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September 1990

An Outbreak of Hepatitis B Associated With Jet Injections in a Weight Reduction Clinic

Author Affiliations

From the Division of Field Services, Epidemiology Program Office (Drs Canter and Horan and Ms Good), the Nosocomial Infections Laboratory Branch, Hospital Infections Program (Mr Bond) and Hepatitis Branch, Division of Viral Diseases (Dr Alter), Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga; the Long Beach (Calif) Department of Public Health (Ms Mackey); and the Infectious Disease Branch, California Department of Health Services, Berkeley, Calif (Drs Roberto and Chin).

Arch Intern Med. 1990;150(9):1923-1927. doi:10.1001/archinte.1990.00390200105020

• From January 1984 through November 1985, 31 clinical cases of hepatitis B occurred among attendees of a weight reduction clinic (clinic 1). Before the onset of illness, each case-patient had received a series of injections of human chorionic gonadotropin administered by jet injectors at clinic 1. Clinical history, risk factor assessment, serologic evaluation, and review of clinic injection records were obtained on 287 (84%) of 341 persons who had attended clinic 1 in the first 6 months of 1985. Of this cohort, 21% (60/287) had evidence of acute infection with hepatitis B virus (either documented clinical cases or antibody to hepatitis B core antigen, IgM positive). Of persons who had been given human chorionic gonadotropin at the clinic during the period studied, 24% (57/239) of those receiving human chorionic gonadotropin only by jet injector experienced acute hepatitis B virus infection. None of the 22 persons who had received injections only by syringe experienced hepatitis B virus infection. Stopping the use of the jet injectors on July 2, 1985, at clinic 1, was associated with the termination of this outbreak. This investigation demonstrated that jet injectors can become contaminated with hepatitis B virus and then may be vehicles for its transmission.

(Arch Intern Med. 1990;150:1923-1927)