Public Health Laboratory Service surveillance of prophylaxis by specific hepatitis B immunoglobulin in England and Wales during the period 1975-1987.

Surveillance of specific hepatitis B prophylaxis given after accidental or sexual exposure was continued throughout the period 1975-1987 by keeping records of exposures and ascertaining acute attacks of hepatitis B by postal enquiry. Acute hepatitis B developed in 53 (0.6%) of 9370 recipients of prophylaxis; the highest rate (3.7%) was among 564 sexually exposed, 0.9% among 2056 accidentally inoculated and 0.2% among 5747 persons who had other skin or minor exposures affecting the mucous membranes. There were no cases among 1003 recipients whose exposures did not meet the criteria for prophylaxis. None of the 53 patients died and only one of the 44, for whom sickness records were completed, reported a severe attack. Comparisons of six attacks among 623 who had inoculation injuries with material tested for hepatitis 'e' antigen and antibody gave no indication of better protection by early prophylaxis or by a two-dose schedule.