The US Justice Department has ruled that two applicants with hepatitis B virus (HBV) have the right to attend medical school at the University of Medicine and Dentistry of New Jersey. The Justice Department based its ruling on the Americans with Disability Act (ADA) and a 2012 update of CDC’s guidelines for management of health workers and students with HBV. The decision marks the first time the Justice Department “pursued an ADA complaint” for an HBV-infected person.
A medical student at New Jersey’s state school said that he felt pressured to quit school when school officials learned he was a carrier for the chronic liver disease. Until he felt “persistently tired” and went to the doctor, the student had no idea he had HBV, which he contracted at birth from his mother. HBV spreads through blood and other bodily fluids; unprotected sex and injection drug use are risk factors for the virus. CDC estimates that up to 1.4 million Americans have chronic HBV.
CDC revised its 1991 guidelines last year because of advances in HBV prevention and treatment. Universal infant immunization cut the number of new HBV cases by 80 percent, and new drugs can reduce the amount of virus in a patient’s blood to very low or undetectable levels, which decreases the risk of transmission. CDC reports only one case of doctor-to-patient transmission since 1991, when an orthopedic surgeon who was unaware he had HBV infected two to eight patients.
The medical student has responded well to HBV treatment and plans to resume his medical studies, perhaps in the field of hepatology. Approximately 25 percent of medical and dental students were born to mothers from countries where HBV is endemic, according to CDC.
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