Hepatitis B Outbreak Following a Mass-casualty Incident, Australia

[Guest guest]

http://jid.oxfordjournals.org/content/204/3/400.abstract?etoc

Hepatitis B Outbreak Following a Mass-casualty Incident, Australia

M. Italiano1,

J. Speers2,

Glenys R. Chidlow3,

K. Dowse4,

G. on5 and

P. Flexman6,7

+ Author Affiliations

1Department of Microbiology and Infectious Diseases, Royal Perth Hospital

2Department of Microbiology

3Queen II Medical Centre, PathWest Laboratory Medicine Western

Australia, Nedlands

4Department of Health, Communicable Disease Control Directorate

5Disaster Management, Regulation and Planning Directorate, Western Australian

Department of Health, Perth

6Department of Microbiology and Immunology, University of Western Australia,

Perth

7Department of Microbiology and Infectious Diseases, Pathwest Laboratory

Medicine Western Australia, Royal Perth Hospital, Australia

Correspondence: Italiano, MBBS, Infectious Diseases Unit, Level 2 Menara

Utama, Dept of Medicine, University of Malaya Medical Centre, Lembah Pantai

59100, Kuala Lumpur, Malaysia (claire_italiano@...).

Abstract

(See the editorial commentary by Ward and Averhoft, on pages 338–9.)

On 16 April 2009, a boat carrying 47 Afghan asylum seekers and 2 Indonesian crew

exploded in Australian waters, resulting in mass casualties. Of these

casualties, 23 persons who suffered significant burns were transferred to Royal

Perth Hospital, Perth, Western Australia. One patient was subsequently shown to

be a hepatitis B virus (HBV) carrier at the time of the explosion. Over the

following months, 3 other patients received a diagnosis of acute hepatitis B,

and an additional 4 patients showed serological evidence of recent HBV

infection, including 1 patient who was transferred to another Australian city.

Molecular typing determined that the strains from the HBV carrier and the acute

and recent case patients formed a closely related cluster, and the investigation

suggested that transmission occurred at or around the time of the boat

explosion. This is the first report of confirmed transmission of HBV following a

disaster, and it reinforces the importance of postexposure prophylaxis for HBV

in mass casualty situations.

Received December 1, 2010.

Accepted March 2, 2011