A surgeon with AIDS: lack of evidence of transmission to patients

Article Abstract:

More than 4,500 cases of acquired immunodeficiency syndrome (AIDS) have been reported among health care workers, including physicians and surgeons, in the US. There have, however, been no confirmed reports of an occupational transmission of human immunodeficiency virus (HIV) from an infected health care worker to a patient. In the health care setting, there have been reports of HIV transmission from infected patients to health care workers. A surgeon diagnosed with AIDS had a confirmed-positive HIV antibody test and biopsy-confirmed Pneumocystis carinii pneumonia, a common infection among AIDS patients. Significant attention by the media resulted in concerns by the public regarding possible transmission of the HIV infection to the surgeons' patients. The estimated time of the onset of the surgeon's initial infection with HIV was calculated to be seven years prior to development of AIDS. This study attempted to contact by mail all patients who had operations performed by the surgeon with AIDS. Of 2,160 patients, 1652 were located and their medical histories were evaluated; the remaining patients had moved or died. A total of 615 patients were tested for HIV antibody. No patient was found to have died of any of the diseases associated with AIDS; however, the surgeon did remove a lymph node from a patient who may have been already infected with AIDS at the time of surgery. The patient was an intravenous drug user and acknowledged frequent sexual encounters with prostitutes. The patient tested positive for HIV antibody and the lymph node cultured positive for Mycobacterium tuberculosis, another common organism causing infection in patients with AIDS. There was no evidence of HIV transmission from the surgeon with AIDS to any of his patients. The risk of HIV transmission from a surgeon to a patient is judged to be low. According to the guidelines established by the Centers of Diseases Control (CDC), each case of an HIV-infected health care worker must continue to be evaluated on an individual basis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Standards, Medical care, Social policy, HIV (Viruses), HIV, AIDS (Disease), Surgeons, United States. Centers for Disease Control and Prevention

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Mumps transmission in hospitals

Article Abstract:

The childhood disease mumps is caused by a virus infecting the parotid glands in the neck. The disease, which is usually mild in children, can be quite severe in adults. Although some patients have acquired mumps infections during hospitalization, few outbreaks have been reported. In 1986, about 18 percent of mumps outbreaks reported nationally were found in Tennessee. The transmission of mumps, rarely reported, is investigated in a Tennessee hospital. Information regarding mumps infections was obtained from 146 infection control practitioners and 17 hospitals. The mumps infections were acquired by six healthcare workers from three different hospitals while in the hospital. In two facilities housing mainly adolescents, nine patients contracted mumps. A number of individuals in this institution had an opportunity to contract mumps in the community, which was experiencing an outbreak at the time. It is difficult to determine whether patients are contracting the virus during hospitalization, because the incubation period is from 16 to 18 days. Additionally, many infected patients do not have symptoms of the disease. Although the risk for acquiring mumps is relatively low, patients with mumps should be isolated for nine days after the appearance of gland swelling. It is suggested that during community outbreaks, hospitals should make sure that susceptible healthcare workers and patients are protected. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Diseases, Communicable diseases, Nosocomial infections, Cross infection, Epidemics, Mumps

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Fetal carbon monoxide poisoning at a motel

Article Abstract:

Accidental carbon monoxide poisoning causes an estimated 1,500 deaths in the United States each year. In one accident, a man died and his wife was found in a coma due to carbon monoxide poisoning in their motel room. Emergency care providers neglected to check other rooms in the motel for similar cases of poisoning, although the first cases were clearly diagnosed as being carbon monoxide poisoning. After more than 10 hours, two more cases were found in adjacent motel rooms. The motel was evacuated and an investigation revealed that a structural defect in the walls allowed the motel's air conditioning system to draw carbon monoxide air from gas heaters of the indoor pool into the rooms in question. In cases of environmental exposure, emergency personnel must make every effort to identify other people potentially at risk.

Physiological aspects, Accidents, Hotels and motels, Poisoning, Accidental, Accidental poisoning, Carbon monoxide

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