AIDS Anxiety

Concern over health workers

In Boston, a 46-year-old medical technician lay dying of acquired immune deficiency syndrome last week. Before he became too ill to speak, he insisted that he did not belong to any of the four high-risk AIDS categories: homosexual men, intravenous drug users, Haitians and hemophiliacs. Instead, he blamed his illness on accidentally pricking himself with a needle while taking blood samples at the laboratory where he worked.

In England, a nurse at an undisclosed hospital became ill after pricking herself with a syringe containing blood drawn from an AIDS patient. For more than 20 days she suffered from the fiulike symptoms and fever that often characterize the early stage of the lethal disease. Though she appears to have recovered, her blood shows evidence of infection with the AIDS-related virus.

These two cases caused a flurry of concern in the medical community. Ever since the disease was first described, doctors have feared that it would spread to health-care workers. The pattern of transmission—through body fluids and needles—closely resembles that of hepatitis B, a dangerous virus that poses a serious threat to hospital personnel.

According to officials at the Centers for Disease Control in Atlanta, there have been 232 cases of AIDS in American healthcare workers; of these, 23 did not belong to one of the four risk groups. None of these cases, however, has been directly connected to occupational exposure, insists Dr. James Curran, director of the CDC task force on AIDS. Even the Boston case is subject to question. So far, investigators have been unable to find out if the laboratory worker had actually handled AlDS-con-taminated blood. "Whether he got AIDS from the needle stick is unclear and is likely to remain unclear," says Curran.

The British incident is more worrisome and appears to be the first documented case of transmission from patient to medical worker. However, this case has several unusual features. According to the journal Lancet, it was not an ordinary needle-prick injury since it may have involved the actual injection of infected blood. Also, the nurse's patient apparently had contracted AIDS in Africa, where the virus seems to have different characteristics from its American cousins and appears to be spread primarily by heterosexual contact.

Fears were allayed somewhat last week with the release of a new study by Dr. Martin Hirsch of Massachusetts General Hospital. Hirsch has followed 85 hospital employees who routinely worked with AIDS patients or samples of their body fluids over periods of one to three years. None contracted the disease. As long as the CDC's safety guidelines for working with the AIDS virus are followed closely, says Hirsch, "health-care workers are at low risk."