Jaundice in Army Personnel in the Western Region of the United States and Its Relation to Vaccination Against Yellow Fever1

Sawyer, Wilbur A.; Meyer, Kathelenn; Eaton, Monroe D.; Bauer, Johannes H.; Putnam, Persis; Schwentker, Francis F.

doi:10.1093/oxfordjournals.aje.a118911

Cited by 39 publications

(14 citation statements)

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“…In order to prevent the spread of infectious diseases, several state armies worldwide implemented obligatory vaccination programs of their recruits. During World War II, a notable epidemic of hepatitis B occurred in the United States (US) Army which was linked to yellow fever vaccine containing HBV contaminated human serum (8). Another hepatitis outbreak in the US Army took place between 1971 and 1973 among US military personnel in Fort Hood, Texas, mainly linked to intravenous drug use (IVDU) (10).…”

Section: Discussionmentioning

confidence: 99%

“…To prevent the spread of infectious diseases, several state armies implemented obligatory vaccination programs for both conscripts and professional soldiers, also practiced in the former Yugoslav National Army (YNA). However, in the past century, iatrogenic HBV transmissions during vaccinations in armies were well documented, but to the best of our knowledge, no such study was performed in the former Yugoslavia (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia

et al. 2021

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Background: To prevent the spread of infectious diseases, several state armies implemented obligatory vaccination programs also practiced in the former Yugoslav National Army (YNA). Iatrogenic hepatitis B virus (HBV) transmissions during vaccinations in the armies were well documented, but to the best of our knowledge, no such study has been performed in the former Yugoslavia. Objectives: In the present study, we determined risk factors for acquiring chronic hepatitis B (CHB) infection in patients in Slovenia. This study focused on the detection of a statistically significant risk factor in males, namely “vaccination in the YNA”. Methods: One thousand seven hundred and twenty-nine patients from all Slovenian regions who tested positive for HBV surface antigen (HBsAg) at the national referential laboratory for viral hepatitis diagnostics between January 1997 and December 2010 were included retrospectively. Accordingly, demographic, epidemiological, virological, and clinical data were extracted from the medical documentation and were statistically analyzed. Results: For 1,122 (64.9%) out of 1,729 patients, data regarding risk factors for acquiring HBV infection were available. The risk factor for infection of almost 60% of HBV chronically infected individuals with available data, followed by “HBV infection in the family” (19.8%) and “blood/blood products transfusion before the nineties” (8%) was unknown. Seven males (0.6%) (mean age ± SD, 53.7 ± 4.50 years) reported “vaccination in the YNA” as a risk factor for acquiring chronic HBV infection. “Vaccination in the YNA” was a significant risk factor for CHB infection in men over 46 years of age (P = 0.006). Conclusions: A significant risk factor for infection in Slovenian men over 46 years of age was identified as “vaccination in the YNA”, which is specific to this geographic region and, to the best of our knowledge, has not been previously described in the peer-reviewed literature.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia

et al. 2021

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“…Mixing the vaccine with human sera was done to stabilise the live virus prior to desiccation. 5 Although unknown to science in 1941, the addition of human sera allowed the unsuspected entry of hepatitis B virus (HBV) into the YF vaccine. When war-time demand required massive scale-up of vaccine production, additional sources of human sera were needed.…”

Section: Yf Vaccine Causes Hepatitis Epidemicmentioning

confidence: 99%

“…Although US soldiers were also immunised against smallpox, typhoid fever and tetanus, it was clear from early in the epidemiological investigation of the jaundice that it was associated with YFV vaccine. 5,6 Within a few months, the variable nature of the exposure was proven in that only some lots of the YFV vaccine caused jaundice, thus suggesting that it was not the vaccine itself but some additive that was responsible. The Navy and US Marine Corps were largely spared, even though they received the same YFV vaccine largely because of the random nature of exposure to HBV led to the infection of lots of YFV vaccine.…”

Section: Yf Vaccine Causes Hepatitis Epidemicmentioning

confidence: 99%

Immunisation used for offensive and defensive purposes during the Second World War

Shanks

2023

Internal Medicine Journal

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The best defence against natural or intentional biological agents during armed conflict is usually immunisation, as with typhoid fever, but exceptional circumstances are informative. A large iatrogenic epidemic of hepatitis B occurred in 1942 due to contaminated lots of yellow fever (YF) vaccine used in the US military, even though there was no natural risk of infection. YF vaccine was intended to protect against Japanese Army's use of YF as a biowarfare agent, which did not eventuate. Salmonella typhi was used to infect German soldiers in a Paris café during Christmas 1941 in the knowledge that the café staff but not the soldiers were likely to be immunised against typhoid fever. German Army use of the Weil–Felix reaction to eliminate civilians likely to be typhus infected was subverted by Polish medical officers. They immunised civilians with locally produced Proteus antigens to create false‐positive Weil–Felix reactions in order to exempt men from forced labour schemes. Immunisation against biowarfare agents has a mixed record, indicating that vaccines rarely cover well for intelligence gaps.

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“…Jaundice resulting from an apparently transmissible hepatitis of varying degrees of severity has been recognized as a fairly frequent disease of human beings. One form of mild hepatitis with jaundice has recently gained great importance because of the rather widespread occurrence of this disease following inoculation of Army personnel with a yellow fever vaccine containing human serum (A.M.A., 1942;Sawyer, et al, 1944). A similar disease following yellow fever vaccination had previously occurred in England (Findlay, 1940;Findlay and MacCallum, 1938) and more recently in Brazil (Fox, et al, 1942).…”

Section: Introductionmentioning

confidence: 99%

Experiments on the Transmission of an Icterogenic Agent in Yellow Fever Vaccine to Horses and Swine

Carle¹,

Dewhirst²,

Braun³

et al. 1944

J Bacteriol

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The studies and observations reported in this paper were initiated by a study group of the Commission on Tropical Diseases under the Board for the Investigation and Control of Influenza and Other Epidemic Diseases in the Army, Preventive Medicine Division, Office of the Surgeon General, United States Army, and continued with the support and under the auspices of The Rockefeller Foundation Health Commission. The authors are greatly indebted to Professor C. M. Haring, Director of the Division of Veterinary Science, who made this work possible.2 The studies were carried out principally in the Division of Veterinary Science of the University of California and the authors are on the staff of the Division of Veterinary Science of the University of California, except M. D. Eaton, who is on the staff of the

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Jaundice in Army Personnel in the Western Region of the United States and Its Relation to Vaccination Against Yellow Fever1

Cited by 39 publications

References 0 publications

Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia

Vaccination in the Yugoslav National Army: A Significant Risk Factor for Acquiring Chronic Hepatitis B Virus Infection During Army Service in the Former Yugoslavia

Immunisation used for offensive and defensive purposes during the Second World War

Experiments on the Transmission of an Icterogenic Agent in Yellow Fever Vaccine to Horses and Swine

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