Lessons from patient notification exercises following the identification of hepatitis B e antigen positive surgeons in an English health region.
The results of hepatitis B virus (HBV) serology from notification exercises conducted in cohorts of patients exposed to three surgeons positive for hepatitis B e antigen (HBeAg) identified in one English health region in 1994 and 1995 were reviewed. Of 777 patients notified, serology results at six months or more after exposure were available for 514 individuals who had not received post exposure prophylaxis. In one case DNA analysis confirmed transmission of HBV from surgeon to patient. Pre-existing natural immunity to HBV was found in a further 19 patients, none of whom had evidence of recent infection, and in 13 patients (classified as cases of undetermined origin) transmission during surgery could not be excluded. The overall estimated transmission rate was 0.2% for confirmed cases (95% confidence interval (CI) 0.004-1.1) and 2.7% (95% CI 1.5-4.5) if cases of undetermined origin were included. The management of recall exercises should consider the risks of the operative procedures performed and the time that has elapsed since exposure.
Department of Social Medicine, University of Bristol. s.e.oliver@bris.ac.uk
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Oliver
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Woodhouse
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Hollyoak
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D018563:Disease Notification; D004739:England; D005260:Female; D013502:General Surgery; D006509:Hepatitis B / Q000517:prevention & control*; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D006513:Hepatitis B e Antigens