title: Transmission of hepatitis B with resultant restriction of surgical practice.
abstract: Five patients developed acute hepatitis B (HB) within four months after major operations by the same obstetric-gynecologic surgeon. Investigation documented that the surgeon was HB surface antigen and HB e antigen positive; all five patients had an HB subtype matching that of the surgeon and no other identifiable risk factors for HB viral infection. A seroprevalence study comparing exposed surgical and obstetric patients with a control group showed no significant additional subclinical HB transmission. The surgeon resumed his surgical practice but was required to obtain written informed consent from patients, to double-glove, and to employ appropriate surgical techniques to avoid self-injury. Seven months later, acute HB occurred in a patient two months after a cesarean section, resulting in exclusion of the surgeon from major operations. This is the fifth outbreak of nosocomial HB linked to an obstetric-gynecologic surgeon, and it reinforces the need for health care workers to receive preexposure prophylaxis with HB vaccine to prevent such occurrences.
mesh_terms: D002353:Carrier State; D004196:Disease Outbreaks; D005260:Female; D013502:General Surgery; D006176:Gynecology; D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000032:analysis; D006512:Hepatitis B Core Antigens / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008297:Male; D009774:Obstetrics; D011183:Postoperative Complications
chemical_list: D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D007075:Immunoglobulin M