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American Journal of Epidemiology Vol. 127, No. 3: 591-598
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health


research-article

A LARGE OUTBREAK OF ACUPUNCTURE-ASSOCIATED HEPATITIS B

GEORGE P. KENT1,2, JACK BRONDUM2, RICHARD KEENLYSIDE2, LEONARD M. LAFAZIA2 and H. DENMAN SCOTT2

1Division of Field Services, Epidemiology Program Office, Centers for Disease Control Atlanta, GA 30333
2Rhode Island Department of Health Providence, RI

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An epidemiologic investigation of an acupunctunst'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 <150 needles was 9%, compared with 33% for patients who received ≥450 needles (p < 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.

acupuncture; epidemiologic methods; hepatitis B; hepatitis B surface antigens; hepatitis B virus


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