Prevalence of hepatitis B carriers in a mental health in-patient facility: implications for employee screening and vaccination.

Health care employees in a variety of institutional settings may be exposed to Hepatitis B virus through blood contact with patients carrying this infectious agent. Employees may be protected from such risk by administration of pre-exposure Hepatitis B vaccine or post-exposure immunoglobulin prophylaxis. Prior to establishing a Hepatitis B vaccination program for employees, a prevalence survey of hepatitis B surface antigen (HBsAg) positivity in mental health care facility inpatients was conducted to assess employee exposure risk. Survey results demonstrated that 15/270 inpatients (5.5 percent) had positive HBsAg serologies. These results suggest that positivity may be much higher in mental health care facilities than in acute care hospitals. Mental health care facilities should routinely survey inpatient populations for the presence of HBsAg positivity and consider establishing Hepatitis B serologic screening and vaccination programs for personnel involved in delivering care.