Hepatitis B virus transmission in an elementary school setting.

CONTEXT The risk of transmission of hepatitis B virus (HBV) in day care centers and schools is low. OBJECTIVE To investigate the source of HBV transmission for an elementary school teacher with acute hepatitis B. DESIGN Serologic survey for HBV infection among elementary school students, school staff, and household members of an HBV-infected teacher and student. SETTING General community and elementary school. PATIENTS Elementary school students and staff members and household members of an HBV-infected teacher. MAIN OUTCOME MEASURES Elementary school students, school staff, and household members of an HBV-infected teacher were tested for markers of HBV infection. Samples positive for hepatitis B surface antigen (HBsAg) were tested for HBsAg subtype using monoclonal antibodies and examined for HBV DNA homology by polymerase chain reaction techniques. RESULTS An HBV-infected student and the teacher were found to have the same HBV subtype (ayw1-2) and to have identical HBV DNA sequences. The teacher reported none of the usual risk factors for acquiring HBV infection, and none of her family members had been infected prior to her illness. The specific means of HBV transmission from student to teacher was not identified. Of 108 total children in the same grade as the HBV-infected student, 102 (94%) were tested for serologic markers of HBV infection, and none was positive. CONCLUSIONS This investigation documented transmission from an HBV-infected student to a teacher in an elementary school setting without a reported overt percutaneous or permucosal exposure to blood or infectious body fluids. Transmission of HBV to other students or staff members in the school was not observed.

[1]  S. Solomon,et al.  Risk of infection with hepatitis A, B or C, cytomegalovirus, varicella or measles among child care providers. , 1996, The Pediatric infectious disease journal.

[2]  D. Isaacs,et al.  Molecular evidence of transmission of hepatitis B in a day-care centre , 1996, The Lancet.

[3]  J. Boase,et al.  Surveillance for transmission of hepatitis B in child day care. , 1994, Pediatrics.

[4]  D. Nalin,et al.  Hepatitis infections in the day-care setting. , 1994, Pediatrics.

[5]  R. Repp,et al.  Risk of hepatitis B virus transmission in school , 1994, The Lancet.

[6]  C. Deseda,et al.  Hepatitis B virus transmission between a child and staff member at a day-care center. , 1994, The Pediatric infectious disease journal.

[7]  Alter Mj,et al.  The epidemiology of viral hepatitis in the United States. , 1994 .

[8]  H. Margolis,et al.  Hepatitis B virus infection in Honolulu students. , 1993, Pediatrics.

[9]  P. Swenson,et al.  Determination of HBsAg subtypes in different high risk populations using monoclonal antibodies. , 1991, Journal of virological methods.

[10]  M. E. Levy,et al.  Hepatitis B virus transmission between children in day care , 1989, The Pediatric infectious disease journal.

[11]  G. Taliani,et al.  NURSERY-ACQUIRED ASYMPTOMATIC B HEPATITIS , 1989, The Lancet.

[12]  H. Nomura,et al.  Hepatitis B virus transmission in nursery schools. , 1987, American journal of epidemiology.

[13]  R. Sampliner,et al.  Hepatitis B infection in households of chronic carriers of hepatitis B surface antigen: factors associated with prevalence of infection. , 1982, American journal of epidemiology.

[14]  D. Francis,et al.  Transmission of Hepatitis B Virus , 1981, Seminars in liver disease.

[15]  J. Oleske,et al.  Transmission of hepatitis B in a classroom setting. , 1980, The Journal of pediatrics.

[16]  K. Goel,et al.  Hepatitis B in the school environment. , 1978, British medical journal.

[17]  R. Purcell,et al.  Transmission of hepatitis B to chimpanzees by hepatitis B surface antigen-positive saliva and semen , 1977, Infection and immunity.

[18]  W. Szmuness,et al.  Intrafamilial spread of asymptomatic hepatitis B. , 1975, The American journal of the medical sciences.

[19]  J. Maynard,et al.  Epidemic hepatitis in a clinical laboratory. Possible association with computer card handling. , 1974, JAMA.

[20]  W. Bancroft,et al.  Transmission of hepatitis B virus to gibbons by exposure to human saliva containing hepatitis B surface antigen. , 1977, The Journal of infectious diseases.