Kent G P, Brondum J, Keenlyside R A, LaFazia L M, Scott H D
Division of Field Services, Centers for Disease Control, Atlanta, GA 30333.
Am J Epidemiol. 1988 Mar;127(3):591-8. doi: 10.1093/oxfordjournals.aje.a114834.
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.
一项针对罗德岛一名针灸师诊疗情况的流行病学调查发现，1984年有35名患者感染了乙肝病毒。在该针灸师1984年接诊的366名患者中，316名（86%）完成了问卷调查并提交了血清进行乙肝血清学检测。使用乙肝核心抗原免疫球蛋白M抗体检测（IgM抗-HBc）发现了17例患者，否则这些患者可能未被发现。35例患者中的34例仅在该针灸师经营的两家诊所中的一家接受过治疗。在治疗过程中接受更多针灸针数的患者更有可能被感染；接受少于150针的患者的发病率为9%，而接受大于或等于450针的患者的发病率为33%（p<0.001）。在1984年的一个月期间，首例病例患者更有可能处于病毒血症状态，这期间的发病率高于其他任何时期（相对风险=4.1，95%置信区间=2.3-7.3）。在观察该针灸师的操作技术时，研究人员注意到了针具污染的几种潜在机制。这项研究凸显了重复使用针具情况下乙肝传播的可能性。
