An outbreak of acute hepatitis B infection among injecting drug users in Inverclyde, Scotland.

This large outbreak of acute hepatitis B infection among injecting drug users (IDUs) was precipitated by an increase in injecting heroin use in Inverclyde in the West of Scotland, between 1997 and 1999. Ninety-two cases of hepatitis B infection in residents of Inverclyde were reported to Argyll and Clyde Health Board from January 1996 to December 1999. An investigation of risk factors found 87% (80/92) of the cases were IDUs, of whom four-fifths were men. Fifty six per cent of cases were aged 20-29 years old and 12% were aged 16-19 years old. Further investigations among this close community of young and relatively inexperienced IDUs revealed that many admitted to sharing injecting equipment particularly spoons, water and filters. Only a minority had been using local needle exchange facilities in the area. After public consultation a second needle exchange was opened in 1998 staffed by a dedicated needle exchange development worker who has continued to develop harm reduction services locally.