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Lawrence S. Friedman, MD; Thomas F. O'Brien, MD; Leonard J. Morse, MD; Lennig W. Chang, MD; Warren E. C. Wacker, MD; Diane M. Ryan; Jules L. Dienstag, MD

JAMA. 1985;254(6):774-776.

Abstract
Clinical and biochemical data collected during the Holy Cross College football team hepatitis A outbreak in 1969 suggested that 32 team members had icteric hepatitis, 58 had anicteric illness, and only seven were not infected. Using a currently available radioimmunoassay, we tested stored serum samples obtained during the outbreak for IgM antibody to hepatitis A virus (IgM anti-HAV). Only individuals with icteric hepatitis were found to have IgM anti-HAV in serum; those with presumed anicteric illness were shown not to be infected with hepatitis A virus. The attack rate was thus only 34%, not 93% as originally reported, and the incidence of icteric illness in those infected was 100%, not 33%. This serological analysis of a classic outbreak of hepatitis A illustrates the utility and importance of IgM anti-HAV testing in seroepidemiologic investigations of hepatitis outbreaks.

(JAMA 1985;254:774-776)

Author Affiliations
From the Gastrointestinal Unit (Medical Services), Massachusetts General Hospital (Drs Friedman and Dienstag and Ms Ryan), the Division of Infectious Diseases, Brigham and Women's Hospital (Drs O'Brien and Chang), and the Department of Medicine, Harvard Medical School (Drs Friedman, O'Brien, Chang, Wacker, and Dienstag and Ms Ryan), Boston; and the Department of Public Health, Worcester, Mass (Dr Morse).

Footnotes
Reprint requests to the Division of Gastroenterology and Hepatology, Department of Medicine, Jefferson Medical College, 1025 Walnut St, Philadelphia, PA 19107 (Dr Friedman).

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