A Large Outbreak of Acupuncture-Associated Hepatitis B

Abstract

An epidemiologic investigation of an acupuncturist's practice in Rhode Island identified 35 patients who were infected with hepatitis B virus during 1984. Of 366 patients seen by the acupuncturist during 1984, 316 (86%) completed questionnaires and submitted serum for hepatitis B serology. Use of tests for immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) identified 17 case-patients who otherwise may have gone undetected. Thirty-four of the 35 case-patients were treated in only one of the two clinics run by the acupuncturist. Patients who received a greater number of acupuncture needles during their treatment course were more likely to have been infected; the attack rate for patients who received less than 150 needles was 9%, compared with 33% for patients who received greater than or equal to 450 needles (p less than 0.001). Attack rates were higher during a one-month period when the index case-patient was more likely to have been viremic than during any other period in 1984 (relative risk = 4.1, 95% confidence interval = 2.3-7.3). While observing the acupuncturist's technique, the investigators noted several potential mechanisms for needle contamination. This study highlights the potential for transmission of hepatitis B in situations of repeated needle use.

Relationship of cosmetic procedures and drug use to hepatitis C and hepatitis B virus infections in a low-risk population

“…However, outbreaks of HBV infection related to individual tattoo and acupuncture establishments have been reported. 24,25 Furthermore, the results of this study may not apply to populations in which HCV or HBV infection rates are high, such as among those who are injection drug users or those who are older and whose exposures to these procedures or practices occurred more than 20 years ago. Additional studies will be necessary to determine if these results are applicable to older-aged populations.…”

Selected Infectious Diseases

“…By monitoring the exposures of recently infected persons, surveillance for acute disease also provides the information critical for identifying outbreaks of hepatitis B that, while uncommon, do occur. Nosocomial outbreaks involving patient-to-patient transmission have occurred in association with a variety of transmission vehicles including multidose medication vials, reusable fingerstick devices, and other contaminated medical equipment 8,9,10,11,12 . Although cases of provider-to-patient transmission of HBV are rare in the United States continued vigilance is needed to detect these cases should they occur.…”

Measuring the Thickness of the Abdominal Wall at Abdominal Acupoints Using Ultrasonography and Analyzing Correlations with Physical Examination Values in Functional Dyspepsia Patients

“…Complications in acupuncture practice may result from violations of sterile procedure and/or negligence of the practitioners. Serious side effects include cardiac tamponade [43,44], pneumothorax [45,46], endocarditis [47][48][49], hepatitis [50][51][52], chylothorax [53], and spinal cord injury [50,54], and minor side effects include fainting [55,56] and skin reactions [57][58][59][60]. Pneumothorax is the most common mechanical organ injury associated with acupuncture treatment [50,[61][62][63][64], and the related reports are from the United States [65][66][67], Canada [68], The Netherlands [69,70], France [71], Norway [63], Portugal [72,73], Denmark [74], Taiwan [75], Japan [50,76], China [45,77], and Hong Kong [78].…”