Nonparenteral Serum Hepatitis

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Abstract
Five household contacts of a renal hemodialysis patient in Memphis developed hepatitis in March and April 1970. The suspect index case was a 31-year-old man with chronic glomerulonephritis who had been undergoing hemodialysis for 18 months and whose blood was known to contain hepatitis-associated antigen. The five secondary cases were present in mid-January when the dialysis patient hemorrhaged extensively at home from an eroded external shunt cannula. The three-month incubation period, detection of hepatitis-associated antigen in three of the five, and ineffectiveness of prophylactic immune serum globulin characterized their illness as serum hepatitis. Despite intensive questioning, none of the household contacts could recall sustaining minor injuries or abrasions during the first-aid effort, and a nonparenteral route of infection was postulated.