Proper infection control guidelines to tackle the growing number of acupuncture-transmitted diseases are urgently required, experts have said.

Acupuncture is one of the most widely practised strands of alternative medicine and is based on the theory that inserting and manipulating fine needles at specific points in the body helps to promote the flow of Qi or energy.

However according to Prof Patrick Woo of the University of Hong Kong, acupuncture may pose risks to patients as needles are inserted up to several centimetres beneath the skin. He believes that the number of reported cases of acupuncture-transmitted diseases are ‘the tip of the iceberg’.

Writing in the British Medical Journal, Prof Woo and his colleagues said that while most patients recover from infections, up to 10% of the reported pyogenic (pus making) bacterial infections end up with serious problems including joint destruction, multi-organ failure, flesh eating disease and paralysis.

He noted that while most infections caused are bacterial, there have been outbreaks of hepatitis B, and perhaps cases of hepatitis C and HIV that are believed to have been transmitted via acupuncture.

He also noted that in the 21st century, a new clinical syndrome has emerged – acupuncture mycobacteriosis. This is an infection caused by mycobacteria that rapidly grow around the acupuncture insertion point as a result of contaminated cotton wool swabs, towels and hot-pack covers. There is a long incubation period but the infection usually leads to large abscesses and ulcers.

“To prevent infections transmitted by acupuncture, infection control measures should be implemented, such as the use of disposable needles and skin disinfection procedures. Stricter regulation and accreditation requirements are also needed,” Prof Woo and his colleagues concluded.