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Hepatitis B infections after gynaecological surgery
J Welch1, M Webster, A J Tilzey
1Department of Virology, United Medical School, (St. Thomas' Campus), London.
Abstract:
When acute hepatitis B developed in 3 patients who had had gynaecological surgery, the surgeon was found to be a carrier of hepatitis B e antigen. Of 268 patients operated on by this surgeon in one hospital, 247 were screened for markers of recent or current hepatitis B. 22 (9%) had such markers, associated with symptoms in 5. The operations carrying greatest risk of infection were hysterectomy (10/42) and caesarean section (10/51). These findings strengthen the case for vaccination of all surgeons and medical students against hepatitis B.
Insights
Hepatitis B transmission occurred from a surgeon carrying the hepatitis B e antigen to patients undergoing gynecological surgery. Vaccination is recommended for all surgeons and medical students to prevent hepatitis B infection.
Area of Science:
- Hepatology
- Infectious Diseases
- Surgical Safety
Background:
- Hepatitis B virus (HBV) poses a significant risk in healthcare settings.
- Surgical procedures can facilitate HBV transmission if healthcare providers are carriers.
Purpose of the Study:
- To investigate the transmission of hepatitis B from a carrier surgeon to patients.
- To identify surgical procedures with the highest risk of HBV transmission.
Main Methods:
- Screening of 247 patients operated on by a surgeon identified as a hepatitis B e antigen carrier.
- Serological testing for markers of recent or current hepatitis B infection.
Main Results:
- 22 out of 247 (9%) patients showed markers of hepatitis B infection.
- Hysterectomy and caesarean section were associated with the highest rates of infection (10/42 and 10/51, respectively).
- 5 patients developed symptomatic hepatitis B.
Conclusions:
- A surgeon can be a source of hepatitis B virus transmission during gynecological surgery.
- Specific procedures like hysterectomy and caesarean section carry a higher risk.
- Universal hepatitis B vaccination for surgeons and medical students is strongly supported.