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A case of acute hepatitis B related to previous gynecological surgery in Japan

Abstract

A 41-year-old woman became ill with acute hepatitis B after gynecological surgery performed by a surgeon who was hepatitis B surface antigen positive. The surgeon was positive for hepatitis B e antigen, and HBV DNA concentrations in the serum, saliva, and sweat of the surgeon were very high. HBV genotype and partial HBV DNA sequences from the HBV-infected surgeon were identical to those in the HBV-infected patient. Extensive research by the committee including infection control and prevention specialists judged the source of infection to be a surgeon infected with HBV. Transmission of HBV from a healthcare worker to patients who are not immune to HBV can actually happen. This case report illustrates the importance of a stringent policy of a nationwide HBV universal vaccination program.

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References

  1. Lettau LA, Smith JD, Williams D, Lundquist WD, Cruz F, Sikes RK, et al. Transmission of hepatitis B with resultant restriction of surgical practice. JAMA. 1986;255:934–7.

    PubMed  Article  CAS  Google Scholar 

  2. Welch J, Webster M, Tilzey AJ, Noah ND, Banatvala JE. Hepatitis B infections after gynaecological surgery. Lancet. 1989;1:205–7.

    PubMed  Article  CAS  Google Scholar 

  3. Polakoff S. Acute hepatitis B in patients in Britain related to previous operations and dental treatment. Br Med J. 1986;291:33.

    Article  Google Scholar 

  4. Prentice MB, Flower AJE, Morgan GF, et al. Infection with hepatitis B virus after open heart surgery. BMJ. 1992;302:761–4.

    Article  Google Scholar 

  5. Heptonstall J. Lessons from two linked clusters of acute hepatitis B in cardiothoracic surgery patients. Commun Dis Rep CDR Rev. 1996;6:R119–25.

    PubMed  CAS  Google Scholar 

  6. Shaw FE, Barrett CL, Hamm R, Peare RB, Coleman PJ, Hadler SC, et al. Lethal outbreak of hepatitis B in a dental practice. JAMA. 1986;255:3261–4.

    Article  Google Scholar 

  7. Rimland D, Parkin WE, Miller GB Jr, Schrack WD. Hepatitis B outbreak traced to an oral surgeon. N Engl J Med. 1977;296:953–8.

    PubMed  Article  CAS  Google Scholar 

  8. Crob PJ, Bischof B, Naeff F. Cluster of hepatitis B transmitted by a physician. Lancet. 1981;2:1218–20.

    Google Scholar 

  9. Johnston BL, MacDonald S, Lee S, LeBlanc JC, Gross M, Schlech WF, et al. Nosocomial hepatitis B associated with orthopedic surgery. Can Commun Dis Rep. 1992;18:89–90.

    PubMed  CAS  Google Scholar 

  10. Pas SD, Fries E, De Man RA, Osterhaus AD, Niesters HG. Development of a quantitative real-time detection assay for hepatitis B virus DNA and comparison with two commercial assays. J Clin Microbiol. 2000;38:2897–901.

    PubMed  CAS  Google Scholar 

  11. Jenison SA, Lemon SM, Baker LN, Newbold JE. Quantitative analysis of hepatitis B virus DNA in saliva and semen of chronically infected homosexual men. J Infect Dis. 1987;156:299–307.

    PubMed  Article  CAS  Google Scholar 

  12. Corden S, Ballard AL, Ijaz S, Barbara JA, Gilbert N, Gilson RJ, et al. HBV DNA levels and transmission of hepatitis B by health care workers. J Clin Virol. 2003;27:52–8.

    PubMed  Article  CAS  Google Scholar 

  13. Bond WW, Favero MS, Peterson NJ, Gravelle CR, Ebert JW, Maynard JE. Survival of hepatitis B virus after drying and storage for one week. Lancet. 1981;1:550–1.

    PubMed  Article  CAS  Google Scholar 

  14. Bell DM, Shapiro CN, Ciesielski CA, Chamberland ME. Preventing bloodborne pathogen transmission from health-care workers to patients. The CDC perspective. Surg Clin N Am. 1995;75:1189–203.

