Rimland D, Parkin W E, Miller G B, Schrack W D
N Engl J Med. 1977 Apr 28;296(17):953-8. doi: 10.1056/NEJM197704282961701.
Over a four-year period in a five-county area, 71 patients with clinical hepatitis B had dental work performed in the two to six months before their illness. Fifty-five cases were traced to a single oral surgeon. Seventy-nine per cent of these patients were positive for hepatitis B surface antigen (HBsAg) and most had no other recognized source of hepatitis. An investigation of the implicated dentist uncovered no gross inadequacies in instrument sterilization or general dental procedures; however, the dentist was found to be an asymptomatic carrier of HBsAg of the same subtype (ay) as nine of 11 of his patients who had hepatitis and whose serums were available for testing. Since no HBSAg was found in the dentist's saliva, urine or feces, and since he admitted to having frequent cuts on his fingers, it is possible that a "hemoral" transmission of HBs Ag produced hepatitis in his patients.
在一个五县地区的四年时间里，71名临床诊断为乙型肝炎的患者在患病前两到六个月内接受了牙科治疗。55例病例可追溯到同一名口腔外科医生。这些患者中有79%的乙型肝炎表面抗原（HBsAg）呈阳性，且大多数患者没有其他已知的肝炎感染源。对涉事牙医的调查发现，其器械消毒或一般牙科操作并无明显不当之处；然而，发现该牙医是无症状的HBsAg携带者，其携带的HBsAg亚型（ay）与11名患肝炎且血清可供检测的患者中的9名相同。由于在该牙医的唾液、尿液或粪便中未发现HBsAg，且他承认手指经常受伤，因此有可能是HBsAg通过“血液”传播导致其患者感染了肝炎。
