NEW YORK (Reuters Health) – A study in the February 11th issue of the Archives of Internal Medicine suggests that an anesthesiologist acquired hepatitis C virus (HCV) from one patient and later transmitted it to another patient while administering anesthesia during a thoracotomy.
"An anesthesiologist was diagnosed as having acute hepatitis C 3 days after providing anesthesia during the thoracotomy of a 64-year-old man (patient A)," Dr. Sara H. Cody, of Santa Clara County Public Health Department, San Jose, California, and colleagues note. "Eight weeks later, patients A was diagnosed as having acute hepatitis C."
The investigators tested serum samples from the surgical team and from surgical patients at the two hospitals where the anesthesiologist worked for antibodies to HCV. They sequenced the quasispecies from hypervariable region 1 in order to determine the genetic relation of the HCV isolates.
Only the anesthesiologist tested positive for antibody to HCV out of all the surgical team members. Six of the 348 surgical patients tested positive for antibody to HCV. Two of these patients –patients A and a woman, termed patient B–had the same genotype (1a) as the anesthesiologist.
"The quasispecies sequences of these three isolates clustered with nucleotide identity of 97.8% to 100.0%," the authors explain. "Patient B was positive for antibody to HCV before her surgery 9 weeks before the anesthesiologist's illness onset."
No exposure-prone invasive procedures were performed by the anesthesiologist, and he reported no breaks in technique or incidents. In addition, he denied any risk factors for HCV.
The authors of the report point out that current guidelines "do not recommend restrictions of the professional activities of HCV-infected healthcare workers."