Hepatitis A outbreaks among illicit drug users and their contacts in Queensland, 1997

Med J Aust. 1999 Jun 21;170(12):584-7. doi: 10.5694/j.1326-5377.1999.tb127904.x.


Objective: To describe five outbreaks of hepatitis A virus (HAV) infection associated with illicit drug use during a statewide outbreak of HAV infection in Queensland.

Design: Risk factor prevalence survey.

Patients and setting: All 875 cases of HAV infection notified to Public Health Units in Queensland in the 12 months to 30 November 1997.

Main outcome measure: Type and prevalence of illicit drug use.

Results: Risk factor assessment was completed for 804 cases (91.9%). We identified five outbreaks of HAV infection linked to illicit drug use. These outbreaks accounted for 24.6% (215/875) of all notified cases and 39% (190/482) of notified cases in the 15-34 years age group. The main type of illicit drug use in four of the five outbreaks was injecting drug use (74%; 118/160), while in the other outbreak it was sharing of smoking implements for marijuana (38%; 21/55).

Conclusion: Illicit drug use may be an under-recognised risk factor for HAV infection, particularly in young people. Faecal-oral transmission through poor personal hygiene, including sharing of implements for smoking marijuana, is the most probable route of transmission in these drug-linked outbreaks. The role of contaminated drug and needle-sharing remains to be clarified.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Disease Outbreaks*
  • Female
  • Hepatitis A / epidemiology*
  • Hepatitis A / etiology*
  • Hepatitis A / transmission
  • Humans
  • Incidence
  • Infant
  • Male
  • Middle Aged
  • Population Surveillance
  • Prevalence
  • Queensland / epidemiology
  • Risk Factors
  • Sex Distribution
  • Substance-Related Disorders / complications*