A hepatitis epidemic in a dialysis unit. Occurrence and persistence of Australia-antigen among patients and staff.

During an epidemic of hepatitis at a dialysis unit blood samples were regularly obtained during an 18 month period from staff members and patients and examined for increase in GPT and for the occurrence of Au-antigen. During this period hepatitis was diagnosed in 30 members of the staff and in 30 patients. The clinical picture in the former group differed essentially from that in the latter. The disease was more severe but shorter in the members of the staff than in the patients receiving haemodialysis. The 2 groups differed from one another also in respect of the occurrence of Au-antigen in the serum. In the staff the Au-antigen appeared in association with the clinical signs of hepatitis and usually disappeared within 12 days after the onset of the disease and long before the clinical signs. In the patients with renal disease, however, the antigen appeared in the serum much earlier, usually 5 weeks before other signs of hepatitis. Once the patients had become positive they usually remained so for long periods of time. Blood used for dialysis should be examined for Au-antigen to reduce the possibility of the blood being a portal of entry of infectious hepatitis at a department of dialysis. Patients undergoing dialysis should be regularly examined for the presence of Au-antigen in the serum.