Moeschlin P, Grob P J, Joller-Jemelka H I
Schweiz Med Wochenschr. 1975 Oct 11;105(41):1307-14.
357 cases of acute hepatitis occurring in 1974 in two distinct areas of Eastern Switzerland have been analyzed. The incidence of hepatitis was 54,8 per 100 000 per year in an urban region (Winterthur, pop approx. 95 000) and 33,7 per 100 000 per year in a rural area (St. Galler-Oberland, pop 47 000). These figures are three to four times higher than those reported by the public health authorities. More than 50% of the hepatitis patients were 16-30 years old and only 3% were children below 15 years of age. Males were slightly in excess. HBSAg (Hepatis Bsurface-Antigen) was detectable by radioimmunoassay in 49% and anti-HBS alone in 8% of all patients. According to a careful anamnestic survey the mode of transmission was thought to be parenteral in 137 (39%) of the patients (68% of these being HBSAg positive), enteral in 131 (38%) (38% of these being HBSAg positive), while no anamnestic clue was found in the remaining patients (23% with 39% HBSAg positives). In 12% of the hepatitis cases, contact with other diseased individuals at the relevant time was recorded; however, no clusters of more than 2 patients occurred within the study area. The results are discussed in regard to other studies concerning hepatitis epidemiology in Switzerland. In an additional survey the medical staff of several laboratories have been repeatedly tested for HBSAg and anti-HBS at intervals of one to three months. Transitory antigenemia (up to 55% positive in one laboratory with only one hepatitis case), and transitory high incidences of anti HBS (up to 40% in one laboratory) suggest epidemic spread of hepatitis B infection. From all available data it is estimated that the ratio of hepatitis B infection to overt disease varies between 1:1 and 23:1 depending on the epidemiological situation.
对1974年在瑞士东部两个不同地区发生的357例急性肝炎病例进行了分析。在一个城市地区（温特图尔，人口约95000），肝炎发病率为每年每10万人54.8例；在一个农村地区（圣加仑上州，人口47000），发病率为每年每10万人33.7例。这些数字比公共卫生当局报告的数字高三到四倍。超过50%的肝炎患者年龄在16至30岁之间，只有3%为15岁以下儿童。男性略多。通过放射免疫测定法，在所有患者中，49%可检测到乙肝表面抗原（HBSAg），仅8%可检测到单独的抗-HBS。根据详细的病史调查，137例（39%）患者的传播方式被认为是肠道外传播（其中68%为HBSAg阳性），131例（38%）为肠道传播（其中38%为HBSAg阳性），而其余患者（23%，其中39%为HBSAg阳性）未发现病史线索。在12%的肝炎病例中，记录到在相关时间与其他患病个体有接触；然而，在研究区域内未出现超过2例患者的聚集情况。结合瑞士其他关于肝炎流行病学的研究对结果进行了讨论。在另一项调查中，几个实验室的医务人员每隔一到三个月反复进行HBSAg和抗-HBS检测。短暂性抗原血症（在一个仅有1例肝炎病例的实验室中阳性率高达55%）以及抗-HBS的短暂高发病率（在一个实验室中高达40%）表明乙肝感染呈流行传播。根据所有现有数据估计，乙肝感染与显性疾病的比例在1:1至23:1之间，具体取决于流行病学情况。
