Intrafamilial clustering of hepatitis A

The intrafamilial clustering of hepatitis A virus infections (HAV) in families with an index case of sporadic hepatitis A was studied. Four hundred and three family members (84.3%) of 113 children with acute hepatitis A admitted to the Paediatric Department of the West Attica Hospital were included in the study. Epidemiological data and serum samples were collected within 1 week after the patient's admittance to the hospital. Enzyme-immunoassays were used to detect recent or past HAV infections. The attack rate of HAV infections in susceptible family members was found to be similar in susceptible fathers (16.6%, 1/6), mothers (23.5%, 4/17) and siblings (18.1%, 37/204). The infected family members belonged to 22 families. The attack rate was found to be higher in families with a lower immunity level, while the social class was not found to play an important role. The administration of ISG prevented further spread of hepatitis A among those susceptible. Our data suggest that immunoglobulin for HAV prevention should be given not only to children but also to parents and other adult family members in areas with a low prevalence of anti-HAV among adults.