Horizontal Nonparenteral Spread of Hepatitis B Among Children

Abstract

Two families with an unusually high incidence of hepatitis B infection (15 or 21 persons) were investigated over an 18 mo. period. Serologic evidence of past or present infection hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) or antibody to hepatitis B core antigen (anti-HBc) was found in 11 of the 12 members of 1 family, 4 of whom were chronic HBsAg carriers and in 4 of 9 members of a contact family. Anti-HBc was the only serologic marker of infection in 5 persons. HLA typing failed to show an association between carriage of HBsAg and specific HLA markers. Chewing gum was a potential vehicle as HBsAg were detected in gum samples from 3 of 4 children who were chronic HBsAg carriers. Horizontal, nonparenteral transmission of hepatitis B virus probably accounted for the clustering of infection in these families, especially via the exchange among children of objects contaminated with oral secretions.