The study is based on the epidemic of 50,000 cases of viral hepatitis in the United States Army in 1942, traced to yellow fever vaccine prepared by the Rockefeller Foundation and contaminated with a virus of hepatitis, now thought to have been the hepatitis B virus (HBV). A serologic survey to identify the virus with certainty has been completed by the Veterans Administration (VA) and the Liver Diseases Section of the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases on about 600 men-- 200 who suffered from acute hepatitis during the 1942 epidemic (Group I), 200 who received vaccine from one of the seven contaminated lots but were not clinically ill (Group II) and 200 who did not receive the Rockefeller vaccine (Group III). Two epidemiologic studies are being performed with the Medical Follow-up Agency of the National Research Council: 1) a mortality study of three cohorts of 20,000 men each defined as in the serologic survey, with primary liver cancer the chief end-point and 2) a case-control study of an estimated 1,400 WWII Army Veterans discharged from VA hospitals for primary liver cancer and 2,800 matched controls, the comparison to be based on immunization history with attention to the lot number of the yellow fever vaccine. In the serologic survey, testing for anti-HBs and anti-HBc has identified the B virus as the source of the infection. In addition, anti-HBs levels are high, and only one carrier (HBsAg+) was identified in Group I, none in Group II or III. Preliminary data on the cohort mortality study suggest that Group II may have some excess mortality from liver cancer, although deaths coded to primary cancer of the liver do not differ significantly among the three survey groups. The case-control study is underway.
