This data linkage study examined the extent of hepatitis B transmissio
n and co-infection with HIV among 636 former inmates of Glenochil pris
on, Scotland, during an outbreak of bloodborne diseases in 1993 which
was related to needle sharing. Eleven inmates imprisoned during the fi
rst half of 1993 presented with hepatitis B infection, of whom co-infe
ction with HIV was detected in six. Based on dates of test results in
relation to time of imprisonment, seven definitely acquired their hepa
titis B infection within the prison. Only two infections were reported
to Scotland's hepatitis B register and neither could be prison-linked
. This outbreak of hepatitis B is the first of its kind to be reported
but not the first to have occurred. It not only highlights the urgenc
y for measures to prevent further spread of infection among prisoners
but also illustrates the need for comprehensive surveillance of hepati
tis B infection, and the need for a protocol on how to manage such out
breaks and on how to establish the extent of transmissions when acute
hepatitis B occurs in prison.