During the fall of 1964 and winter of 1965, an outbreak of viral hepatitis occurred in narcotics users in Rhode Island. A history of intravenous drug use was elicited from 27 persons, one of whom had three distinct episodes of hepatitis. Twenty-four of the 27 patients were males aged 17 to 30, and they accounted for 30% of all reported cases of hepatitis in this age group. Although the majority of the patients were hospitalized, they had a mild course and there were no deaths. Eleven of the 27 patients, or 41%, were not initially recognized as drug users by their attending physicians. Epidemiologic data suggested that the cause of the outbreak was the virus of serum hepatitis, and that it was transmitted by the use of contaminated injection equipment.
Rosenstein BJ. Viral Hepatitis in Narcotics Users: An Outbreak in Rhode Island. JAMA. 1967;199(10):698–700. doi:10.1001/jama.1967.03120100060010
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