Investigation of a large community-based outbreak of hepatitis B infection in the United Kingdom

Andersson, M. I.; Low, N; Irish, C. J.; Verlander, N. Q.; Carrington, D.; Horner, P.; Stuart, J. M.; Hickman, M.; Hepatitis B Outbreak Investigation Team, Bristol (2012). Investigation of a large community-based outbreak of hepatitis B infection in the United Kingdom. Epidemiology and infection, 140(1), pp. 47-57. Cambridge: Cambridge University Press 10.1017/S0950268811000148

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We describe the largest outbreak of hepatitis B virus infection reported to date in the UK. Between July 2001 and December 2005, 237 cases were identified in Avon, South West England. The likely route of transmission was injecting drug use in 44% (104/237) and heterosexual intercourse in 30% (71/237) of cases. A case-control study in injectors showed that injecting crack cocaine [adjusted odds ratio (aOR) 23·8, 95% confidence interval (CI) 3·04-186, P<0·001] and sharing injecting paraphernalia in the year before diagnosis (aOR 16·67, 95% CI 1·78-100, P=0·010) were strongly associated with acute hepatitis B. In non-IDUs number of sexual partners and lack of consistent condom use were high compared to a national sample. We describe the control measures implemented in response to the outbreak. This outbreak has highlighted the problems associated with the low uptake from the national hepatitis B vaccination policy which targets high-risk groups, the difficulties of identifying those at risk of acquiring hepatitis B infection through heterosexual sex, and injecting crack cocaine as a risk factor for hepatitis B.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Low, Nicola




Cambridge University Press




Factscience Import

Date Deposited:

04 Oct 2013 14:22

Last Modified:

05 Dec 2022 14:06

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URI: (FactScience: 212739)

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