No abstract

The intrafamilial clustering of hepatitis A virus infections (HAV) in families with an index case of sporadic hepatitis A was studied. Four hundred and three family members (84.3%) of 113 children with acute hepatitis A admitted to the Paediatric Department of the West Attica Hospital were included in the study. Epidemiological data and serum samples were collected within 1 week after the patient's admittance to the hospital. Enzyme-immunoassays were used to detect recent or past HAV infections. The attack rate of HAV infections in susceptible family members was found to be similar in susceptible fathers (16.6%, 1/6), mothers (23.5%, 4/17) and siblings (18.1%, 37/204). The infected family members belonged to 22 families. The attack rate was found to be higher in families with a lower immunity level, while the social class was not found to play an important role. The administration of ISG prevented further spread of hepatitis A among those susceptible. Our data suggest that immunoglobulin for HAV prevention should be given not only to children but also to parents and other adult family members in areas with a low prevalence of anti-HAV among adults.

No abstract

The first reported case of cephalosporium meningitis in a newborn infant is presented. The diagnosis was suspected by the morphological features of the yeast-like organisms on direct smears in two separate cerebrospinal fluid specimens and confirmed by two cerebrospinal fluid cultures. The outcome was entirely satisfactory. We consider it possible that recovery was spontaneous and that amphotericin B could be instrumental in the patient's recovery only if cephalosporia were present in foci other than the cerebrospinal fluid.

We would like to thank Dr. W. Hughes for his stimulating comment on our paper on "Cephalosporium Meningitis." It is true that the term "yeast-like" organisms was misleading, as the elements seen on the direct smear were not budding cells but elliptical spores. In our patient, as Dr. Hughes mentions, Candida albicans was isolated from the nose, throat, and rectal cultures but not from the Cerebrospinal fluid. We were led to believe cephalosporium was the etiologic agent of the disease in this baby because the same elliptical spores, distinct from C. albicans, have been isolated in two different CSF cultures taken with all possible precautions for accidental contamination.