Nosocomial Viral Hepatitis B

Abstract

In 2-mo. 4 cases of hepatitis B occurred in hospital staff. Three months later 2 patients, hospitalized for open-heart surgery when the staff members had been infected, developed acute hepatitis B. Sera from all 6 ill individuals were subtype ayw and e-determinant positive. Epidemiologic investigation showed that the 4 staff had been exposed 3 mo. earlier to an asymptomatic hepatitis B surface antigen-positive (HBsAg) patient who was also e positive. To determine transmission from staff to patients, 17 open-heart surgery patients were studied. Four of 17 were HBsAg or anti-HBs positive. No correlation between infection and contact with 3 of 4 ill staff members of receipt of blood products was noted; 22 (46%) of 48 arterial blood gas specimens had been obtained from infected patients by 1 staff member, an inhalation therapist; this compared with 7 (4%) of 157 specimens she obtained from control subjects (P < 0.001). She handled indwelling arterial cannulae 25 (76%) of 33 times in infected patients compared with (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.