Outbreak of hepatitis B associated with acupuncture

Area of Science:

• Infectious Diseases
• Public Health
• Medical Microbiology

Background:

• Hepatitis B virus (HBV) is a significant global health concern.
• Acupuncture is a traditional medical practice involving needle insertion.
• Concerns exist regarding the potential for infectious disease transmission during acupuncture if proper sterilization protocols are not followed.

Purpose of the Study:

• To investigate an outbreak of acute hepatitis B infections.
• To determine the association between acupuncture procedures and hepatitis B transmission.
• To identify the source and mode of transmission of hepatitis B in affected patients.

Main Methods:

• A retrospective cohort study was conducted among patients attending a chiropractic clinic.
• Epidemiological data on patient attendance, acupuncture exposure, and hepatitis B diagnosis were collected.
• Statistical analysis, including calculating attack rates and comparing infection frequencies, was performed.

Main Results:

• Six cases of acute hepatitis B were identified among patients who received acupuncture between February and May 1980.
• Hepatitis B occurred significantly more frequently in patients who received acupuncture (6/103) compared to those who did not (0/408; P < .0001).
• Infectious hepatitis B virus was likely transmitted via reused acupuncture needles that were inadequately disinfected with benzalkonium chloride, remaining infectious for 20-27 hours.

Conclusions:

• Inadequate disinfection of reusable acupuncture needles poses a significant risk for hepatitis B transmission.
• The study strongly suggests that improper sterilization practices at the chiropractic clinic led to the hepatitis B outbreak.
• Recommendations include the exclusive use of disposable needles or reusable needles that are properly cleaned and autoclaved after each use to prevent HBV transmission during acupuncture.