1988 年 35 巻 3 号 p. 147-157
An outbreak of infantile papular acrodermatitis (IPA) occurred in and around Saga City from May 1977 through April 1978, infecting 26 patients. Over 50% of the patients were two years of age or younger. As most of the patients came from the same clinic, the source of the Hepatitis B virus infection was probably contaminated syringes used in that clinic. The 12 patients examined for subtype were all adw, whereas Ishimaru et al. (1976) reported that the subtype in Matsuyama was ayw. Apart from the Saga and Matsuyama outbreaks, the subtypes reported in 39 sporadic cases in various parts of Japan, including three sporadic cases which we experienced, were : adr, 25 cases (64%); adw, 10 cases (26%); ayr, 1 case (2%); and ayw, 3 cases (8%). This distribution pattern is similar to that for adult HBV carriers in Japan. It was confirmed that IPA was present in every HBsAg subtype, and therefore IPA was not subtype specific. Half of the patients (13/26) had maximum serum GOT levels over 1000 K. U. The average level was also much higher in the Saga patients than in the Matsuyama patients. HBs-antigenemia disappeared within 2 months after the onset of the disease in 46% of the patients, and within 3 months in 65% of the patients, whereas 5 of 26 or 19% still were positive HBsAg even after 6 years. Horizontal transmission to parents occurred in 7 cases (2 fathers and 5 mothers), and to siblings in 5 cases. The HBsAg positive rate was 23% (7/31) among the parents checked. This was significantly higher than the rate of 3% (10/358) found in a healthy population from a neighboring district (po= 0.0000).
