Document 0299
 DOCN  M95A0299
 TI    Nosocomial transmission of hepatitis A in a pediatric hospital traced to
       an anti-hepatitis A virus-negative patient with immunodeficiency.
 DT    9510
 AU    Burkholder BT; Coronado VG; Brown J; Hutto JH; Shapiro CN; Robertson B;
       Woodruff BA; Hepatitis Branch, Centers for Disease Control and
       Prevention,; Atlanta, GA 30333, USA.
 SO    Pediatr Infect Dis J. 1995 Apr;14(4):261-6. Unique Identifier : AIDSLINE
       MED/95327440
 AB    From July through October 1991, an outbreak of hepatitis A virus (HAV)
       infection involving 26 hospital staff, inpatients and household contacts
       occurred in a pediatric hospital. All ill staff members had cared for
       one inpatient who had profuse diarrhea with gross fecal contamination of
       the environment, negative HAV serology and idiopathic immunodeficiency.
       HAV infection in this patient was later confirmed by polymerase chain
       reaction. Among hospital staff HAV attack rates were highest in nursing
       personnel (15%). A retrospective cohort study of nurses found that the
       risk of infection was greatest in those who handled the source patient's
       soiled bed pad (relative risk, 6.7; 95% confidence intervals, 1.6,
       27.8), diaper (relative risk, 5.4; 95% confidence intervals, 0.8, 39.2)
       or gown (relative risk, 2.9; 95% confidence intervals, 1.1, 7.8). Glove
       use during these activities was not associated with a lower risk of
       infection, possibly because of gross environmental contamination or less
       use than reported. This situation was unusual because the patient was
       HAV-infected but had negative serology, probably because of
       immunodeficiency. In situations of potentially extensive environmental
       contamination, such as with a diapered or incontinent patient with
       suspected or confirmed hepatitis A, careful attention to frequent
       handwashing is an essential protective measure; in addition strict glove
       use whenever entering the patient's room should be followed to provide
       additional protection.
 DE    Adult  Cohort Studies  Confidence Intervals  Contact Tracing  Cross
       Infection/DIAGNOSIS/EPIDEMIOLOGY/*IMMUNOLOGY/TRANSMISSION
       Feces/MICROBIOLOGY  Female  Hepatitis
       A/DIAGNOSIS/EPIDEMIOLOGY/*IMMUNOLOGY/TRANSMISSION  Hepatitis
       Antibodies/*BLOOD  Hospitals, Pediatric  Human  IgM/BLOOD
       Immunocompromised Host/*IMMUNOLOGY  Incidence  Infant  Male  Middle Age
       Polymerase Chain Reaction  Retrospective Studies  Risk Factors
       Serodiagnosis  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).