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ARTICLE |

Hepatitis B Prophylaxis in Dental Professionals FREE

Calvin E. Oyer, MD; Teresita Redondo, MD
JAMA. 1986;256(23):3217-3217. doi:10.1001/jama.1986.03380230041017
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To the Editor.—  The report of an outbreak of hepatitis B (HB) transmitted by a dentist1 was of much interest and was informative in emphasizing one of the methods of spread of a serious illness. In the last paragraph of the article, however, the authors concluded that this tragic outbreak "should reinforce recommendations to administer HB vaccine to dental professionals early in their careers" and implied that earlier vaccination of the dentist in question would have prevented this tragedy.While the dentist was a carrier of HB virus (as indicated by his positivity to hepatitis B surface antigen [HBsAg] and hepatitis B e antigen persisting for at least one year), the conclusion that earlier vaccination would have prevented this state cannot be supported. It has been demonstrated2 that administration of vaccine to HBsAg carriers does no harm but fails to eliminate the persistent positivity to HBsAg. Administration of

REFERENCES

Shaw FE, Barrett CL, Hamm R, et al:  Lethal outbreak of hepatitis B in a dental practice . JAMA 1986;;255:3260-3264.
Dienstag JL, Stevens CE, Bhan AK, et al:  Hepatitis B vaccine administered to chronic carriers of hepatitis B surface antigen . Ann Intern Med 1982;;96:575-579.
Wong VCW, Reesink HW, Ip HMH, et al:  Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis B vaccine and hepatitis B immunoglobulin: Double-blind randomised placebo-controlled study . Lancet 1984;;1:921-926.

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Shaw FE, Barrett CL, Hamm R, et al:  Lethal outbreak of hepatitis B in a dental practice . JAMA 1986;;255:3260-3264.
Dienstag JL, Stevens CE, Bhan AK, et al:  Hepatitis B vaccine administered to chronic carriers of hepatitis B surface antigen . Ann Intern Med 1982;;96:575-579.
Wong VCW, Reesink HW, Ip HMH, et al:  Prevention of the HBsAg carrier state in newborn infants of mothers who are chronic carriers of HBsAg and HBeAg by administration of hepatitis B vaccine and hepatitis B immunoglobulin: Double-blind randomised placebo-controlled study . Lancet 1984;;1:921-926.
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To understand the clinical management of acute heart failure syndromes.
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