    PubMed  CAS  Google Scholar 

  15. Harpaz R, Von Seidlein L, Averhoff FM, Tormey MP, Sinha SD, Kotsopoulou K, et al. Transmission of hepatitis B virus to multiple patients from a surgeon without evidence of inadequate infection control. N Engl J Med. 1996;334:549–54.

    PubMed  Article  CAS  Google Scholar 

  16. Mukerjee AK, Westmoreland D, Rees HG. Response to the discovery of two practising surgeons infected with hepatitis B. Commun Dis Rep CDR Rev. 1996;6:R126–8.

    PubMed  CAS  Google Scholar 

  17. Halle M. Patients want ban on operations by doctors with hepatitis B. BMJ. 1996;313:576.

    PubMed  Article  CAS  Google Scholar 

  18. The Incident Investigation Teams and Others. Transmission of hepatitis B to patients from four infected surgeons without hepatitis B e antigen. N Engl J Med. 1997;336:178–84.

    Article  Google Scholar 

  19. Sundkvist T, Hamilton GR, Rimmer D, Evans BG, Teo CG. Fatal outcome of transmission of hepatitis B from an e antigen negative surgeon. Commun Dis Public Health. 1998;1:48–50.

    PubMed  CAS  Google Scholar 

  20. Oliver SE, Woodhouse J, Hollyoak V. Lessons from patient notification exercises following the identification of hepatitis B e antigen positive surgeons in an English health region. Commun Dis Public Health. 1999;2:130–6.

    PubMed  CAS  Google Scholar 

  21. Molyneaux P, Reid TM, Collacott I, McIntyre PG, Dillon JF, Laing RB. Acute hepatitis B in two patients transmitted from an e antigen negative cardiothoracic surgeon. Commun Dis Public Health. 2000;3:250–2.

    PubMed  CAS  Google Scholar 

  22. Spijkerman IJ, van Doorn LJ, Janssen MH, Wijkmans CJ, Bilkert-Mooiman MA, Coutinho RA, et al. Transmission of hepatitis B virus from a surgeon to his patients during high-risk and low-risk surgical procedures during 4 years. Infect Control Hosp Epidemiol. 2002;6:306–12.

    Article  Google Scholar 

  23. Laurenson IF, Jones DG, Hallam NF, Saunders CJ, Fraser DM, Carman WF. Transmission of hepatitis B virus from a vaccinated healthcare worker. J Hosp Infect. 2007;66:393–4.

    PubMed  Article  CAS  Google Scholar 

  24. Henderson DK, Dembry L, Fishman NO, Grady C, Lundstrom T, Palmore TN, et al. SHEA guideline for management of healthcare workers who are infected with hepatitis B virus, hepatitis C virus, and/or human immunodeficiency virus. Infect Control Hosp Epidemiol. 2010;31:203–32.

    PubMed  Article  Google Scholar 

  25. Department of Health and Human Services, Centers for Disease Control and Prevention. Implementation of newborn hepatitis B vaccination—worldwide, 2006. MMWR Morb Mortal Wkly Rep. 2008;57:1249–52.

    Google Scholar 

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Acknowledgments

The authors are indebted to Dr. Shogo Iwabuchi, Director of Ohuna Chuo Hospital, and Dr. Satoshi Kimura, Director of Tokyo Teishin Hospital, for their important suggestions and advice during the investigation and preparation of the manuscript.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Correspondence to Hirokazu Komatsu.

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Sugimoto, S., Nagakubo, S., Ito, T. et al. A case of acute hepatitis B related to previous gynecological surgery in Japan. J Infect Chemother 19, 524–529 (2013). https://doi.org/10.1007/s10156-012-0477-5

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  • DOI: https://doi.org/10.1007/s10156-012-0477-5

Keywords

  • Acute hepatitis B
  • HBV genotype
  • HBV DNA sequence
  • Surgery
  • Transmission
  • Vaccine