92 Decision Citation: BVA 92-04584 Y92 BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 DOCKET NO. 91-39 852 ) DATE ) ) ) THE ISSUE Entitlement to service connection for hepatitis. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Lisa K. Holliday, Associate Counsel INTRODUCTION This matter came before the Board on appeal from an October rating decision of the Houston, Texas, regional office (hereinafter RO), which denied service connection for hepatitis. The notice of disagreement for this action was received on November 29, 1988. A statement of the case was issued on January 23, 1989, and the substantive appeal was received on February 28, 1989. The appeal was received at the Board on August 13, 1991, and docketed the next day. The appellant has been represented during his appeal by the American Legion, who submitted additional written argument to the Board on or about October 10, 1991. This case is now ready for appellate review. The appellant had active service from October 1941 to December 1971. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that service connection is in order for hepatitis which, he claims, is directly related to the immunizations he received in the 1940's while serving on active duty. DECISION OF THE BOARD For the reasons and bases hereinafter set forth, it is the decision of the Board that the preponderance of the evidence is against the claim for service connection for hepatitis. FINDINGS OF FACT 1. The veteran served on active duty from October 1941 to December 1971. 2. Hepatitis was not present in service and was not manifest until many years after separation from service. CONCLUSION OF LAW Hepatitis was not incurred in or aggravated by active service. 38 U.S.C. § 1110, § 1131. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS We note that we have found the veteran's claim to be "well-grounded" within the meaning of 38 U.S.C. § 5107(a) (formerly 38 U.S.C. § 3007(a)); effective on and after September 1, 1989. That is, we find that he has presented a claim which is plausible. In evaluating the veteran's claim for service connection for hepatitis, it is necessary to consider the law applicable to the determination. To be entitled to service connection for a disability, the evidence must establish that the claimed injury or disease was incurred coincident with service and that the injury or disease, or residuals thereof, continued after service. 38 U.S.C. § 1110, § 1131. In this case, the veteran's service medical records, spanning approximately 30 years of active duty, are negative for any evidence of hepatitis. The first post service clinical evidence referring to the presence of hepatitis occurred in a February 1984 VA examination, more than 12 years after separation from service. During this examination it was noted that a hepatitis panel done in December 1983, showed a positive hepatitis B surface antibody, and positive hepatitis B core antibody. Hepatitis B surface antigen was negative and the veteran denied any prior history of acute hepatitis. It is the veteran's contention that he contracted hepatitis from yellow fever vaccines he received during World War II. In support of this contention, he has submitted copies of service immunization records, a VA medical consultation form from February 1986, a February 1986 newspaper article from the San Antonio News-Express, and a VA examination from January 1987. The military immunization records show that the veteran received yellow fever vaccines in 1943, 1952 and 1963. A VA consultation report dated February 1986, indicated past exposure to hepatitis B reflected in abnormal liver function tests detected 2 years ago, with history of service in Southeast Asia. The February 1986 newspaper article noted that during World War II, military personnel were vaccinated against yellow fever. It further stated that the vaccine was made from pooled human serum which contained the hepatitis virus. As a result, over 50,000 cases of serum hepatitis occurred. The January 1987, VA examination diagnosed the veteran with chronic hepatitis and indicated historically that he received yellow fever vaccines in the 1940's which contained human serum and possibly transmitted the agent responsible for his hepatitis B. The Board was able to obtain a copy of the 1987 report from the New England Journal of Medicine, which, in our opinion, completely refutes the veteran's contention that he received contaminated yellow fever vaccine during service which led to the development of hepatitis B. This report confirms the fact that a dramatic outbreak of acute viral hepatitis occurred in 1942, and affected approximately 50,000 Army servicemen. However, the article points out that on April 15, 1942, in response to the outbreak, the Surgeon General ordered that yellow-fever vaccination be discontinued, and that existing supplies of vaccines be recalled or destroyed. Shortly after the Surgeon General's order, the vaccination of servicemen resumed, using a new, serum-free, uncontaminated vaccine. Leonard B. Seeff et al., A Serologic Follow-up of the 1942 Epidemic of Post-Vaccination Hepatitis in the United States Army, 316 NEW ENG. J. MED. 965-970 (1987). A copy of this report is attached to this decision. In this case, available service medical records indicate that the veteran's initial yellow fever vaccination occurred in January 1943. In accordance with the preceding medical report, the contaminated vaccine which resulted in hepatitis ceased being used shortly after April 1942. Given these facts, it is logical to conclude that the veteran's 1943 innoculation involved the use of the new, serum-free vaccine. The objective evidence available in this case does not demonstrate that service connection for hepatitis is warranted. Specifically, the service medical records do not show the presence of any such condition and thus, there is no reasonable basis to substantiate the claim. The evidence which the veteran submitted to help prove his claim is outweighed by the aforementioned report in the New England Journal of Medicine, which effectively refutes the existence of an etiological relationship between an event in service and the incurrence of the veteran's post service hepatitis. Accordingly, a grant of service connection is denied. ORDER Service connection for hepatitis is denied. BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 C. P. RUSSELL C. A. QUARLES, M.D. JACK W. BLASINGAME NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (formerly 38 U.S.C. § 4066), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988 (see sec. 402 of the Veterans' Judicial Review Act (Pub. L. 100-687)). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. (Note: The section numbers of title 38, United States Code, have been renumbered by recent legislation, beginning with Public Law 102-40, effective May 7, 1991. Unless otherwise noted, the section numbers of the United States Code cited in this decision are the numbers in effect prior to that date.)