The government yesterday urged health-care workers involved in surgical, obstetric or dental procedures to take special precautions to avoid spreading AIDS -- acquired immune deficiency syndrome -- including routine use of gloves, masks, eye coverings and gowns.
The federal Centers for Disease Control said it has no reports that the AIDS virus has been transmitted from a health-care worker to a patient or a patient to a health-care worker during "invasive" medical procedures.
After consulting with major medical organizations and public-health experts, the agency concluded that routine blood screening of health-care workers involved in surgical and dental procedures for signs of AIDS infection "is not necessary . . . since the risk of transmission in this setting is so low."
Because the AIDS virus is known to be carried in blood and bodily fluids, however, the agency warned health-care professionals involved in surgical and dental procedures to "use extraordinary care" to prevent injuries to hands from sharp instruments and to take special precautions to prevent contamination with blood.
If an accident occurs during a medical procedure in which a patient is exposed to the blood of a health-care worker, the CDC said, "the patient should be informed of the incident."
If there is reason to believe that the worker is infected with the AIDS virus, the government said additional steps should be considered, including blood testing and follow-up.
"Invasive" medical procedures of special concern are operations involving surgical entry into tissues, cavities or organs or repair of major traumatic injuries.
They also include such obstetrical procedures as vaginal or Cesarean section delivery or others in which bleeding occurs, or dental procedures involving manipulation, cutting or removal of oral tissues or teeth in which bleeding may occur.
The CDC's Dr. James M. Hughes said yesterday that an extensive review has concluded that, if precautions are observed health workers infected with the AIDS virus need not be restricted from operative and dental work.
He said the biggest debate concerned whether to screen workers for infection. Although some people favored screening, "it was very much a minority view," Hughes said.
CDC studies have reported only two confirmed cases and three suspicious ones in which health-care workers became infected with AIDS through exposure to patient blood when using hypodermic needles.
But CDC officials say that, of the more than 19,000 AIDS cases reported, about 1,000 cases represent workers in health-care fields believed to have acquired the disease because of high-risk activities outside their work.
For every reported AIDS case, 50 to 100 times as many individuals may be infected with the virus, experts say. Those at highest risk of AIDS are homosexual and bisexual men, intravenous drug abusers, hemophiliacs, and their sexual partners.
In a case last fall of a Florida surgeon who died of AIDS, the CDC checked 400 of his patients and found no evidence of AIDS transmission.