Hepatitis outbreak in UK blamed on alternative doctor
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* Caroline Richmond

A physician has been condemned for causing Europe's largest outbreak of hepatitis B at his clinic in north London. Dr. Madhusadan Shivadikar, 69, a registered physician, practised an obscure form of acupuncture. A report by the local health authority says 60 people from across Britain were infected after undergoing treatment at the Finchley Alternative Medical Centre.

The report, prepared with the Public Health Laboratory Service, found there was no infection control policy in place. Shivadikar had made no arrangements for blood spillages or splashes, and some of his medical notes were so stained with blood that inspectors did not want to touch them.

They found that he did not wear a gown or gloves to treat his patients and that the centre did not have any sterilization equipment. Clinical waste was thrown into an open rubbish bin and disposed of with general household waste.

His technique, called autohemotherapy, involves extraction of some of the patient's blood, mixing it with saline and reinjecting it. Although Shivadikar used sterile needles he used the same syringe each time, and he used the same bottle of saline on up to 15 patients. "The incident team felt that this procedure posed a high risk of cross-contamination and the multidose bottle was the most likely vehicle of transmission of the infection," reported Dr. Stephen Farrow, the authority's director of public health.

A spokesperson for the General Medical Council, the disciplinary body for British doctors, told *CMAJ* that Shivadikar has been suspended. Despite the damning evidence, Shivadikar was unrepentant. "I do not believe all those people got hepatitis from here," he told reporters. "The equipment would not have got contaminated and I do not know how it could happen. Lots of people are carriers already. I will practise it again because it helps people."

## Acknowledgments

Plans are well under way for the country's largest medical bonspiel and golf tournament, which will be held in Victoria Mar. 29-Apr. 1, 2000. Calgary pathologist Trygve Larsen, one of the organizers, says the Canadian Interprovincial Medical Bonspiel and Golf Tournament is open to all Canadian physicians. MD Management Ltd., the CMA's financial subsidiary, is one of the main sponsors. Details on registration, accommodations and costs are available from Larsen, 403 209-5204; (fax) 403 209-5292; trygve.larsen{at}cls.ab.ca. (Figure)

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/6/678.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/161/6/678.1/F1)

Figure.