Hepatitis C virus transmission from an anesthesiologist to a patient.
BACKGROUND
An anesthesiologist was diagnosed as having acute hepatitis C 3 days after providing anesthesia during the thoracotomy of a 64-year-old man (patient A). Eight weeks later, patient A was diagnosed as having acute hepatitis C.


METHODS
We performed tests for antibody to hepatitis C virus (HCV) on serum samples from the thoracotomy surgical team and from surgical patients at the 2 hospitals where the anesthesiologist worked before and after his illness. We determined the genetic relatedness of the HCV isolates by sequencing the quasispecies from hypervariable region 1.


RESULTS
Of the surgical team members, only the anesthesiologist was positive for antibody to HCV. Of the 348 surgical patients treated by him and tested, 6 were positive for antibody to HCV. Of these 6 patients, isolates from 2 (patients A and B) were the same genotype (1a) as that of the anesthesiologist. The quasispecies sequences of these 3 isolates clustered with nucleotide identity of 97.8% to 100.0%. Patient B was positive for antibody to HCV before her surgery 9 weeks before the anesthesiologist's illness onset. The anesthesiologist did not perform any exposure-prone invasive procedures, and no breaks in technique or incidents were reported. He denied risk factors for HCV.


CONCLUSIONS
Our investigation suggests that the anesthesiologist acquired HCV infection from patient B and transmitted HCV to patient A. No further transmission was identified. Although we did not establish how transmission occurred in this instance, the one previous report of bloodborne pathogen transmission to patients from an anesthesiologist involved reuse of needles for self-injection.
Cody
Sara H
SH
California Department of Health Services, Berkeley, USA. sara.cody@hhs.co.santa-clara.ca.us
Nainan
Omana V
OV
Garfein
Richard S
RS
Meyers
Hildy
H
Bell
Beth P
BP
Shapiro
Craig N
CN
Meeks
Emory L
EL
Pitt
Harriett
H
Mouzin
Eric
E
Alter
Miriam J
MJ
Margolis
Harold S
HS
Vugia
Duc J
DJ
D000208:Acute Disease; D000776:Anesthesiology; D001483:Base Sequence; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis* / Q000635:transmission*; D006801:Humans; D017757:Infectious Disease Transmission, Professional-to-Patient; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011322:Primary Prevention / Q000379:methods*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D018570:Risk Assessment; D012307:Risk Factors
D012367:RNA, Viral