Follow-up of needlesticks in medical staff.

In an on-going study, 104 events of needlestick or contamination of apparent skin lesions were evaluated for the risk of hepatitis. Whenever possible, a blood sample of the 'donor' was screened for HBsAg as well as for elevated transaminases. Members of the staff were bled immediately after exposure and were followed up for 9 months. At present the follow-up is completed in twenty probands. - Hepatitis B immunoglobulin (= HBIG) was given in 51 cases. HBsAg was detected in 21 donors and strongly supposed in 27 cases. Only one nurse developed acute hepatitis B ten months after exposure to HBsAg-positive blood. 53 probands were exposed to HBsAg-negative blood. 32 persons received SIG. Only 5 'donors' were classified as probable Non-A, Non-B hepatitis which did not induce apparent infections in passively immunized persons. 23 persons did receive neither HBIG nor SIG. 2 persons had been exposed to HBsAg-positive blood by needlestick, still being without seroconversion. Passive immunization after needlestick should be performed after testing blood samples of donors and recipient. After exposure to non-A, non-B hepatitis, secondary infections did not appear in passively immunized persons.

Hepatitis markers in a psychiatric institution.

Hepatitis A and B markers were determined in 714 patients and in 291 members of the staff of a psychiatric institution for adults. The leading diagnosis were psychosis (71.8%), neurosis (17.7%), and oligophrenia (10.6%). Anti-HAV was found in 84.4% of the patients and in 69.2% of the staff. 26.8% of the patients and 19.9% of the staff had at least one HBV marker. The frequency of HBV markers correlated with the age of the patients but not with the duration of the hospitalization. After the exclusion of IgM-anti-HAV, IgM-anti-CMV and IgM-anti-EBV or possible toxic effects, 2.6% of all patients remained as presumable non-A, non-B hepatitis infections. In this study HBV markers were not found in an hyperendemic pattern reported previously in psychiatric institutions.

Non-A, non-B hepatitis in hemodialysis.

Episodes of presumable non-A, non-B hepatitis were determined among hemodialysis patients during a two year period as well as possible secondary infections in household contacts. We determined hepatitis A and B markers by commercial RIA kits, and IgM-anti-CMV and IgM-anti-EBV by ELISA techniques. 154 dialysis patients, 118 relatives of patients, and 42 members of the staff were included in the study. 71% of the center dialysis patients, 63% of the home dialysis patients, 50% of the staff, and 19% of the relatives were HBV marker positive. Spouses of patients more often had HBV markers than other relatives. Anti-HAV was highly prevalent both in center patients (98.8%) and in home dialysis patients (83.3%). The incidence of IgM-anti-CMV was marked in home dialysis patients (15.5%). During a two year period, 9% of all dialysis patients had an episode of presumable non-A, non-B hepatitis. As compared to previous data in the same dialysis centers, there is a change in the epidemiology of hepatitis.