar to those used to control hepatitis B has probably been effective in controlling the spread of this disease. It is hoped that the discovery of the etiologic agent(s), with the eventual goal of screening blood products and the development of a vaccine, will lead to full control of this disorder.

Dialysis↗