Orenstein W A, Wu E, Wilkins J, Robinson K, Francis D P, Timko N, Wayne R
Pediatrics. 1981 Apr;67(4):494-7.
A nosocomial outbreak of hepatitis A occurred after hospitalization of a 21-month-old girl with amebic liver abscess and unsuspected, anicteric hepatitis A. The index patient, who had an acute diarrheal illness prior to enzyme elevations, seroconverted from IgM hepatitis A antibody to IgG hepatitis A antibody. Of the 103 hospital personnel with known or potential exposure, three physicians (2.9%) contracted clinical hepatitis A, 27 to 29 days after their initial contact with the source patient. A fourth physician developed subclinical infection. Two of the three clinical cases occurred in two of the three primary care physicians of the source patient. Hepatitis A should be considered in any patient with acute, unexplained liver enzyme abnormalities. Diarrhea occurring in a fecally incontinent child incubating hepatitis A may increase the risk of transmission.
一名21个月大的女童因阿米巴肝脓肿住院，同时患有未被怀疑的无黄疸型甲型肝炎，之后发生了甲型肝炎的医院内暴发。首例患者在酶升高之前患有急性腹泻病，其甲型肝炎抗体从IgM转换为IgG。在103名已知或可能接触过的医院工作人员中，三名医生（2.9%）在首次接触源患者27至29天后感染了临床型甲型肝炎。第四名医生发生了亚临床感染。三例临床病例中有两例发生在源患者的三名初级保健医生中的两名身上。任何出现急性、不明原因肝酶异常的患者都应考虑甲型肝炎。在感染甲型肝炎的粪便失禁儿童中发生腹泻可能会增加传播风险。
