Journal of Urban Health

, Volume 82, Issue 3, pp 468–478 | Cite as

Risk factors for hepatitis B in an outbreak of hepatitis B and D among injection drug users

  • Stephanie R. Bialek
  • William A. Bower
  • Karen Mottram
  • Dave Purchase
  • T. Nakano
  • Omana Nainan
  • Ian T. Williams
  • Beth P. Bell
Article

Abstract

During January–April, 2000, 12 cases of acute hepatitis B were reported in Pierce County, Washington, compared with seven in all of 1999. Seven (58.3%) case patients were injection drug users (IDUs), three of whom were coinfected with hepatitis D virus (HDV) and died of fulminant hepatitis. Vaccination clinics were implemented at the local health department and needle exchange program to control the outbreak. We investigated this outbreak to determine risk factors for hepatitis B virus (HBV) transmission among IDUs. Hepatitis B cases were ascertained through routine surveillance and prevaccination testing at vaccination clinics. We conducted a case-control study comparing IDU case patients with HBV-susceptible IDUs identified at the vaccination clinics. Fifty-eight case patients were identified during January–December, 2000, 20 (34.5%) of whom were coinfected with HDV. Thirty-eight case patients (65.5%) reported current IDU. In the case-control study, the 17 case patients were more likely than the 141 controls to report having more than one sex partner [odds ratio (OR)=4.8, 95% confidence interval (CI)=1.5–15.0], injecting more than four times a day (OR=4.5, 95% CI=1.2–15.6) and sharing drug cookers with more than two people (58.8% vs. 14.0%, OR=14.0, 95% CI=2.4–81.5). Results were similar after controlling for syringe sharing in multivariable analysis. IDUs should be vaccinated against hepatitis B and should be advised against sharing drug injection equipment.

Keywords

Hepatitis B Hepatitis D Intravenous drug abuse 

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Copyright information

© Oxford University Press on behalf of the New York Academy of Medicine 2005

Authors and Affiliations

  • Stephanie R. Bialek
    • 1
  • William A. Bower
    • 1
  • Karen Mottram
    • 2
  • Dave Purchase
    • 3
  • T. Nakano
    • 1
  • Omana Nainan
    • 1
  • Ian T. Williams
    • 1
  • Beth P. Bell
    • 1
  1. 1.Unired States Public Health Service, Division of Viral Heparitis, National Center for Infectious DiseasesCenters for Disease Control and PreventionAtlanta
  2. 2.Tacoma Pierce County Health DepartmentWashington, DC
  3. 3.Point Defiance AIDS ProjectsWashington, DC

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