hepatitis transmission via acupuncture

[Guest guest]

Some studies on hepatitis transmission via acupuncture are below.

 

- Bill Schoenbart

 

............................

Bill Schoenbart, L.Ac.

PO Box 8099

Santa Cruz, CA 95061

 

831-335-3165

plantmed

 

 

 

Br J Cancer. 2002 Jul 29;87(3):314-8.

 

Hepatitis B and C virus prevalence in a rural area of South Korea: the role

of

acupuncture.

 

Shin HR, Kim JY, Kim JI, Lee DH, Yoo KY, Lee DS, Franceschi S.

 

Division of Cancer Control and Epidemiology, National Cancer Center Research

Institute, 809 Madu-dong, Ilsan-Gu, Koyang, Kyonggi, 411-764 South Korea.

 

A cross-sectional study evaluated the prevalence of and the risk factors for

hepatitis C and B viruses among 700 adults above the age of 40 years in a

rural

area of South Korea. Seropositivity for hepatitis C virus antibody (11.0%,

95%

confidence interval: 8.7-13.6) was higher than that for hepatitis B surface

antigen (4.4%, 95% confidence interval: 3.0-6.2). Anti-hepatitis C virus

seropositivity was associated with a history of repeated acupuncture (odds

ratio=2.1, 95% confidence interval: 1.1-4.0), and blood transfusion (odds

ratio=5.5, 95% confidence interval: 1.6-19.3) before 1992 when hepatitis C

virus

screening in blood donors became mandatory. Hepatitis C virus 2a was the

most

prevalent genotype, followed by 1b. Hepatitis C virus risk attributable to

acupuncture was 38% (9% for men and 55% for women). Safer acupuncture

practice

has become a priority for hepatitis C virus prevention in South Korea.

Copyright

2002 Cancer Research UK

 

 

 

Altern Ther Health Med. 2003 Jan-Feb;9(1):72-83.

 

Is acupuncture safe? A systematic review of case reports.

 

Lao L, Hamilton GR, Fu J, Berman BM.

 

University of Maryland School of Medicine, Complementary Medicine Program,

Baltimore, USA.

 

OBJECTIVE: The greater acceptance of acupuncture by healthcare professionals

and

the public has increased the importance of addressing public concern about

its

safety. Of particular concern has been the potential for transmission of

infectious disease and organ and tissue injury, as well as the training and

professional standards of acupuncture practitioners. This paper, therefore,

addresses the following question: What is the frequency and severity of

adverse

complications and events in acupuncture treatment? DATA SOURCES: All

first-hand

case reports of complications and adverse effects of acupuncture that could

be

identified in the English language literature were reviewed and classified

according to type of complication or adverse effect, circumstances of the

event,

credentials of the acupuncturist, country of occurrence, and long-term

patient

outcome. STUDY SELECTION: The case reports were selected by a search of 9

databases and covered the years between 1965-1999. DATA EXTRACTION: Relevant

papers were collected and analyzed by 2 reviewers. Over the 35 years, 202

incidents were identified in 98 relevant papers reported from 22 countries.

RESULTS: Types of complications included infections (primarily hepatitis

from a

few practitioners), and organ, tissue, and nerve injury. Adverse effects

included cutaneous disorders, hypotension, fainting, and vomiting. There is

a

trend toward fewer reported serious complications after 1988. CONCLUSIONS:

Declines in adverse reports may suggest that recent practices, such as clean

needle techniques and more rigorous acupuncturist training requirements,

have

reduced the risks associated with the procedure. Therefore, acupuncture

performed by trained practitioners using clean needle techniques is a

generally

safe procedure.

 

 

Commun Dis Public Health. 1999 Jun;2(2):137-40.

 

Comment in:

Commun Dis Public Health. 1999 Jun;2(2):79-81.

 

Outbreak of hepatitis B in an acupuncture clinic.

 

Walsh B, Maguire H, Carrington D.

 

Department of Public Health Medicine, Kingston and Richmond Health

Authority,

Surbiton. b.walsh

 

A retrospective cohort serological study identified five confirmed cases of

acute hepatitis B virus (HBV) infection in three and a half years at an

acupuncture clinic in London. These cases made up 1.7% of those treated by

an

acupuncturist who was a hepatitis B 'e' antigen (HBeAg) carrier. Virus

subtyping

and polymerase chain reaction--single strand conformation polymorphism assay

(PCR-SSCPA) showed that strains of virus from the acupuncturist and two of

the

five patients for whom it was possible to perform the test were

indistinguishable. Nine other patients who attended the same acupuncturist

had

antibody to the hepatitis B core antigen but had other risk factors for HBV

infection. No obvious mode of transmission was identified but cross

contamination of needles could not be ruled out in two cases. The fifth case

was

exposed to HBV after disposable needles were introduced. Routine

immunisation of

acupuncturists against HBV is recommended.

 

 

 

Harefuah. 1989 Mar 15;116(6):300-2.

 

[An outbreak of hepatitis B associated with acupuncture]

 

[Article in Hebrew]

 

Zahger D, Moses A, Slater PE, Ben-Ishai P, Levental A, Bashary A, Costin C,

Shouval D.

 

2 clusters of between 5 and 11 cases of hepatitis B virus infection were

associated with acupuncture by a physician late in 1986. The source of the

infection is believed to have been an Ethiopian immigrant, a known HBsAg

carrier. While he was being operated on a nurse cut her finger on a scalpel

blade. During the prodromal period of hepatitis which followed, she was

treated

by acupuncture. The acupuncture needles were supposedly sterilized by dry

heat

for 80 minutes at 200 degrees. However, there were apparently breaks in

technique which were responsible for the spread of the infection to at least

4

other women, ranging in age from 26 to 80 years. We stress the need for

strict

enforcement of correct sterilization procedures whenever needles are used to

pierce skin. This should be performed only by licensed practitioners of

officially recognized occupations, some of which are not as yet covered by

our

national health regulations.

 

 

 

Am J Epidemiol. 1988 Mar;127(3):591-8.

 

A large outbreak of acupuncture-associated hepatitis B.

 

Kent GP, Brondum J, Keenlyside RA, LaFazia LM, Scott HD.

 

Division of Field Services, Centers for Disease Control, Atlanta, GA 30333.

 

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.

 

 

 

J Fam Pract. 1986 Feb;22(2):155-8.

 

Outbreak of hepatitis B associated with acupuncture.

 

Stryker WS, Gunn RA, Francis DP.

 

In the period February to May 1980, acute hepatitis B occurred in six

patients

who had received acupuncture at a chiropractic clinic. Of persons attending

the

clinic (October 1979 to April 1980), hepatitis B occurred more frequently

among

those who had received acupuncture (6 of 103) than among those who had not

(0 of

408; P less than .0001). Hepatitis patients had received acupuncture during

two

exposure periods: November 27-28, 1979, and February 19-20, 1980. During

these

periods the clinic reused acupuncture needles after immersing them overnight

in

a 1:750 solution of benzalkonium chloride. The sequence of acupuncture

sessions

suggests that hepatitis B virus remained infectious on the acupuncture

needles

for 20 to 27 hours despite this procedure. It is recommended that only

either

disposable needles or reuseable needles that have been physically cleaned

and

autoclaved after each use be used in acupuncture procedures.