Hepatitis B outbreak in a state correctional facility, 2000

On March 31, 2000, acute hepatitis B was confirmed serologically in a 34-year-old man (index patient) who had been incarcerated for 2.5 years at a high-security state correctional facility and who presented to the facility medical unit with jaundice and abnormal liver enzymes. He reported having unprotected sex with his cellmate as his only risk factor for infection during the 6 months preceding his illness. Serologic testing of the 21-year-old cellmate confirmed that he had chronic hepatitis B virus (HBV) infection. He reported no history of symptoms compatible with hepatitis and was previously unaware of his chronic infection, but he did report having unprotected sex with the index patient and two additional inmates in the dormitory (dorm Y). On May 15, 2000, the state's department of health and department of corrections and CDC initiated an investigation to identify additional cases and determine risk factors for HBV infection. This report summarizes the results of the investigation, which identified additional cases of HBV infection in this correctional facility and underscores the need to implement hepatitis B vaccination in correctional facilities.