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January 22, 1973, Vol 223, No. 4 >
ARTICLE | January 22, 1973

Viral Hepatitis: An Occupational Hazard to Surgeons FREE

James L. Rosenberg, MD; Don P. Jones, MD; Lance R. Lipitz, MD; Joseph B. Kirsner, MD, PhD
[+] Author Affiliations

Read before the 22nd annual meeting of the American Association for the Study of Liver Disease, Chicago, Nov 4, 1971.

Reprint requests to 950 E 59th St, Chicago 60637 (Dr. Rosenberg).


JAMA. 1973;223(4):395-400. doi:10.1001/jama.1973.03220040013003
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References

An epidemic of serum hepatitis (hepatitis-associated antigen [HAA]-positive) among surgical house staff occurred at Albert Merritt Billings Hospital in the winter of 1971. Four surgeons, who had operated on a patient in whom HAA-positive serum hepatitis subsequently developed, were affected. Arthralgia or arthritis and rash were prominent clinical features of this outbreak. Reduced synovial fluid complement level and a synovial fluid that was HAA-positive were found in one of the surgeons. A detailed evaluation of the 75 medical and allied medical personnel who cared for this patient before, during, and after surgery uncovered no additional cases of hepatitis. We believe, therefore, that the serum hepatitis virus was transmitted to the surgeons while they were operating, most likely through tissue penetration by contaminated surgical instruments or materials.

REFERENCES

1 +
Leibowitz S, et al:  Serum hepatitis in a blood bank worker . JAMA 140:1331-1333, 1949;.
2 +
Trumbull ML, Greiner DJ:  Homologous serum jaundice: Occupational hazard to medical personnel . JAMA 145:965-967, 1951;.
3 +
Strömbeck JP:  Hepatiten som kirurgisk yrkessjukdom . Norm Med 46:1468, 1951;.
4 +
Byrne EB:  Viral hepatitis: An occupational hazard of medical personnel . JAMA 195:362-364, 1966;.
5 +
Kozlovskii PA:  Botkin's disease in surgeons . Sov Med 22:148-149, 1958;.
6 +
Schüttmann W:  Die gutachterlicke Beurteilung der Hepatitisgefahrdung in chirurgischen Einrichtungen . Z Gesamte Hyg 14:755-761, 1968;.
7 +
Prince AM, Burke K:  Serum hepatitis antigen (SH): Rapid detection by high voltage immunoelectroosmophoresis . Science 169:593-595, 1970;.
8 +
Barker LF, et al:  Transmission of serum hepatitis . JAMA 211:1509-1512, 1970;.
9 +
Wright R, McCollum RW, Klatskin G:  Australia antigen in acute and chronic liver disease . Lancet 2:117-121, 1969;.
10 +
Allen JG, Sayman WA:  Serum hepatitis from transfusions of blood . JAMA 180:10791085, 1962;.
11 +
Kingdon HS:  Hepatitis after Konȳne . Ann Intern Med 73:656-657, 1970;.
12 +
Russel TR, Rogue FE, Miller FA:  A new method for detection of the leaky glove. A study on incidence of defective gloves and bacterial growth from surgeons' hands . Arch Surg 93:245-248, 1966;.
13 +
Luparello FJ, Wolf J:  Hospital epidemic of hepatitis . Am J Dig Dis 3:436-443, 1958;.
14 +
Mirick GS:  Infective hepatitis , in Hoffbauer FW (ed): Transactions of the 11th Conference on Liver Injury . New York, Macy, 1952;, pp 20-71.
15 +
Hoagland CL, Shank RE:  Infectious hepatitis: A review of 200 cases . JAMA 130:615-621, 1946;.
16 +
Fernandez R, McCarty DJ:  The arthritis of viral hepatitis . Ann Intern Med 74:207-211, 1971;.
17 +
Alpert E, Isselbacher KJ, Schur PH:  The pathogenesis of arthritis associated with viral hepatitis: Complement component studies . N Engl J Med 285:185-189, 1971;.
18 +
Onion DK, Crumpacker CS, Gilliland BC:  Arthritis of hepatitis associated with Australia antigen . Ann Intern Med 75:29-33, 1971;.

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1 +
Leibowitz S, et al:  Serum hepatitis in a blood bank worker . JAMA 140:1331-1333, 1949;.
2 +
Trumbull ML, Greiner DJ:  Homologous serum jaundice: Occupational hazard to medical personnel . JAMA 145:965-967, 1951;.
3 +
Strömbeck JP:  Hepatiten som kirurgisk yrkessjukdom . Norm Med 46:1468, 1951;.
4 +
Byrne EB:  Viral hepatitis: An occupational hazard of medical personnel . JAMA 195:362-364, 1966;.
5 +
Kozlovskii PA:  Botkin's disease in surgeons . Sov Med 22:148-149, 1958;.
6 +
Schüttmann W:  Die gutachterlicke Beurteilung der Hepatitisgefahrdung in chirurgischen Einrichtungen . Z Gesamte Hyg 14:755-761, 1968;.
7 +
Prince AM, Burke K:  Serum hepatitis antigen (SH): Rapid detection by high voltage immunoelectroosmophoresis . Science 169:593-595, 1970;.
8 +
Barker LF, et al:  Transmission of serum hepatitis . JAMA 211:1509-1512, 1970;.
9 +
Wright R, McCollum RW, Klatskin G:  Australia antigen in acute and chronic liver disease . Lancet 2:117-121, 1969;.
10 +
Allen JG, Sayman WA:  Serum hepatitis from transfusions of blood . JAMA 180:10791085, 1962;.
11 +
Kingdon HS:  Hepatitis after Konȳne . Ann Intern Med 73:656-657, 1970;.
12 +
Russel TR, Rogue FE, Miller FA:  A new method for detection of the leaky glove. A study on incidence of defective gloves and bacterial growth from surgeons' hands . Arch Surg 93:245-248, 1966;.
13 +
Luparello FJ, Wolf J:  Hospital epidemic of hepatitis . Am J Dig Dis 3:436-443, 1958;.
14 +
Mirick GS:  Infective hepatitis , in Hoffbauer FW (ed): Transactions of the 11th Conference on Liver Injury . New York, Macy, 1952;, pp 20-71.
15 +
Hoagland CL, Shank RE:  Infectious hepatitis: A review of 200 cases . JAMA 130:615-621, 1946;.
16 +
Fernandez R, McCarty DJ:  The arthritis of viral hepatitis . Ann Intern Med 74:207-211, 1971;.
17 +
Alpert E, Isselbacher KJ, Schur PH:  The pathogenesis of arthritis associated with viral hepatitis: Complement component studies . N Engl J Med 285:185-189, 1971;.
18 +
Onion DK, Crumpacker CS, Gilliland BC:  Arthritis of hepatitis associated with Australia antigen . Ann Intern Med 75:29-33, 1971;.

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