Hepatitis: What Every Health Care Worker Needs to Know (AGD 148)
Presenter: John A. Molinari, PhD and Eve Cuny, RDA, MS
The risk of cross-infection between dental practitioners, auxiliaries and patients is considered significant, particularly because most human microbial pathogens have been isolated from the oral cavity. It follows that the incidence of certain infectious diseases is significantly higher among dental professionals than that observed in the general population. Concern over these occupational disease states, with particular attention given to viral hepatitis, has led to increased awareness and understanding by health personnel in the matter of infectious disease and infection control. Health professional organizations have issued guidelines and recommendations to assist treatment providers in the prevention of disease transmission. We consider the five major types of viral hepatitis in terms of clinical and asymptomatic disease, transmission and diagnostic tests, with major emphasis on hepatitis B and hepatitis C. The significance of infection to dental health care workers is discussed by considering manifestations of disease, chronic sequelae of infection, implications of a carrier state, clinical vaccines, and recommendations for appropriate infection control precautions.
John A. Molinari, PhD - Dr. Molinari received a B.A. in Biology from St. Vincent College and a Ph.D. in Microbiology from the University of Pittsburgh, School of Dental Medicine. He is currently Director of Infection Control for THE DENTAL ADVISOR. Previously, he served for 32 years at the University of Detroit Mercy School of Dentistry as Professor and Chairman of the Department of Biomedical Sciences and Director of Infection Control. He has published over 350 scientific articles, text chapters, and abstracts in the areas of microbiology and immunology, and lectures nationally and internationally on topics dealing with infectious diseases and infection control. Dr. Molinari is also co-author of the text Cottone’s Practical Infection Control in Dentistry, with the 3rd edition published in 2009. He was a founding member of the Organization for Safety, Asepsis and Prevention (OSAP) and received that organization’s highest honor, the Dr. James Crawford Award, for his lifetime achievement in the fields of infection prevention and safety. His activities also include serving as a consultant for the CDC, ADA Council on Scientific Affairs, Council on Dental Practice, and hospitals in the Detroit area in the areas of infectious disease and infection control. Previously, he was the Project Coordinator for the governmental Health Resources and Services Administration Task Force on AIDS and Dental Education, as well as Chairman of the American Association of Dental School’s Curriculum Advisory Committee on Bloodborne Infectious Diseases. Dr. Molinari also was appointed and served as Chairman of the State of Michigan Governor’s Risk Reduction and AIDS Policy Commission. He was the Infection Control section editor for The Compendium of Continuing Education in Dentistry and a member of the Editorial Board for The Journal of the American Dental Association. He currently writes a monthly column for Dental Economics. In recognition of his efforts, Dr. Molinari was inducted as an honorary member of the Michigan Dental Association, the International College of Dentists, the American College of Dentists, and is a 2009 recipient of the ADA Golden Apple Award.
Eve Cuny, RDA, MS - Ms. Cuny received her BA in management and MS in Health Services Administration from Saint Mary’s College of California. She is the Director of Environmental Health and Safety and Assistant Professor, Department of Dental Practice at the University of the Pacific School of Dentistry in San Francisco, CA. Ms. Cuny has published numerous textbook chapters and articles in the scientific literature. She lectures extensively in the United States and Latin America on infection control and regulatory compliance. Ms. Cuny has acted as advisor or reviewer for the California Dental Association, the California Dental Board, the Centers for Disease Control and Prevention, and the American Dental Association. She is past Chairperson and a previous board member for the Organization for Safety and Asepsis Procedures (OSAP).
Upon completion of this course, the dental professional should be able to:
• Define hepatitis and its symptomatology.
• Distinguish between the various viruses associated with hepatitis.
• Describe the general features of hepatitis A, hepatitis B, hepatitis C, hepatitis D, hepatitis E, and hepatitis Non A-E including the etiology, transmission, diagnosis, sequelae, prophylaxis, and precautions for each.
• List and discuss the serologic markers that are utilized in the diagnosis of hepatitis B
• Identify risk factors for hepatitis B virus and other hepatitis viruses.
• Discuss the typical course of acute hepatitis B infection, from the prodromal state to recovery.
• Explain the carrier state for hepatitis B.
• Recall viral hepatitis contraction and transmission risks for dental health professionals.
• Describe the formulation and clinical applications of immune serum globulin, hepatitis B immune globulin, and available hepatitis B vaccines.
• Summarize the recommended standard precautions for infection control to be observed by dental professionals when treating patients.
CONTINUING EDUCATION CREDIT
The ADAA has an obligation to disseminate knowledge in the field of dentistry. Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.
The ADA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.
Credits earned upon completion of this course may be used to meet DANB’s Recertification Requirements.
CONCERNS OR HELP
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