DAVID R. SNYDMAN, M.D.; STEPHEN H. HINDMAN, M.D.; MICHELE D. WINELAND, B.A., R.N.; JOHN A. BRYAN, M.D.; JAMES E. MAYNARD, M.D., Ph.D.
In a 2-month period four cases of hepatitis B occurred in hospital staff. Three months later two patients, hospitalized for open-heart surgery when the staff members had been infected, developed acute hepatitis B. Sera from all six ill individuals were subtype ayw and e-determinant positive. Epidemiologic investigation showed that the four staff had been exposed 3 months earlier to an asymptomatic hepatitis B surface antigen-positive (HBsAg) patient who was also e positive. To determine transmission from staff to patients study of 17 open-heart surgery patients was undertaken. Four of 17 were either HBsAg or anti-HBs positive. No correlation between infection and contact with three of four ill staff members or receipt of blood products was noted; however, 22 (46%) of 48 arterial blood gas specimens had been obtained from infected patients by one staff member, an inhalation therapist; this compared with seven (4%) of 157 specimens she obtained from control subjects (P < 0.001). Furthermore, she handled indwelling arterial cannulae 25 (76%) of 33 times in infected patients compared with three (3%) of 95 times in control subjects (P < 0.001). Transmission may have occurred via the arterial cannulae from a severe exudative dermatitis on the therapist's hands.
SNYDMAN DR, HINDMAN SH, WINELAND MD, et al. Nosocomial Viral Hepatitis B: A Cluster among Staff with Subsequent Transmission to Patients. Ann Intern Med. 1976;85:573–577. doi: https://doi.org/10.7326/0003-4819-85-5-573
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Published: Ann Intern Med. 1976;85(5):573-577.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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