AN EPIDEMIC OUTBREAK OF HEPATITIS A AMONG HOMOSEXUAL MEN IN STOCKHOLM

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Abstract
In 1979–1980, a dlstlnct outbreak of hepatttis A occurred among homosexual men in Stockholm, Sweden, city and county area. The epidemk comprlsed 145 known cases. It began in December 1979 and progressed in waves during the following 10 months, with three distinct peaks separated by about six-week intervals. Actually, the incidence of hepatitis A in the Stockhoim area showed a fivefold increase during 1980 as compared to the previous year. Clinical, serologic, and socia1 characteristks were studted more closely in 98 of the 145 homosexual men. Verification of hepatitis A was made by a solid-phase radioimmunoassay technique for detection of antlbody to hepatttis A virus of the immunoglobulin M class. In addttlon, 64% of the men showed findings consistent with a prior hepatttis B (antibody to hepatitis B core antigen andlor antibody to hepatttls B surface antigen) and 34% were Treponema pallidurm immobilizatlon-positive from a prior or concomitant syphllis. Employment in risk professions was common; thus, 19% worked In restaurants or otherwise handled food and 20% were engaged in medical care as compared to the 1% occupied in etther branch of work among the general population in Sweden. Sexual habtts with multiple partners and oral-anal sexual contacts were judged to be of major importance in the spread of this epidemic. Some spread of hepatttls A to the general population probably occurred due to the risk occupations of many homosexual men.