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Nursery-associated hepatitis A traced to a male nurse
Insights
A nursery outbreak of hepatitis A (HA) revealed silently infected children transmitted the virus to adults. The epidemic was controlled with human gamma globulin, except for two cases.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Nursery-associated outbreaks of hepatitis A (HA) can occur.
- Asymptomatic or silently infected individuals can play a role in disease transmission.
- Identifying transmission routes is crucial for outbreak control.
Purpose of the Study:
- To investigate a nursery-associated hepatitis A outbreak.
- To understand the role of silently infected children in transmission.
- To evaluate the effectiveness of control measures.
Main Methods:
- Epidemiological investigation of a hepatitis A outbreak in a nursery setting.
- Contact tracing to identify infected individuals and transmission chains.
- Administration of human gamma globulin for prophylaxis.
Main Results:
- A male nurse transmitted HA to four children before symptom onset.
- Two of these children subsequently infected their parents.
- The outbreak was successfully terminated in most contacts following gamma globulin administration.
- Two breakthrough cases occurred despite prophylaxis.
Conclusions:
- Silently infected children can be significant vectors in nursery-associated hepatitis A outbreaks.
- Human gamma globulin is an effective measure for controlling hepatitis A transmission in nursery settings.
- Vigilance is required to identify and manage potential breakthrough cases.
Abstract:
A small epidemic of nursery-associated hepatitis A (HA), in which silently infected children played a cryptic role in transmitting the illness to adult contacts, was investigated. It was found that a male nurse had transmitted HA to four children before he fell ill. He was not heard from for about two months as he was a part-time worker and was admitted to a local hospital in another prefecture. Two of the four silently infected children transmitted HA to their parents who then revealed the presence of nursery-associated HA. The epidemic was terminated by injection of human gamma globulin to nursery children and to antibody-negative parents, nursery staff and other contacts except for two breakthrough cases.