Sydney S. Gellis

CHEMICAL, CLINICAL, AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. XXXVI. INACTIVATION OF THE VIRUS OF HOMOLOGOUS SERUM HEPATITIS IN SOLUTIONS OF NORMAL HUMAN SERUM ALBUMIN BY MEANS OF HEAT

The extensive administration of whole blood, plasma, and serum in the past few years has made the problem of homologous serum hepatitis an important one. The 23,000 cases of hepatitis in Armed Forces personnel (1) resulting from the injection of certain lots of yellow fever vaccine which had been stabilized with human serum gave great impetus to study of the disease in this country. Most epidemiological investigations suggest strongly that the risk of transmitting hepatitis is greater with plasma than with whole blood (2). This presumably depends on the practice of pooling the plasma from a number of donors, an occasional one of whom may harbor the virus, and of administering each pool to multiple recipients. In the preparation of pooled plasma for the Armed Services from blood collected by the American Red Cross during the war, the size of the pools was set at 25 or 50 bloods depending upon final distribution in packages of 250 ml. or of 500 ml. In the preparation of normal human serum albumin, similarly collected pools of plasma representing from 250 to 2,000 bloods were used as starting material for the process of plasma frac-

Homologous serum hepatitis and infectious (epidemic) hepatitis: Studies in volunteers bearing on immunological and other characteristics of the etiological agents☆

A. Etiological Agents. The hepatitis viruses used in these studies were obtained from three different immediate sources: 1. Virus SH. This virus was present in the pool of mumps convalescent plasma that has been described in previous reports as plasma A. 1.2 It P robably is the same virus that, as a result of its presence in certain lots of yellow fever vaccine, was responsible for a large outbreak of hepatitis in the United States Army in 1942.’ This virus (in plasma A) consistently produced acute hepatitis in volunteers two to four and onehalf months after its parenteral injection. As this syndrome is characteristic of that described as homologous serum hepatitis or jaundice,1,2*3 the causative agent will be referred to herein as virus SH (virus, serum hepatitis). The following human biological materials related to this virus were used for the studies in volunteers: (a) Plasma A: The origin and preparation of this pool of mump convalescent plasma and the probable relationship between the hepatitis agent it contained and that in the icterogenic lots of army yellow fever vaccine have been described in detail elsewhere.1,3 (b) Feces Pools 1, 2, and 3 FSH: These preparations also have been described in detail in a previous report.4 Briefly, these pools were composed of feces specimens obtained from six volunteers during various stages of acute hepatitis that had been induced by parenteral injection of virus SH (plasma A). In addition to the crude preparations, a bacteriologically sterile Seitz filtrate of a mixture of feces pools 2 and 3 FSH was employed in one of the present studies. (c) Nasopharyngeal washing pool 1