Epidemic hepatitis B: a sustained outbreak in a large military population

A sustained outbreak of viral hepatitis occurred at an Army base in Texas between January 1971 and June 1973. Seven hundred ninety-two admissions but no deaths were recorded in a military population of 35,000. Cases were sporadic, with highest attack rates in low-ranking soldiers with disciplinary problems. Twenty-nine per cent of patients had histories of intravenous drug use within six months prior to hospitalization; most of the rest had close personal contact with jaundiced persons. Of 505 patients tested, 31% were seropositive for hepatitis B antigen (HBSAg) by counterelectrophoresis. Comparison of 38 hepatitis patients (cases) to 34 orthopedic patients (controls) revealed marked differences in rates of exposure to jaundiced persons are shared needles. Sixteen (94%) of 17 antigenemic cases tested were of subtype ayw. Seven (78%) of nine NBSAg-negative cases tested were antibody (anti-HBS) positive three months later.