PEDIATRICS Vol. 67 No. 4 April 1981, pp. 494-497
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Hospital-Acquired Hepatitis A: Report of an Outbreak

Walter A. Orenstein MD1, Earnest Wu MD1, Jeanette Wilkins MD1, Karen Robinson MD1, Donald P. Francis MD1, Nikke Timko MD1, and Ronald Wayne MD1

1 Los Angeles County-University of Southern California Medical Center, Los Angeles; Field Services Division, Bureau of Epidemiology, Center for Disease Control, Atlanta; and Hepatitis Laboratory Division, Bureau of Epidemiology, Center for Disease Control, Phoenix, Arizona

A nosocomial outbreak of hepatitis A occurred after hospitalization of a 21-month-old girl with amebic liver abscess and unsuspected, anicteric hepatitis A. The index patient, who had an acute diarrheal illness prior to enzyme elevations, seroconverted from IgM hepatitis A antibody to IgG hepatitis A antibody. Of the 103 hospital personnel with known or potential exposure, three physicians (2.9%) contracted clinical hepatitis A, 27 to 29 days after their initial contact with the source patient. A fourth physician developed subclinical infection. Two of the three clinical cases occurred in two of the three primary care physicians of the source patient. Hepatitis A should be considered in any patient with acute, unexplained liver enzyme abnormalities. Diarrhea occurring in a fecally incontinent child incubating hepatitis A may increase the risk of transmission.

Submitted on April 21, 1980
Accepted on July 14, 1980