In August, the national Centers for Disease Control in Atlanta reported the first case of a patient being infected with the AIDS virus by a health professional. Kimberly Borgalis, who was diagnosed with the disease in December of 1989, was apparently infected with the disease during oral surgery in 1987. Her dentist did not reveal to her that he was infected with the AIDS virus. Since Borgalis' case was revealed by the CDC, two more of the dentists' patients have tested positive for the AIDS virus.

The Florida State Health Department released a letter the dying dentist had written to his patients when he was in the last stages of AIDS. In the letter, the dentist notes that he took all of the precautions urged by the CDC guidelines -- including the wearing of gloves and a mask -- and apologized for continuing to treat the patients after learning that he was infected with the AIDS virus. The letter also charges that if he did spread the disease to any of his patients, the fault lies with the CDC for failing to issue adequate guidelines to health care workers with AIDS about precautions to take while treating patients.

More recently, it was disclosed that a prominent breast surgeon at Johns Hopkins Hospital, Dr. Rudolph Almaraz, died of AIDS in November. Dr. Almaraz had performed surgery until March of this year. Johns Hopkins is doing a study of 1,600 of his patients to determine whether any became infected during surgery.

Hopkins officials also have called for better guidance from the CDC in this area. Indeed, both incidents raise new questions about the CDC's guidelines for preventing AIDS infection of patients by health care workers -- specifically, the question of whether the guidelines should allow carriers of the AIDS virus to be employed as health care workers who perform invasive surgical procedures.

Early CDC guidelines acknowledged a risk of transmission of the AIDS virus during an invasive surgical procedure where the health care worker is injured and his blood mingles with the blood of the patient. The guidelines relied on by the Florida dentist noted that "transmission {of the AIDS virus} during invasive surgical procedures remains a possibility." The CDC expressed hope that, if followed, its guidelines "will minimize the risk of transmission of {the AIDS virus} from health care workers to patients during invasive surgical procedures."

It is significant that the CDC does not say that following the guidelines will eliminate the risk of transmission of the AIDS virus, but that such practices will only "minimize the risk." It is time that the CDC recommends a program of serological testing for health care workers, which would all but eliminate the risk of transmission of the AIDS virus from health care workers to their patients.

The CDC has already acknowledged that gloves can be damaged during invasive surgical procedures resulting in injury to the health care worker and the mingling of blood. An article on the CDC guidelines for prevention of surgical wound infections, published in the professional journal Infection Control, observed that punctures in gloves "occur frequently." The article cites an earlier bacteriological study which noted that 20 percent of the gloves used in invasive surgical procedures may be perforated during operations.

After conceding that the risk of health care workers transmitting the AIDS virus to patients during invasive surgical procedures cannot be eliminated, the CDC specifically refused to rule out the utility of a serological testing program for health care workers who perform invasive surgical procedures. The implementation of such a testing program as a requirement for employment of health care workers who perform invasive surgical procedures is likely to be upheld by the courts because of the close relationship between the test and the reasonable employment qualifications of the position being sought.

According to Tom Skinner at Centers For Disease Control in Atlanta, as of May 1990, there were 144 dental workers in the United States known to have the AIDS virus. Overall, there are 5,000 health care workers who have AIDS. Many more are infected with the virus but do not show any symptoms of the disease. Existing federal guidelines allow them to continue treating patients.

The nature of the relationship between a prostrate, helpless surgical patient and the members of the surgical team is such that the employment standards used to hire these health care workers should ensure that the patients is not subjected to any unnecessary health risks. The right of the patient to have all steps taken to avoid any unnecessary health risks dictates a high standard of safety that the members of the surgical team should be required to meet.

Anything less than a CDC guideline requiring that all health care workers involved in invasive surgical procedures be tested for the AIDS virus, and prohibiting those testing positive from participating in such procedures, would be a violation of the Hippocratic oath. It is clear that new guidelines are needed. But for Kimberly Borgalis, the new guidelines will have come too late.

The writer is a lawyer in Phoenix.