Acute hepatitis B in patients in Britain related to previous operations and dental treatment.

Abstract

The frequency of transmission of hepatitis B virus infection from health service staff to patients was assessed from reports of confirmed cases of acute clinical hepatitis in 1980-3. During the four years 4505 reports (91% of the total) included replies to a question about recent operations; 153 patients (3.4%) had this history. Transfused blood or blood products were considered the source for 27 cases (0-06%). Eleven patients (0-02%) were infected in two clusters, both in cardiac surgery units; six were caused by a perfusion technician, who was a symptomless carrier, and five by a surgical registrar during the incubation period of an acute hepatitis B infection. The estimated average annual risk of a patient developing acute hepatitis B as part of a cluster caused by staff during surgical procedures was one in a million operations. For another 11 patients blood transfusion could not be excluded as a source. Where no association between surgery and hepatitis was found the incidence of a history, lay between 2-3 and 2.6%. The Hospital In-Patient Enquiry data showed that about 2-4% of the population had had operations in a six month period.These findings suggest that transmission of hepatitis B infection from staffto patients is rare in Britain and that the small risk could be eliminated by attention to measures to preserve asepsis and by immunising staff at risk. IntroductionThe acquisition of hepatitis B infection by health service staff from patients is an occupational hazard, the size of which can be estimated by comparing infection rates in health service staff with those in the general population.' 2 Reports of transmission in the other direction-that is, from staff to patients-are uncommon, and attempts to assess their frequency were considered unnecessary in Britain, where both the incidence of acute hepatitis B and the prevalence of hepatitis B surface antigen (HBsAg) carriage are low. After an outbreak of acute hepatitis B among patients, however, which was caused by a gynaecologist who was a symptomless carrier of the infection,3 a study was designed to estimate the frequency of such events. A similar episode, which was discovered in England and investigated locally before plans for the national study were completed, emphasised the need for the investigation (Anonymous Control of Infection Team, unpublished observations).We decided to make a nationwide study based on confirmed cases of acute hepatitis B which are reported from laboratories through-

Transmission of Hepatitis C Virus from a Patient to an Anesthesiology Assistant to Five Patients

“…To our knowledge, such events have been occasionally recorded only for nonsurgical personnel infected with hepatitis B virus (HBV). [15][16][17][18] Our conclusion is supported by both epidemiologic and molecular evidence. The five patients had no known risk factors for HCV infection, and there were no evident contacts among them -a fact that excludes the possibility of patient-to-patient transmission.…”

Hepatitis B virus infection in dentistry: a forgotten topic

“…The acquisition of HBV infection by health service staffs or HCWs from patients is an occupational hazard [31], which can be estimated by comparing infection rates in health service staff with the general population [32]. During normal dental practice, dentists are at risk of infection from micro-organisms carried by patients [33].…”

“…Because of extensive HBV vaccination, it can now be claimed that transmission from a HCW to a patient is unlikely [39]. A study estimated that the probability of transmission of HBV infection from dentists to patients is 1 in 250 000 [32]. A study estimated that the probability of transmission of HBV infection from dentists to patients is 1 in 250 000 [32].…”

Risk and Management of Blood-Borne Infections in Health Care Workers

“…One factor associated with increased risk of transmission is the HCW being HBeAg positive, indicating a higher level of infectivity (137,138,217,218,221,275). In the United Kingdom, several episodes of HBeAg-negative surgeons transmitting HBV have been reported (127,128,145,250).…”