A STUDY OF THE ROLE OF TISSUE-PENETRATIONS IN THE TRANSMISSION OF VIRAL HEPATITIS

Frequency of detectable HBsAg in fluid adherent to the endoscope, gastric juice, and saliva collected during endoscopy in patients positive for HBsAg

Gastric juice, saliva, and fluid adherent to the endoscope were collected from 50 patients who were seropositive for hepatitis B surface antigen (HBsAg) during the endoscopic examination of the upper gastrointestinal tract, and examined for HBsAg, using the radioimmunoassay. A positive test was obtained from 42.0% of the saliva samples, in 32.0% of the gastric juice specimens, and in 31.3% of the fluid adherent to the scope. These results should be taken as a warning, that calls for a more careful screening of the patients and disinfection of the endoscope.

Viral hepatitis as an occupational hazard of dentists

To estimate the risk of viral hepatitis for practicing dentists, a questionnaire survey was conducted in the greater Los Angeles area among the part-time faculty of the University of Southern California School of Dentistry. An icteric episode diagnosed as hepatitis had been experienced by 11, representing 3.9% of the 285 dentists to whom questionnaires were mailed or 4.5% of the 242 respondents. All illnesses occurred after graduation from dental school, and five were after 1967. For general dentists, the minimal frequency was 2.7 (5 of 187 in the sample). Specialists with emphasis in surgical forms of dentistry had hepatitis with a significantly higher frequency: 3 of 19 oral surgeons; 1 of 13 periodontists; and 1 of 9 endodontists. The risk did not vary in this sample with the proportion of young adult patients (15 to 29 years of age) in the practice or recognizable illicit self-injection among patients. Auxiliary dental personnel seem to have a lower risk than dentists themselves. Measures to reduce the hazard are indicated, but at present these are confined to greater care in avoiding percutaneous introduction.