Mentally retarded hepatitis-B surface antigen carriers in NYC public school classes: a public health dilemma.

Abstract

The placement of retarded children who have been institutionalized and are asymptomatic hepatitis-B surface antigen carriers into public school classes for the retarded has caused controversy and presented the New York City Health Department with an unusual medical-ethical dilemma.In this situation, the cost of interfering with deinsti-

Homosexuality in Institutionalized Retardates

“…Although the movement is viewed as an important social advance, the occasional presence of hepatitis B carriers among such individuals has generated public h e a l t h c o n c e r n s , e s p e c i a l l y in schools. 1 It is well recognized that hepatitis B infection is unusually prevalent among institutionalized retardates and that carrier rates are high, especially among Down's syndrome subjects. 2 Congregate living, reduced personal hygiene, and behavioral aberrations such as biting and scratching are thought to enhance disease spread.…”

Management of the Hepatitis B Surface Antigen (HBsAg) Carrier

“…Mentally Retarded HBsAg Carriers in Public School Systems. Legislation and judicial decisions permitting the placement of formerly institutionalized mentally retarded children into public school classes for other mentally retarded children have created formidable potential health problems in the school room [4]. In the first place, it is clear that a number of HBsAg carriers are present in these deinstitutionalized populations because the prevalence of the carrier state is usually increased in large institutions for the mentally retarded.…”

“…The return of the carriers to mixed classrooms coupled with the enormous difficulties in altering classroom behavior may yet result in HBV transmission to susceptible children, teachers, aides, and their families. If continuing surveillance does indicate the health problem anticipated, a return to the courts is likely [4]. While a hepatitis B vaccine would be extremely useful in this setting, HBIG administration to all susceptibles would entail heavy costs and logistic problems.…”

Hepatitis B virus transmission in a public school: effects of mentally retarded HBsAG carrier students.

“…Public school officials have been especially concerned because their programs may allow for close personal interaction between students and staff. [2][3][4][5] Since 1980, we have prospectively studied HBV transmission in two schools that have integrated carrier mentally retarded students into their educational programs. After a 14-month period of study, we reported a 1.8 percent incidence of HBV acquisition among peer students and no occurrence of hepatitis B infection among school staff.6 Now, 3.5 years since the project began, we report the final results of this study.…”