Electric Razors as a Potential Vector for Viral Hepatitis

http://wwwlawyer.com/articles/article3642.cfm

                        Viral hepatitis is an important public health threat. In the United States

                        the prevalence of chronic hepatitis C infection is approximately 1.5

                        percent and that of chronic hepatitis B infection is 5.5 percent. (1) The

                        viruses that cause these infections are transmitted primarily through

                        contaminated blood and body fluids, with the most efficient mode of

                        transmission being direct, percutaneous exposure to blood.

                        The rate of viral hepatitis is significantly higher among patients in the

                        Veterans Affairs medical system than it is in the general population. As

                        many as 24 percent of nonalcoholic patients in Veterans Affairs facilities

                        who do not have liver disease have antibodies to hepatitis B, and 3.0

                        percent have antibodies to hepatitis C. (2) While rotating through the

                        Veterans Affairs Hospital in Jamaica Plain, Massachusetts, I noted a

                        dangerous practice that could be a potential source of transmission of

                        hepatitis virus among patients. On rounds one morning, I observed a

                        patient shaving with an electric razor labeled "9C" (identifying the ward).

                        After this patient finished using the razor, another patient immediately

                        picked it up and began using it. On inquiry, I learned that this razor was

                        not regularly disinfected. In speaking with medical school colleagues who

                        work within the Veterans Affairs system, I learned that the communal use

                        of an electric razor is not unique to this hospital.

                        Although I am not aware of whether hepatitis B or C virus has been

                        isolated from electric razors, transmission of these and other pathogens

                        through use of community razors is a potential hazard. Shaving is well

                        known to cause abrasions and small cuts. Household contacts of

                        persons infected with hepatitis viruses are counseled not to share razor

                        blades or toothbrushes. (3) The observation that 38 percent of Sicilian

                        barbers had antibodies to hepatitis C suggested that shaving is a

                        potential route of transmission. (4) In this era of increased vigilance and

                        care regarding blood-borne pathogens, I was surprised that the practice of

                        sharing razors has not been questioned. Efforts should be made to

                        replace community razors with the disposable, single-use variety in

                        Veterans Affairs hospitals and in any other institution where they are in

                        use.

                        Colleen R. Kelly, M.D.

                        Boston Medical Center

                        Boston, MA 02118

                        References

                        1. McQuillan GM, Coleman PJ, Kruszon-Moran D, Moyer LA, Lambert

                        SB, Margolis HS. Prevalence of hepatitis B virus infection in the United

                        States: the National Health and Nutrition Examination Surveys, 1976

                        through 1994. Am J Public Health 1999;89:14-8.

                        2. Mendenhall CL, Seeff L, Diehl AM, et al. Antibodies to hepatitis B virus

                        and hepatitis C virus in alcoholic hepatitis and cirrhosis: their prevalence

                        and clinical relevance. Hepatology 1991;14:581-9.

                        3. Shapiro CN. Transmission of hepatitis viruses. Ann Intern Med

                        1994;120:82-4.

                        4. Tumminelli F, Marcellin P, Rizzo S, et al. Shaving as potential source

                        of hepatitis C virus infection. Lancet 1995;345:658.

                        3/9/2000