Acute hepatitis B in patients in Britain related to previous operations and dental treatment.
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 staff to 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.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D003814:Dentistry, Operative; D004739:England; D005260:Female; D006280:Health Workforce; D006509:Hepatitis B / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012306:Risk; D013029:Space-Time Clustering; D013514:Surgical Procedures, Operative; D014852:Wales