Dialysis-associated hepatitis in Edinburgh; 1969-1978

Area of Science:

• Infectious Diseases
• Hepatology
• Epidemiology

Background:

• A severe hepatitis outbreak occurred in Edinburgh hemodialysis units in 1969-1970.
• High mortality rates were observed in both renal patients (24%) and staff (31%).

Purpose of the Study:

• To review the epidemiology and control measures of the outbreak.
• To re-evaluate infection control strategies using modern diagnostic techniques for hepatitis A and B viruses.

Main Methods:

• Retesting of stored patient and staff specimens using advanced diagnostic methods for hepatitis A and B viruses.
• Epidemiological analysis of the outbreak and subsequent control efforts over an eight-year period.

Main Results:

• The outbreak involved dual infections with hepatitis B and non-A, non-B hepatitis viruses.
• Dual infections were likely linked to the outbreak's high virulence.
• Routine serotesting and isolated dialysis facilities proved effective in controlling hepatitis B spread.

Conclusions:

• Strict serological screening of patients and staff is crucial for preventing hepatitis B transmission in hemodialysis settings.
• Geographically separate isolation facilities for infected patients are effective control measures.
• Modern diagnostics aid in understanding complex viral outbreaks and validating control strategies.