Posttransfusion hepatitis A in a neonatal intensive care unit
R. C. Noble, M. A. Kane, S. A. Reeves and I. Roeckel
A single unit of infected blood transfused into 11 neonates resulted in a
large multistate outbreak of 55 cases of hepatitis A, 35 of which were
symptomatic. The person who donated the blood to the 11 neonates became ill
with hepatitis A one week after the donation. Hepatitis A infection was
then acquired by nurses and physicians having direct contact with the
neonates and by parents and relatives. Three additional newborns who had
not received transfusions with the infected unit also acquired hepatitis A.
The neonates with hepatitis A were all asymptomatic. The attack rate in
susceptible nurses was 16%; in susceptible physicians, 4%. A survey of the
relatives of the 11 newborns who received transfusions revealed eight
symptomatic cases of hepatitis A in 32 immediate family contacts, ie,
mother, father, and siblings, with a resulting attack rate of 25%
uncorrected for prior immunity. The setting of the neonatal intensive care
unit appears to be ideal for the transmission of hepatitis A.
