title: [Hepatitis B infection: studies on endemic disease in the closed ward of a psychiatric hospital].
abstract: Following the occurrence of 3 cases of icteric hepatitis in the period August 1980 to January 1981 in a closed male ward for mentally retarded patients in a psychiatric institution, the present study was undertaken to determine the type, investigate the source and reconstruct the sequence of viral infection, and to make recommendations for its containment. For this purpose, serologic markers for HAV and HBV (including anti HBcIgM) were determined and serum transaminase (AST) measured in March 1981 in all 24 patients (mean age 40) and in the 39 members of the medical, nursing and housekeeping staff (mean age 39). Subsequently, HAV and HBV serologies were repeated after 6 and 9 months respectively. The propositus (B.F.) and the two subsequent cases with overt hepatitis (F.P. and K.E.) showed the serologic constellation of positive HBs, HBe and anti HBcIgM, together with elevated AST levels (600, 800 and 200 I.U. respectively) at the time of clinical illness, consistent with an acute HBV infection. Since 7 (18%) among the staff members were immune to HBV (positive anti HBs and anti HBc) and the remainder sero-negative; the remaining 6, however, showed evidence of active viral replication (S. P. and K. E.), viral infection (F. P. and J. L.) or incomplete immune response (B.F. and G.H.). During the 9 months' follow-up their serologic status did not change, with the exception of 2 (F.P. and B.F.), in whom HBs disappeared. The incidence of anti HAV in patients was 42% and in the staff 44%.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis; D001219:Aspartate Aminotransferases / Q000032:analysis; D004812:Epidemiologic Methods; D006509:Hepatitis B / Q000453:epidemiology*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006507:Hepatovirus / Q000276:immunology; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000009:adverse effects; D011863:Radioimmunoassay; D013557:Switzerland
chemical_list: D000914:Antibodies, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D011619:Psychotropic Drugs; D001219:Aspartate Aminotransferases
vernacular_title: Hepatitis-B-Infektion: Untersuchungen zu einer "Endemie" in der geschlossenen Abteilung einer psychiatrischen Klinik.