Dialysis-associated hepatitis in Edinburgh; 1969-1978.

In 1969-1970 there was a sharp outbreak of hepatitis associated with hemodialysis in two Edinburgh hospitals; mortality was 24% among renal patients and 31% in staff members. The epidemiology of the outbreak, the measures taken to control it, and the efforts made to exclude hepatitis B virus infections during an eight-year period after the outbreak, were reviewed in the light of a retesting of stored specimens by modern diagnostic techniques for hepatitis A and B viruses. This review reveals that the outbreak involved some dual infections with both hepatitis B and non-A, non-B hepatitis viruses and that the occurrence of two infections at once was probably related to the exceptional virulence of the outbreak. The review also reaffirms that the routine serotesting of renal patients and staff members and the dialysis of infected patients in a geographically separate isolation facility are effective methods of controlling the spread of hepatitis B virus in hemodialysis units.