Shortly after getting a nose ring during Thanksgiving, a New York City mother became extremely ill and required a lifesaving liver transplant. The cause was an extremely rare type of hepatitis B that doctors say was likely linked to the nose ring. (In general, hepatitis B virus is preventable and treatable.)

As WABC reports (you can watch the video below), 37-year-old Dana Smith of Queens, New York, asked her sister to take her to the emergency room January 12. By that point, she was unable to eat food or hold down water, and she had begun to vomit blood. Smith hardly remembers the trip to Long Island Jewish Medical Center, but she woke up at North Shore University Hospital—with a new liver.

She had been diagnosed with fulminant hepatitis B (fulminant means extreme and fast). As a result, Smith was put in a medically induced coma while doctors waited for an available liver for transplantation. A matching living donor was found within 48 hours, and Smith returned home January 26.

She was recently reunited with her doctor, Lewis Teperman, MD, director of Northwell’s Transplant Services, WABC reports. The two have advice they want to share.

The decision to go to the hospital despite her fears of COVID-19 likely saved her life, Smith said, urging others not to put off seeking needed care during the pandemic.

And for anyone considering getting piercings, doctors say you should make sure you are vaccinated against hepatitis B.

The hepatitis B virus is transmitted through hep B–positive blood, semen and other body fluids. It is highly infectious and can be spread through sharing needles, razors, glucose monitors and even toothbrushes as well as through sex. It can also be transmitted from pregnant mothers to their babies during birth.

The hep B virus attacks the liver. In most cases, the infection resolves on its own, leaving the person immune to future hepatitis B infection. But in chronic cases—those that don’t clear up within six months—the virus can lead to fibrosis (mild to moderate liver scarring), cirrhosis (serious liver scarring), liver cancer, liver failure and death. Chronic hepatitis B is not curable, but a number of hep B treatments can prevent liver damage.

Fulminant hepatitis is very rare but can occur with both hepatitis A (spread through contaminated food and water) and hepatitis B. These sudden and severe hepatitis cases are more common in hep A, occurring in about 1 out of 100 people with hepatitis A. In the United States, fulminant hep B accounts for 7% of all fulminant hepatitis cases.

The good news is that hepatitis B is preventable. A vaccine for the virus became available in the late 1980s, and the Centers for Disease Control and Prevention (CDC) recommends universal vaccination of infants within 24 hours of birth. Because of the vaccine, the number of people estimated to be living with hep B in the United States dropped from about 260,000 in 1980 to nearly 21,000 in 2016. According to the most recent CDC data, only 3,322 cases of hep B were reported in 2018.

To learn more about the different types of hepatitis, including details on treatments, prevention and cures, see the Hepatitis Basics in For a collection of articles about hep B, click #Hepatitis B.