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Why Are Surgeons Susceptible To Hepatitis?

According to data gathered by the World Health Organization, over 1.5 million individuals die from the hepatitis virus each year. Studies further suggest that 1 in 3 people become exposed or contract hepatitis B or C, sometimes both, with many of them unaware of the infection due to symptoms lying dormant. Though there are people who exhibit symptoms like dark-colored urine, nausea, fatigue, vomiting, jaundice, and pain in the abdomen, there is still a large chunk of infected people who continue to be asymptomatic. Therefore, receiving proper testing is vital.

Despite testing for hepatitis being easily accessible, there are still many instances of contamination occurring. Unfortunately, some of these instances happen quite often in the medical industry. One such example can be found in the continuous rise of surgeons who are infected by the hepatitis virus. But why are surgeons susceptible to hepatitis?

Hepatitis a quick overview

An inflammatory condition in the liver is referred to as hepatitis. This infection in the liver is caused by an extremely contagious virus. This virus is just one of the numerous types categorized under hepatitis that can drastically affect the overall function of the liver.

More often than not, the hepatitis virus can be acquired through close contact with an infected individual or contamination from an object, food, or water. In most cases, mild hepatitis does not need treatment. Individuals who are diagnosed with hepatitis often completely recuperate without any lasting damage to the liver.

Hepatitis classifications and how they can be transmitted in the healthcare industry

No matter how careful surgeons are in the workplace there’s still a fairly good chance of them catching this deadly virus. Currently, there are five types of hepatitis known to man, they are as follows:

Hepatitis A

Of all the viruses hepatitis A is the mildest and is considered to be a short-term health issue. Generally, this type does not necessitate treatment. For the most part, individuals diagnosed with Hep A are simply advised to take some bed rest, hydration, and nutrition when symptoms are causing any malaise (vomiting or diarrhea, etc.).  Thankfully, the infection can be prevented through vaccination. Both children and adults can be administered with the hepatitis A shot, it can also be combined with the vaccine for Hep B.

In the healthcare industry HAV or healthcare associated hepatitis virus can occur through fecal to oral contamination. Medical professionals, especially surgeons are susceptible to hepatitis, particularly when an undiagnosed patient passes it on through fecal transmission.  Diarrhea, neglecting to wash hands and disinfect, or from eating, drinking or sharing food and items with the patient or his family members.

Hepatitis B

Unlike Hep A, the B variant has lifelong repercussions. HBV or hepatitis B virus can cause cirrhosis or liver scarring, failure, cancer, and even death when left untreated. In the healthcare environment, hepatitis B can be transferred whenever an infected patient’s bodily fluid or blood enters another person’s body. Aside from fluid transfer, other primary points of contamination include contact with syringes, sharp implements, and needles that were exposed to an infected person.

Hepatitis C

It is important to understand that liver disease in the form of hepatitis C can result in a lasting infection. Some of these long-term health issues include scarring in the liver and cancer. HCV can spread from person to person via blood contact. In the medical field, surgeons are susceptible to hepatitis when they become exposed to a patient who remains undiagnosed. It is also possible to contract the disease from coming into contact with sharp implements, needles, and syringes that have been infected with HCV.

Hepatitis D

When a person displays HDV symptoms, he is expected to have a severe case of hepatitis. HDV-positive individuals should expect the rapid progression of cirrhosis in the liver. Often, infections of hepatitis D occur between a mother and her infant, it can also be contracted through intimate sexual relations. Also known as delta hepatitis, this type is rare and is unable to multiply without the presence of HBV (hepatitis B). 

For the time being, info put together by the US National Library of Medicine National Institutes of Health shows that there are no transmissions of HDV from patient to healthcare provider or vice versa.

Hepatitis E

Of all the hepatitis types, Hep E is a disease that’s waterborne. The virus is primarily found in places with unsanitary conditions, usually areas where fecal matter can cross-contaminate a water supply. Studies conducted by the CDC show that the virus is uncommon in the U.S but has been prevalent in Asia, Africa, Central America, and the Middle East. There is currently no data supporting any contamination of hepatitis E in the medical industry.

