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Epidemiologic aspects of Santa Marta hepatitis over a 40‐year period
Author(s) -
Buitrago Bernardo,
Hadler Stephen C.,
Popper Hans,
Thung Swan N.,
Gerber Michael A.,
Purcell Robert H.,
Maynard James E.
Publication year - 1986
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840060611
Subject(s) - period (music) , medicine , hepatitis a , virology , hepatitis , demography , geography , environmental health , art , sociology , aesthetics
Abstract “Santa Marta” hepatitis has been recognized as an unusual type of severe hepatitis occurring in northern Colombia since 1930. Liver specimens from a historic viscerotomy series, used by Gast‐Galvis to identify cases and describe epidemiologic features of this disease, were available for review and histopathologic staining for δ‐virus. Of 86 liver specimens examined from cases of fulminant Santa Marta hepatitis, 81 showed a distinct histopathologic picture, in various stages of progression, with features of eosinophilic necrosis, microvesicular fat infiltration of the liver parenchyma and morula cells; 69% were positive for δ‐antigen by immunoperoxidase staining. This disease occurred predominantly in several small towns within 50 km of Santa Marta, with mortality reaching 1.25 per 1,000 inhabitants per year during the 1940′s. Children under age 15 were most commonly affected and males affected twice as frequently as females. Liver specimens obtained from children, or within 15 hr of death, or which showed early histologic stages of disease were most likely to be positive for δ‐antigen. This and the accompanying study confirm the existence of a distinct type of fulminant hepatitis in Colombia for over 50 years. The epidemiologic and histopathologic features are comparable to severe hepatitis in Venezuela Indians and in the Amazon basin of Brazil, suggesting that all are caused by δ‐superinfection of hepatitis B virus carriers.