The improvement of prophylaxis and the decrease of morbidity rate in hepatitis B are possible on the basis of the introduction of the information subsystem of epidemiological surveillance into practical health service, including health service in rural areas. The necessity of ensuring the specificity of highly sensitive immunodiagnostic techniques by using the combination of these techniques and competitive radioimmunoassay, as well as increasing their availability by the cooperation of laboratories at the district and regional levels, is emphasized.
False positive results obtained in the determination of the immune markers of hepatitis A by the methods of the passive reverse hemagglutination test and the enzyme immunoassay distort the course of the registration of the epidemic process and deteriorate the quality of the antiepidemic measures ensured to the population. The necessity of the standardization of available test systems is postulated.
An outbreak of viral hepatitis B at a sugar refinery in the Ukraine was verified by the detection of HBs antigens and IgM antibodies to hepatitis A virus in the radioimmunoassay. Cases of hepatitis E among workers, employed mainly in heat-treatment departments, appeared due to mass contamination of water mains with sewage water from the residential zone in the presence of a few cases of the disease.
In regions with a low endemic incidence of hepatitis B familial foci of those with a history of viral hepatitis B and HBsAg carriers are less actual objects of epidemiological surveillance than foci of group diseases, chronic carrier state of HBsAg.
Group disease with hepatitis B (or A against the background of chronic HBsAg carrier state) may be diagnosed (or excluded) on the basis of high (or low) detectability of HBsAg in patients with jaundice. Perfection of epidemiological diagnosis is possible with implementation of indication of not less than three immunological markers: HBsAg, IgM anti-Hbs, IgM anti-HAV.