Hepatitis B Virus Transmission in a Dental Office

Redd JT, Baumbach J, Kohn W, Nainan O, Khristova M, Williams I. Patient-to-patient transmission of hepatitis B virus associated with oral surgery. J Infect Dis 2007;195(9):1311�14. View full text.

Allos BM, Schaffner W. Transmission of hepatitis B in the health care setting: the elephant in the room ... or the mouse? J Infect Dis 2007;195(9):1245�47. View full text.

Hepatitis B virus (HBV) is a bloodborne virus of major concern in dental infection control. HBV transmission in a dental health care setting is rare, particularly since standard precautions and routine vaccinations for dental workers were adopted (1985 and 1987, respectively). There have been no reported transmissions from a dental worker to a patient since 1987.

A Journal of Infectious Diseases article describes a patient-to-patient transmission of HBV in a dental setting. The event occurred in 2001, when a person with acute hepatitis B was reported to a state health department. The state health department's epidemiologic investigation found that the patient had none of the traditional hepatitis B risk factors, but reported having recent oral surgery. An investigation of the oral surgery practice where the patient received dental treatment revealed that another surgical patient seen earlier on that same day was on the state's reportable disease registry for HBV. Molecular epidemiologic techniques indicated transmission of HBV between the two patients.

When investigators later visited the office and monitored its operation, they found that the office followed standard infection control practices, and that all staff had been previously vaccinated and were negative for HBV. The investigators could only speculate that a lapse in cleanup procedures had occurred after the source patient, leaving an area contaminated with blood.

This is the only known case of patient-to-patient hepatitis B transmission in a dental setting. The Brief Report, by John T. Redd, MD, MPH, and colleagues from the Centers for Disease Control and Prevention and the New Mexico Department of Health, is accompanied by a Commentary.*
 

Additional Resources

Epidemiologic Notes and Reports Outbreak of Hepatitis B Associated with an Oral Surgeon � New Hampshire. Oral surgeon who was not vaccinated against HBV unknowingly transmitted HBV to four patients.

Hepatitis B Frequently Asked Questions
These FAQs cover hepatitis B infections, vaccinations, chronic hepatitis B, serology, traveler抯 health, and more.

Viral Hepatitis Transmission in Ambulatory Health Care Settings
The delivery of health care has the potential to transmit HBV and hepatitis C virus (HCV) to both health care workers and patients. Recommendations At-a-Glance to prevent outbreaks in health care settings.

Hepatitis B Vaccination Recommendations for Adults
Offers information and resources targeted to each of the different settings in which adult hepatitis B vaccination is recommended.

A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States (PDF�0K)
Health care providers should inform all adult patients about the health benefits of vaccination, who is at risk for HBV infection, and who should be vaccinated.

One or more documents on this Web page is available in Portable Document Format (PDF). You will need Acrobat Reader to view and print these documents.

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Page last reviewed: October 29, 2008
Page last modified: August 7, 2007
Content source: Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion