Seeff L B, Beebe G W, Hoofnagle J H, Norman J E, Buskell-Bales Z, Waggoner J G, Kaplowitz N, Koff R S, Petrini J L, Schiff E R
N Engl J Med. 1987 Apr 16;316(16):965-70. doi: 10.1056/NEJM198704163161601.
An epidemic of icteric hepatitis in 1942 affected approximately 50,000 U.S. Army personnel. This outbreak was linked to specific lots of yellow-fever vaccine stabilized with human serum. To identify the responsible virus and the consequences of the epidemic, during 1985 we interviewed and serologically screened 597 veterans who had been in the army in 1942. These subjects were selected from three groups. Group I consisted of patients who had received the implicated vaccine and had jaundice; Group II had received the implicated vaccine but remained well; Group III had received a new, serum-free vaccine, with no subsequent jaundice. Ninety-seven percent of Group I, 76 percent of Group II, and 13 percent of Group III were positive for antibodies to hepatitis B virus. Only one subject had hepatitis B surface antigen, for a carrier rate of 0.26 percent among recipients of the implicated vaccine. The prevalence of hepatitis A antibody was similar in all three groups, and no subject had antibody to hepatitis delta virus. We conclude that hepatitis B caused the outbreak, that about 330,000 persons may have been infected, that the hepatitis B virus carrier state was a rare consequence, and that the outbreak induced hepatitis B antibodies that appear to persist for life.
1942年，一场黄疸型肝炎疫情影响了约5万名美国陆军人员。此次疫情与用人类血清稳定化的特定批次黄热病疫苗有关。为了确定致病病毒及疫情后果，1985年我们对1942年时在军队服役的597名退伍军人进行了访谈并进行血清学筛查。这些受试者选自三个组。第一组由接种了相关疫苗且出现黄疸的患者组成；第二组接种了相关疫苗但未发病；第三组接种了一种新的无血清疫苗，之后未出现黄疸。第一组97%、第二组76%、第三组13%的人乙肝病毒抗体呈阳性。只有一名受试者有乙肝表面抗原，在接种相关疫苗者中的携带率为0.26%。三组甲型肝炎抗体的流行率相似，且没有受试者有丁型肝炎病毒抗体。我们得出结论，乙肝导致了此次疫情，约33万人可能受到感染，乙肝病毒携带状态是一种罕见后果，且此次疫情诱导产生的乙肝抗体似乎会终生持续存在。