Dangers of hepatitis in surgeons

An increasing number of surgeons have become highly susceptible to hepatitis over the years. Occupational exposure to the hepatitis virus has caused many patients to worry over transmission that could occur when virus-positive surgeons conduct invasive surgeries.

Similarly, surgeons who are assigned to take on operations on patients who are undiagnosed of hepatitis can easily become contaminated during the course of the procedure. Since no information regarding the presence of the disease is known, the patient and of course the surgeon can unknowingly pass it onto the next patient or coworker he comes into contact with. Compared to HIV, surgeons are more likely to become infected with hepatitis B which can manifest itself in the skin, mucous membrane, etc., of a virus carrier.

Diagnosing hepatitis

Just like any other disease, hepatitis can be diagnosed by seeking a consultation with a physician. The doctor will take into account a person’s history in order to establish what potential risk factors can be involved and whether hepatitis detected is infectious or not.

Physical tests conducted by the doctor can include pressing down onto a person’s abdominal region. Any pain or tenderness detected will be noted because this could be indicative of an enlarged liver. Similarly, any visual indication of yellowness in the skin or eyes is also monitored closely.

Liver tests involve drawing blood samples that are used to establish the liver’s condition and its efficiency. Any results from the tests that are abnormal can be indicative of liver problems. The presence of enzyme levels in the liver that are high can further show that stress or damage is present.

Blood tests besides the ones conducted to check on liver function are also likely to be requested by the physician. Additional blood tests are required to determine what the source of the abnormalities are. Further tests conducted on the blood can be used to detect if viruses common in hepatitis are present, along with the possibility of conditions that can be found on autoimmune hepatitis.

Ultrasound exams are a great way to take images of organs that are within the abdominal region. The tests can reveal if there is inflammation or damage in the liver. It can show if the abdomen has any fluid, if any tumors can be seen in the liver, and lastly if the gallbladder has any irregularities. All in all, ultrasounds can give a clearer image of any issues that can be found in the liver or organs in the immediate area.

Liver biopsies are also a fairly normal suggestion. The procedure is slightly invasive and requires the certified physician from taking tissue samples from the liver. The procedure can be done with a needle and does not necessitate actual surgery. Biopsies can help the healthcare practitioner to determine the level of liver swelling or infection.

Surgeons will always be susceptible to hepatitis

The virus brought about by hepatitis can easily be transferred from patients to doctors and vice versa. Thus it is no surprise why surgeons are susceptible to hepatitis. Although the majority of transmissions involve hepatitis B and hepatitis C, other hepatotropic related viruses can also be contracted.

Accidents from infected needles and incidents during suturing are so far the most common modes of contamination between a hepatitis positive patient, the surgeon and other healthcare workers present in the operating theater. Similarly, hepatitis can also be passed on from surgeon to patient especially if the medical professional is unaware of an infection. Other sources of contamination of the hepatotropic virus can come from environmental factors such as blood tainting on countertops, fluids on the equipment, and other surfaces which can leave healthcare workers exposed and at risk of infection.

While many preventive measures and therapeutic modes exist for dealing with the virus have exponentially improved throughout the years, the chances of a surgeon becoming infected with viral hepatitis is not uncommon and remain to be a workplace-related danger. Unless newer treatments and methods are created to better eradicate or at the very least, minimize the risks associated with the transmission of the disease, the best defense a surgeon has is immunization and regular testing. Stringent protocols to avoid hepatitis transmission must be adhered to for the overall safety of patients and workers in the healthcare industry.

Sources:

https://www.euro.who.int/en/health-topics/communicable-diseases/hepatitis/data-and-statistics

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2023923/

https://www.mayoclinic.org/diseases-conditions/hepatitis-a/symptoms-causes/syc-20367007

https://www.healthline.com/health/hepatitis#What-is-hepatitis?

https://www.facs.org/about-acs/statements/22-hepatitis

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