Acupuncture is unregulated in Britain
Infections spread by acupuncture needles are under-diagnosed worldwide, according to doctors in Hong Kong.
Writing in the British Medical Journal, they call for tighter infection controls and regulation.
Acupuncture is currently unregulated in the UK, but the government is consulting on the issue.
The British Acupuncture Council says their members follow a strict code of conduct which includes infection control measures.
Professor Patrick Woo and colleagues, from the University of Hong Kong, argue in an editorial that acupuncture may pose risks to patients because needles are inserted deep beneath the skin, and can introduce infection.
Drawing on worldwide studies, he says there have been cases where bacterial infections have been transmitted to patients who went on to develop serious problems.
They include joint destruction, multi-organ failure, flesh-eating disease and paralysis.
He says acupuncture has also been associated with hepatitis B.
Professor Woo believes the link with acupuncture often goes unrecognised because of the long incubation period of some of the transmitted infections.
The authors call for clinicians to "have a high index of suspicion" for infections that might be transmitted by acupuncture and to "alert health authorities about clusters of cases".
They conclude that "to prevent infections transmitted by acupuncture, infection control measures should be implemented, such as use of disposable needles, skin disinfection procedures, and aseptic techniques".
"Stricter regulation and accreditation requirements are also needed," they say.
British acupuncturists say practitioners who belong to a professional body in the UK have very high standards.
Janet Stringer, a practitioner and spokesperson for the British Acupuncture Council, said members undergo a three and a half year training and follow a strict code which includes the infection control measures suggested in the article.
She said: "Our code covers measures like single-use disposable needles.
"Clean needle technique is taken very seriously."
Dr Mike Cummings, medical director of the British Association of Medical Acupuncturists, said severe infections associated with acupuncture were "incredibly rare".
"Overall acupuncture is extremely safe," he said.
"We inform patients that the risk of severe side effects associated with acupuncture is one in every 200,000 cases."
But Edzard Ernst, Professor of Complementary medicine at the University of Exeter, said that although virtually all UK practitioners would use disposable needles, the infection risk depended on the competence of the therapist.
He said that although acupuncturists who were medically trained would know how to handle sterility, he would be more worried about some of those who do not have a medical background.
He pointed out that acupuncture is unregulated in the UK and anyone can set themselves up as an acupuncturist without training or accreditation.
The government has recently been consulting on whether, and if so how, to regulate herbal medicine and acupuncture practitioners.
A spokesman for the Department of Health said: "We received over 6,000 responses and we are currently in the final stages of the analysis. Our response will be published as soon as possible.
"We won't pre-empt the outcome of the consultation, but safety will be our main concern in making decisions."