Some observations on the epidemiology and transmission of hepatitis B.

Although jaundice was described in the medical writings of Mesopotamia during the Babylonian period, progress in the understanding of infectious hepatitis did not occur until the second world war. Investigations carried out during outbreaks of jaundice in the armed Forces led to the establishment of the viral aetiology of the disease and also confirmed that there were two distinct epidemiological and immunological forms (Von Voegt, 1942; Cameron, 1943). Later the parenteral spread of hepatitis B was clearly established in clinics for the treatment of venereal diseases, diabetic clinics, and antituberculosis dispensaries and was shown to be associated with the repeated use of inadequately sterilised needles and syringes. The virus believed to be responsible for this type of hepatitis, characterised by a long incubation period and parenteral transmission, was termed hepatitis B virus to distinguish it from the virus responsible for classical, short-incubation, infectious hepatitis known as hepatitis A virus. Since the discovery of the Australia antigen and its association with hepatitis B by Blumberg (1964 and 1968) there has been a tremendous increase in knowledge about both viruses and their associated antigens. A recent World Health Organisation Expert Committee (1976) has suggested standardisation and improvements in nomenclature.