A SURGEON would have to cut himself during an operation to pass on the hepatitis B virus to a patient, according to medical experts.
The director of the Virus Reference Laboratory at UCD, Dr Billy Hall, said yesterday that there had been very little study in this area, making it impossible to calculate the exact risk.
However, a person who was a carrier of the virus always had the potential to transmit it. "Accidents do happen during surgery", Dr Hall said. "But a surgeon would have to break his skin before that could happen. Coughing and sneezing would not transmit it."
Anecdotal evidence showed that there was "little if any" transmission to patients from health care workers who were carriers, he said. "However, you must bear in mind that surgery is a higher risk procedure."
Hepatitis B can be contracted through sexual contact, intravenous drug use or exchange of bodily fluids. Some of those infected will develop jaundice. They may run a temperature, have a tender abdomen, darkening of urine, loss of appetite and weight loss. These symptoms will occur within six months. Others will develop no symptoms and become "silent carriers".
"Most people will clear the infection within a six month period. They will self vaccinate", explained Dr Fiona Mulcahy, consultant physician at St James's Hospital. However, a small percentage of people - fewer than 5 per cent - can remain chronically ill. In a worst case scenario the liver becomes "overwhelmingly" infected and a patient can suffer acute liver failure. "This is a possibility, but it is very rare", Dr Mulcahy added.
She said that it was impossible to speculate on the levels of risk which might apply to the 400 patients contacted by the Mater. "It would depend on the surgery performed and on who was doing what. Every now and then surgeons do stab themselves accidentally. That is part of surgery."
She pointed out that some countries offered hepatitis B vaccinations to everyone. In Ireland, a number of hospitals were trying to make it a prerequisite that new employees were vaccinated. Campaigns were aimed at those most at risk, such as gay men and partners of people who had hepatitis B. People travelling to South East Asia, where it is endemic, are advised to seek vaccination.
"It is also not a bad idea really for anyone not in a stable heterosexual relationship", Dr Mulcahy added. However, the cost of the vaccine - up to £80 - can be a disincentive.
The president of the Irish Medical Organisation (IMO), Mr Hugh Bredin, said that he would be reluctant to recommend that screening and vaccination be mandatory. However, he felt there should be largescale voluntary vaccination of those at risk.