title: Transmission of hepatitis C in an isolated area in Japan: community-acquired infection. The South Kiso Hepatitis Study Group.
abstract: OBJECTIVE
  The spread of hepatitis C virus (HCV) infection not due to drug needle sharing or transfusion is largely unknown in communities. A search for risk factors for HCV infection in an endemic area might elucidate inapparent modes of transmission.
  
  
  METHODS
  We conducted screening for hepatitis virus markers and parenteral exposures to blood among 435 inhabitants in an isolated area known for its endemicity for non-A, non-B hepatitis and in a nonendemic area with 1542 inhabitants.
  
  
  RESULTS
  The prevalence of hepatitis B surface antigen was the same in both areas. The prevalence of antibody to HCV verified by the recombinant immunoblot assay was 32.4% in the highly endemic area and 2.3% in the nonendemic area (P < 0.001). Risk factors for HCV infection in the highly endemic area were complex but included folk remedies such as acupuncture and "vacuuming" for congested blood in muscle by the use of a warm glass bottle.
  
  
  CONCLUSIONS
  Folk remedies such as acupuncture and cutting of the skin using nonsterilized knives should be considered as possible routes of HCV transmission not associated with blood transfusion or sharing of drug paraphernalia.
authors.affiliation: Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kiyosawa
authors.forename: E
authors.initials: E
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Sodeyama
authors.forename: K
authors.initials: K
authors.lastname: Yoshizawa
authors.forename: K
authors.initials: K
authors.lastname: Yabu
authors.forename: K
authors.initials: K
authors.lastname: Furuta
authors.forename: H
authors.initials: H
authors.lastname: Imai
authors.forename: Y
authors.initials: Y
authors.lastname: Nakano
authors.forename: S
authors.initials: S
authors.lastname: Usuda
authors.forename: K
authors.initials: K
authors.lastname: Uemura
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000453:epidemiology / Q000635:transmission*; D006525:Hepatitis, Viral, Human / Q000378:metabolism; D006801:Humans; D007564:Japan; D008099:Liver / Q000503:physiopathology; D008107:Liver Diseases / Q000453:epidemiology; D008403:Mass Screening; D008519:Medicine, Traditional; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors
chemical_list: D015415:Biomarkers