title: DNA single strand conformation polymorphism identifies five defined strains of hepatitis B virus (HBV) during an outbreak of HBV infection in an oncology unit.
abstract: An outbreak of hepatitis B virus (HBV) infection in a children's oncology unit was identified in which 61 children were shown to have been infected, 59 of them asymptomatically. In order to establish whether intra-unit cross infection had occurred, we used the single strand conformational polymorphism (SSCP) technique to analyse viral isolates from 57 of the infected children and 40 unrelated controls. HBV-specific primers were designed to amplify a 189 bp fragment of DNA encompassing part of the hypervariable pre-S1 region of the HBV genome. Denatured PCR products were compared after electrophoresis through polyacrylamide gels and staining with silver. By SSCP analysis, the unrelated infections each yielded a unique electrophoretic banding pattern, indicative of a variety of distinct virus strains. In contrast, most of the oncology patients had been infected with one of only five different strains. Three major groups comprising 19, 16, and 9 patients, respectively, and two minor groups of 5 and 3 patients were identified. Results indicate the occurrence of multiple episodes of cross infection, and demonstrate the sensitivity and value of SSCP as a technique to establish common sources of infection.
authors.affiliation: Department of Medical Microbiology, University of Cape Town Medical School, Observatory, South Africa.
authors.forename: D R
authors.initials: DR
authors.lastname: Hardie
authors.forename: J
authors.initials: J
authors.lastname: Kannemeyer
authors.forename: L M
authors.initials: LM
authors.lastname: Stannard
mesh_terms: D001483:Base Sequence; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D017931:DNA Primers; D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks; D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D006514:Hepatitis B Surface Antigens / Q000097:blood / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D008969:Molecular Sequence Data; D016522:Oncology Service, Hospital; D016133:Polymerase Chain Reaction; D018807:Polymorphism, Single-Stranded Conformational; D011498:Protein Precursors / Q000235:genetics; D014759:Viral Envelope Proteins / Q000235:genetics
chemical_list: D017931:DNA Primers; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D011498:Protein Precursors; D014759:Viral Envelope Proteins; C050806:presurface protein 1, hepatitis B surface antigen