TO THE EDITOR: I am troubl through ...

TO THE EDITOR: I am troubl through the following comment that was made by the agency of Dr. Morelli and colleagues: "Although acupuncture has been promot as a safe therapy, significant infections have occurr including human immunodeficiency virus and hepatitis, as a issue of the use of unsterilized needles" (1) This is a poorly researched observation that inaccurately states the even of risk in acupuncture.

Practitioners of acupuncture in the United States take courses forward clean needling technique. Acupuncture needle are gas sterilized to across 300[degrees]F and are individually packaged for single use. the pair the National Acupuncture Certification Board and state regulatory boards inspect safety issues.

Although there have been a not many case reports of human immunodeficiency virus and hepatitis infection, a review (2) of nine prospective studies of the safety of acupuncture construct no reported cases of disease transmission. (2) According to the same hint that Dr. Morelli and colleagues1 cite, the 1997 National Institutes of Health Consensus Statement (3) onward acupuncture notes that the documented proceeding of adverse events with acupuncture is extremely low

The make notes by the authors (1) is made without stating the specific risk flat and exaggerates the risk involved in acupuncture. In reality, acupuncture probably helps relieve pain more than the other modalities discussed.

DEXTER s LEVY, M.D., L.AC.

8966 W Bowle Ave., Unit L

Littleton, CO 80123

REFERENCES

(1) Morelli V Naquin C Weaver V Alternative therapies for traditional disease states: osteoarthritis. Am Fam Physician 2003;67:339-44

(2) Ernst E White AR. Prospective studies of the safety of acupuncture: a systematic review. Am J M 2001;110:481-5

(3) Berman BM Swyer JP Ezzo J The evidence for acupuncture as a treatment for rheumatologic conditions. Rheum Dis Clin North Am 2000;26:103-15

IN REPLY: We agree with Dr Levy's affects As he mentioned, the risks of acupuncture are extremely soft The intention in our article (1) was single to point out that there have been case reports of transmission of human immunodeficiency virus (HIV) and hepatitis from acupuncture needle We decided to mention HIV because of the severity of the disease and to mention hepatitis because acupuncture was cited in the late 1980 to have been the cause of at least sum of two units office-source outbreaks. (2,3) We chose not to mention the a great deal of rarer cases of cardiac tamponade, (4) pneumothorax, and endocarditis. (5)

Again, it is not our intention to present slanted or biased information or to govern patients away from therapies that could be helpful in treating debilitating symptoms. However, acupuncture, like other therapies mentioned in the article, has not been shown to alter the natural course of the disease in any way. And, at the same time, it would be irresponsible not to point abroad potential risks to patients.

VINCENT MORELLI, MD

Louisiana State Health Sciences Center

200 W Esplanade Ave., Ste 412

Kenner LA 70065

REFERENCES

(1) Morelli V Naquin C Weaver V Alternative therapies for traditional disease states: osteoarthritis. Am Fam Physician 2003;67:339-44

(2) Kent GP Brondum J Keenlyside RA, LaFazia LM Scott HD A large outbreak of acupuncture-associated hepatitis B Am J Epidemiol 1988;127:591-8

(3) Slater PE Ben-Ishai P Leventhal A, Zahger D Bashary A, Mose A, et al. An acupuncture-associated outbreak of hepatitis B in Jerusalem. Eur J Epidemiol 1988;4:322-5

(4) Kirchgatterer A, Schwarz CD Holler E Punzengruber C Hartl P Eber B Cardiac tamponade following acupuncture. Chest 2000;117:1510-1

(5) Norheim AJ. Adverse events of acupuncture: a study of the literature for the years 1981-1994 J Altern consummation Med 1996;2:291-7.

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