Interruption of hepatitis B transmission by modification of a gynaecologist's surgical technique

Between January, 1979, and January, 1980, hepatitis B developed in three women within 6 months of their undergoing gynaecological surgery at a community hospital in Mississippi. Subsequent investigation revealed another case of hepatitis B associated with gynaecological surgery. The gynaecologist who carried out all four operations (gynaecologist A) was a chronic carrier of hepatitis B. Hepatitis B surface antigen subtyping on serum from gynaecologist A and from one of the hepatitis B patients gave identical results. Patients of gynaecologist A who underwent total abdominal hysterectomies or bilateral salpingo-oophorectomies were at a greater risk of acquiring hepatitis B than were patients in whom the same procedures were carried out by a control group of gynaecologists. After gynaecologist A modified his surgical technique and began wearing two pairs of gloves during surgery, there was no further hepatitis B transmission to his surgical patients.