Acupuncture transmitted infections.

Among all modalities of alternative medicine, acupuncture is one of the most widely recognized and evidence-based. According to the central concept in Traditional Chinese Medicine, healthy functioning of the various organ systems depends on the body’s circulating energy, known as Qi, moving in a harmonious and balanced way through a network of meridians (channels) and collaterals beneath the skin. In this network of meridians, the most important are the 12 main meridians and two of the eight extra meridians, Du Mai and Ren Mai. By inserting and manipulating fine needles into specific acupuncture points that are located in these channels of energy, it can promote the harmonious flow of Qi and stimulate the body’s own healing response. By 2010, more than 350 specific acupuncture points have been defined in the World Health Organization classification system. Throughout the years, acupuncture has been widely used for chronic pain, digestive, allergic and menstrual problems as well as cessation of smoking and drug and alcohol rehabilitation. Involving the insertion of needles up to several centimeters beneath the skin, the practice of acupuncture may pose risks to the recipients. Among all acupuncture associated complications, transmission of pathogenic microorganisms is one of the most important (Woo et al., 2010). With the increasing use of acupuncture globally, infections transmitted by acupuncture have become an emerging health problem. Needle reuse and/or inadequate skin disinfection has led to the transmission of infectious agents, including pyogenic bacteria, mycobacteria and blood borne viruses, from environment-to-patient and patientto-patient. In this article, we reviewed all cases and outbreaks of acupuncture transmitted infections published in the English literature in the past four decades. The importance of setting up and implementation of proper infection control guidelines is also discussed.