Woman contracts hep B during oral surgery

From Reuters:


NEW YORK - Hepatitis B virus was transmitted from one patient to another when they both underwent oral surgery in the same office on the same day — despite proper infection control measures — public health officials report.

The situation came to light when a 60-year-old woman sought medical care because of joint pain and fatigue, and was found to have hepatitis B. She had no traditional risk factors for hepatitis, but she said she had oral surgery several months earlier.

A cross-match of the state department of health’s hepatitis B registry found a patient infected with hepatitis B virus who had oral surgery a couple hours earlier that day.
Viral DNA from the two subjects was identical, according to Dr. John T. Redd, from the Centers for Disease Control and Prevention in Atlanta.

An inspection of the surgeon’s office showed that appropriate, standard precautions for preventing transmission of blood-borne viruses were being followed, the investigators report in the Journal of Infectious Diseases.

Hepatitis B virus can persist in dried blood on surfaces for a week or longer, and can also be present on surfaces that have no detectable blood.

Infection control procedures have nearly eliminated its spread in health care settings, note Dr. Ban Mishu Allos and Dr. William Schaffner in an accompanying commentary. Still, several similar cases have been reported in which the means of transmission could not be identified, they add.

This is “troubling because it suggests that there are aspects of transmission of blood-borne disease that remain poorly understood,” according to the editorialists, from Vanderbilt University School of Medicine in Nashville.

They advocate universal hepatitis B vaccination of all adults up to 40 years of age, as well as thorough investigations for non-traditional exposure sources when hepatitis B virus is diagnosed in patients with no recognizable risk factors.

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