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Some observations on the ecology of infectious hepatitis.

Analysis of reported rates for infectious hepatitis in the USA and in New York State for the years 1954 through 1962 reveals an inverse relationship between incidence and population density in epidemic as well as inter-epidemic periods. Patterns of age-specific rates were also found to vary with population density, the fluctuations being much greater in rural than in urban areas. The gradual change of hepatitis from a predominantly childhood to an adult disease is noted in data from California.The observations based on data from the USA are compared with those for Denmark and contrasted with recently reported studies from eastern Europe. Such comparisons may prove of value in predicting patterns to be anticipated in areas where infectious hepatitis is currently in the early or pre-epidemic stage of its evolution as a public health problem.

Adolescent↗

Infectious hepatitis in urban India.

The paper is about infectious hepatitis in urban India. The discussion is on two case studies: one of Madras, and the other of Madurai: two major cities in the State of Tamilnadu, South India. The Madras study is on the temporal and spatial analysis of the distribution and diffusion of hepatitis during 1971-1978. The Madras study also relates age to incidence, the major conclusion being that children are more susceptible to hepatitis than elders. The diffusion of hepatitis is said to occur in a wave - like form, covering newer areas and intensifying in time in core areas. The Madurai study is about the epidemic of hepatitis during January-October of 1981. Relating incidence with share of slum population, and number of borewells in city localities, the study yields a positive relation between them with a correlation coefficient value of .7424 and .7812, respectively. General lack of environmental quality and use of contaminated water for domestic purposes appear to be causes of high incidence of infectious hepatitis.

Adolescent↗

[Experience in examining infectious hepatitis patients by using a viral detection method].

Immune electron microscopy was shown to be an acceptable diagnostic method which allowed to detect hepatitis A virus particles in the stools of patients with infectious hepatitis even at the late stages of the disease. The examination of stools from 225 children (aged 2--17 years) hospitalized with diagnosed infectious hepatitis during the period of a seasonal rise in morbidity rate yielded positive findings at an average rate of 10.5%. This rate also depended on the severity of the disease and the patient's age. The results obtained indicated that patients with infectious hepatitis could shed the virus for a long time (about 2 weeks) after the onset of the disease. Patients with the atypical, or anicteric, form of the disease could be equally considered a source of virus shedding. The prolonged excretion of viral particles did not correlate with delayed IgM response. The particles identified as hepatitis A virus seemed to be antigenically very close, if not identical, to the virus circulating in some other countries (USA, Australia, West Germany).

Adolescent↗

[Seroepidemiology of acute infectious hepatitis (author's transl)].

Hbs-Ag, anti-Hbs, anti-Hbc and anti-HA were determined and the concentration of IgM measured in the sera of cases of acute infectious hepatitis which occurred in the Hannover area in 1975. Although there was a high degree of contamination with hepatitis A virus among the population, acute infectious hepatitis A was rare (n = 56). The hepatitis A virus is principally transmitted by contact with infection or while traveling in southern Europe. The greatest part of infectious hepatitis is due to hepatitis virus B (n = 211). Non-A, non-B hepatitis was less frequently observed (n = 62). A high percentage of patients with serum hepatitis and non-A, non-B hepatitis gave a history of parenteral exposure to possibly infectious material.

Acute Disease↗

Effectiveness of immune globulins in preventing infectious hepatitis and hepatitis A: a systematic review.

OBJECTIVE: To assess the effectiveness and safety of immune globulins in preventing infectious hepatitis and hepatitis A. STUDY DESIGN: Systematic review with meta-analysis. DATA SOURCES: We searched the Cochrane Library, MEDLINE, EMBASE, Biological Abstracts and Science Citation Index to December 2002. Vaccine manufacturers were contacted for additional data. REVIEW METHODS: We included randomised controlled trials comparing effectiveness of hepatitis A immune globulins with no intervention or placebo, and carried out a meta-analysis. RESULTS: We included six studies (two in Russian). Tested immune globulins show higher effectiveness than placebo or do-nothing against infectious hepatitis both in primary prevention and in prevention after exposure (effectiveness 83%; RR: 0.17; 95% CI: 0.15-0.19; and effectiveness 69%; RR: 0.31; 95% CI: 0.20-0.47, respectively). We found considerable heterogeneity among studies, possibly due to different methodology, background rates of disease and immune globulins dosage and concentrations. No safety data were reported in the studies. CONCLUSIONS: Immune globulins are efficacious in preventing infectious hepatitis and hepatitis A, but included studies do not report data about their safety. Average length of passive protection was three months. Given the notable heterogeneity of performance of immune globulins, short protection conferred and absence of trial safety data, the only indications for the use of immune globulins may be in situations in which inadequate supplies of vaccine are available or when the eight-day window of opportunity for vaccine use is past.

Chi-Square Distribution↗

Encephalitis following vaccination against distemper and infectious hepatitis in the dog. An optical and ultrastructural study.

A 4-month-old, male, healthy dog developed CNS-symptoms 10 days after the second vaccination with live, attenuated distemper and canine hepatitis virus. The animal was euthanized after 2 weeks of illness. Light and electron microscopic examination of the CNS showed a partly necrotizing encephalomyelitis with numberous intranuclear and intracytoplasmic inclusion bodies, and the presence of probable pseudomyxovirus nucleocapsids and of crystalloid and tubuloreticular aggregates. Although there was conformity of inclusion bodies and probable viral structures as revealed by electron microscopy, the latter showed a much wider distribution. In addition, viral structures of a different type were found in polymorphonuclear leukocytes and vascular endothelial cells. Several morphological criteria led to the supposition that they are Picornaviruses, or possibly Arenaviruses. It is thought that their role in the disease process was at best an indirect one.

Animals↗