Abstract. An outbreak of delta hepatitis occurred during 1998 among the Waorani of the Amazon basin of Ecuador. Among 58 people identified with jaundice, 79% lived in four of 22 Waorani communities. Serum hepatitis B surface antigen (HBsAg) was found in the sera of 54% of the jaundiced persons, and 14% of asymptomatic persons. Ninetyfive percent of 105 asymptomatic Waorani had hepatitis B core (HBc) IgG antibody, versus 98% of 51 with jaundice. These data confirm that hepatitis B virus (HBV) infection is highly endemic among the Waorani. Sixteen of 23 (70%) HBsAg carriers identified at the onset of the epidemic had serologic markers for hepatitis D virus (HDV) infection. All 16 were jaundiced, where as only two of seven (29%) with negative HDV serology were jaundiced (P ϭ .0006). The delta cases clustered in families, 69% were children and most involved superinfection of people chronically infected with HBV. The data suggest that HDV spread rapidly by a horizontal mode of transmission other than by the sexual route.

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We make the interprecision transfers explicit in an algorithmic description of iterative refinement and obtain new insights into the algorithm. One example is the classic variant of iterative refinement where the matrix and the factorization are stored in a working precision and the residual is evaluated in a higher precision. In that case we make the observation that this algorithm will solve a promoted form of the original problem and thereby characterize the limiting behavior in a novel way and obtain a different version of the classic convergence analysis. We also discuss two approaches for interprecision transfer in the triangular solves.

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