A look-back investigation of patients of an HIV-infected physician: public health implications

Article Abstract:

It is estimated that more than 7,000 health care workers in the US have AIDS. Because the human immunodeficiency virus (HIV), the virus that causes AIDS. There is growing concern about the transfer of the virus from infected physicians or health care workers to patients. To date, transmission of the HIV from one infected health care worker to patients has been reported. The case involved five patients who developed HIV infection after receiving treatment from a dentist who was HIV positive. However, the risk of developing HIV infection from an infected health care worker is extremely low. The Centers for Disease Control recommends that HIV-infected health care workers not perform procedures that could expose the patient to the virus. More than 30 HIV-infected health care workers have been identified publicly. In some cases, the patients who had contact with these health care workers were notified and tested for HIV infection. A review of the medical literature indicates that out of 1,166 patients of 4 different HIV-infected surgeons, only 1 patient was HIV positive (a patient with a known history of intravenous drug use). This article describes the case report of a family physician who developed a rash-like infection with small red bumps on his hands, arms, and face, one and a half years before he was diagnosed with HIV infection. The physician had contact with 1,382 patients, 336 of whom were identified as having been at risk for exposure to the virus. These patients were notified and HIV testing was performed on 325 of the 336 patients. All of the patients tested were HIV negative. The cost of performing the investigation was $130,000. It is concluded that look-back investigations, such as this one, be performed only when there is clear evidence that the patients were at risk for exposure to the HIV. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physician and patient, Physician-patient relations, Physicians, Medical professions, HIV infection, HIV infections, Diseases, Disease transmission, AIDS (Disease), Medical personnel and patient, Medical personnel-patient relations

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The emergence of Escherichia coli O157:H7 infection in the United States: the changing epidemiology of foodborne disease

Article Abstract:

The outbreak of Escherichia (E.) coli O157:H7 infections due to apple cider and fast-food hamburgers highlights the need for improved screening for this and other foodborne organisms and the need for better monitoring of food safety. E.coli O157:H7 infections are characterized by bloody diarrhea and are known to cause hemolytic uremic syndrome, which is a form of kidney failure. Because of changes in food production and distribution, outbreaks of foodborne diseases are often widely dispersed throughout a community. The nation's public health system is ill-prepared to handle this type of challenge. Laboratories do not routinely screen stool samples for E.coli O157:H7, and few clinicians consider this infection in making their diagnosis. Only 11 states required clinicians to report cases of E.coli O157:H7 infection to state health authorities as of Oct 1992. There is also limited financing to support surveillance and conduct investigations of outbreaks.

Editorial, Prevention, Foodborne diseases, Escherichia coli infections

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A population-based study of sexually transmitted disease incidence and risk factors in human immunodeficiency virus-infected people

Article Abstract:

Linking state databases on sexually transmitted disease (STD) prevalence and on HIV prevalence may identify HIV-infected individuals with STDs who may need special counseling to avoid putting others at risk. Researchers combined two computer databases created by the state of Minnesota to track cases of gonorrhea and other STDs and cases of HIV. The rate of gonorrhea infection was higher among HIV-infected individuals than among the general population, indicating that they continued to practice high-risk sexual behaviors after acquiring HIV. Such individuals should receive special counseling and their sexual partners should be notified.

Health aspects, Sexually transmitted diseases, Analysis, Demographic aspects, HIV patients, Prevalence studies (Epidemiology)

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