Epidemic Hepatitis B: A Sustained Outbreak in a Large Military Population

Abstract

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.

Molecular evolution and genomics of hepatitis B virus subgenotype C2 strain predominant in the chronic patients in Bangladesh

“…The similar tendency of evolution of C, S and X genes of that strain again support the fact of HBV evolution describe above. Furthermore, investigating the history of HBV outbreaks at the end of twentieth century may confirm the possible evolutions of HBV at that time as suggested in this study [1,5]. Furthermore, Bayesian skyline analysis of C and X genes of HBV revealed a sudden decrease in genetic diversity from early twenty-first century, which may be due to the initiation of mass HBV vaccinations in the world.…”

Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia

“…During World War II, a notable epidemic of hepatitis B occurred in the United States (US) Army which was linked to yellow fever vaccine containing HBV contaminated human serum (8). Another hepatitis outbreak in the US Army took place between 1971 and 1973 among US military personnel in Fort Hood, Texas, mainly linked to intravenous drug use (IVDU) (10). Sporadic epidemic of HBV infection linked to vaccinations against smallpox and tetanus, typhus and paratyphus A/B (TABT) have been reported in the UK Royal Air Force as well (9).…”

Persistence of antibody to hepatitis B surface antigen

“…None of these Present address: Letterman Army Institute of Research, Presidio, San Francisco, Calif. 94129. persons was ill with hepatitis. Ninety-five percent of clinical hepatitis B cases at Fort Hood were of subtype ayw (1); however, only eight of the 30 soldiers with HB,Ag detected in prevalence surveys had HB,Ag/ayw. Five-hundred twenty-three individuals of 3,335 tested during the prevalence surveys were found to have anti-HB, by the passive hemagglutination (PHA) test.…”

“…In this study, we followed a group of military personnel over a 1-year period to determine the persistence of anti-HB, with specificities for a, y, and d antigens of HB,Ag. The military personnel had been shown to have anti-HB, during an investigation of a hepatitis B outbreak (1).…”

“…Initial sera were obtained from a cohort of Army personnel and civilian employees at Fort Hood, Tex. during a study of the prevalence of HB,Ag and anti-HB, at the time of a hepatitis B outbreak in early 1973 (1). None of these Present address: Letterman Army Institute of Research, Presidio, San Francisco, Calif. 94129. persons was ill with hepatitis.…”