Serological evidence of cross infection in a dialysis unit hepatitis-B epidemic

Serological evidence of cross infection in a dialysis unit hepatitis-B epidemic. This study provides serological as well as epidemiological evidence that a dialysis unit hepatitis-B epidemic was spread by cross contamination. There were 74 patients and staff who developed HB-Ag-positive hepatitis during a 28-month hospital surveillance period. Twenty-six of these cases were intimately related to the dialysis unit (21 dialysis/transplant patients and five hospital staff) and 58 were not. Representative sera from each group of cases were further tested for HB-Ag subtype specificity. Thirteen of 14 dialysis/transplant patients had subtype ay whereas ten of 15 general hospital patients had the alternate phenotype ad. All four staff who had probably acquired their infection from dialysis/transplant patients were ay subtype. Eight of the dialysis/transplant patients had never received blood. Transfusion rate in the infected dialysis patients was one-third that of leukemic patients but the hepatitis rate was higher.Preuve sérologique d'une contamination croisée dans une unité de dialyse par le virus B de l'hépatite. Ce travail apporte les preuves sérologiques et épidémiologiques de la contamination croisée d'une unité d'hémodialyse par le virus B de l'hépatite. Soixante-quatorze malades et membres de l'équipe ont développé une hépatite HB-Ag positive dans les 28 mois de la surveillance de l'hôpital. Vingt-six de ces cas ont été liés étroitement à la dialyse (21 malades de dialyse ou transplantation et 5 membres de l'équipe) et 58 ne l'étaient pas. Dans chaque groupe de cas le sérum a été étudié pour identifier les phénotypes de HB-Ag. Treize des 14 malades de dialyse ou transplantation avaient le phénotype ay alors que 10 parmi 15 des malades de l'hôpital général avaient l'autre phénotype ad. Les quatre membres de l'équipe qui avaient probablement contracté leur infection à partir de malades de transplantation ou de dialyse avaient le phénotype ay. Huit des malades de dialyse ou de transplantation n'avaient jamais reçu de sang. Le débit transfusions chez les malades en dialyse atteints par l'hépatite était le tiers de celui des malades leucémiques mais l'incidence de l'hépatite a été plus grande chez les premiers

Acute Hemorrhagic Conjunctivitis: Investigation of a Large-scale Community Outbreak in Dade County, Florida

An outbreak of acute hemorrhagic conjunctivitis (AHC) due to enterovirus type 70 occurred in Dade County, Florida, from September to December 1981. Younger age groups, members of larger households, and the poor were at significantly greater risk of acquiring AHC than others in the community. Schoolchildren were most likely to introduce AHC into the household. After exclusion of all affected children from school, there was a dramatic reduction in reported cases, with attack rates declining more rapidly for school-aged children than for other age groups. Although AHC spread readily among family members, a retrospective study of 124 affected households showed an association between lower attack rates and simple hygienic measures. Should outbreaks of AHC recur, measures to reduce transmission should include exclusion of affected schoolchildren and educating the public about hygienic precautions.(JAMA 1983;249:1283-1289