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Infective hepatitis and the handling of specimens in general practice.

It has been known for some time that the virus of infectious hepatitis with a short incubation period, 15-45 days (IH virus; virus A), is present in the blood (or tissues and tissue fluids) during the later part of the incubation period and during the clinical illness; it also may be in the duodenal juices, faeces and (perhaps) urine at these times. In some patients excretion of virus in faeces may continue well into convalescence. Anicteric cases may be particularly numer¬ ous, especially in children, and are an important source of infection. Gamma globulin given to contacts may protect in the sense of preventing clinically manifest disease but a subclinical infection may still occur. Clearly this virus (IH) may sometimes be transmitted by blood products or tissues collected during the incubation period of an overt case, or conceivably from an anicteric case of the disease. Until recently there seemed to be a clear-cut difference between infectious hepatitis, virus A, and serum hepatitis with the long incubation period, 50-200 days (SH virus, virus B), which was thought to be transmitted exclusively by transferring the blood, blood fractions (except gamma globulin), cells, tissues, tissue fluids or exudates from one individual through the skin of another. In general, it is still correct to regard the viruses as distinct.