Correspondence

Electric Razors as a Potential Vector for Viral Hepatitis

N Engl J Med 2000; 342:744-745March 9, 2000

Article

To the Editor:

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

4 References

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   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;89:14-18
   Web of Science | Medline

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   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;14:581-589
   CrossRef | Web of Science | Medline

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   Shapiro CN. Transmission of hepatitis viruses. Ann Intern Med 1994;120:82-84
   Web of Science | Medline

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   Tumminelli F, Marcellin P, Rizzo S, et al. Shaving as potential source of hepatitis C virus infection. Lancet 1995;345:658-658
   CrossRef | Web of Science | Medline

Citing Articles (4)

Citing Articles

1. 1

   Darryl Macias, Steven Weiss, Amy Ernst, W. Ann Maggiore, Todd Nick, David Sklar. (2010) Comparison of Emergency Physiciansʼ and Juris Doctorsʼ Opinions on Emergency Department Patient Restraints Usage. Southern Medical Journal 103:7, 623-629
   CrossRef

2. 2

   Micha Campbell, Steven Weiss, Philip Froman, Paul Cheney, Doug Gadomski, Melissa Alexander-Shook, Amy Ernst. (2008) Impact of a Restraint Training Module on Paramedic Students' Likelihood to Use Restraint Techniques. Prehospital Emergency Care 12:3, 388-392
   CrossRef

3. 3

   Darryl Macias, Steven Weiss, Amy Ernst, Todd G. Nick, David Sklar. (2007) Development of the Video Assessment of Propensity to Use Emergency Restraints Scale (VAPERS): Results of the VAPERS Study Group. Academic Emergency Medicine 14:6, 515
   CrossRef

4. 4

   (2000) Electric Razors as a Potential Vector for Viral Hepatitis. New England Journal of Medicine 342:24, 1840-1841
   Full Text

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