Posttransfusion hepatitis A in a neonatal intensive care unit

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health

Background:

• Hepatitis A virus (HAV) poses a significant public health risk.
• Blood transfusions are a potential route for infectious disease transmission.
• Neonatal intensive care units (NICUs) present unique challenges for infection control.

Purpose of the Study:

• To investigate a large multistate outbreak of hepatitis A linked to a blood transfusion.
• To identify transmission routes and risk factors for hepatitis A infection in a healthcare setting.
• To assess the role of NICUs in the amplification of hepatitis A outbreaks.

Main Methods:

• Case investigation and contact tracing.
• Epidemiological analysis of outbreak data.
• Assessment of attack rates among healthcare workers and family contacts.

Main Results:

• A single infected blood unit led to 55 hepatitis A cases, including symptomatic adults and asymptomatic neonates.
• Secondary transmission occurred among healthcare professionals (nurses, physicians) and family members.
• The attack rate was 16% in susceptible nurses, 4% in susceptible physicians, and 25% in family contacts.

Conclusions:

• Blood transfusions can initiate large hepatitis A outbreaks.
• NICUs facilitate rapid transmission of hepatitis A to vulnerable populations and staff.
• Enhanced screening and infection control measures are crucial to prevent transfusion-associated hepatitis A.