Confirmation of two more AIDS infections among patients of an infected Florida dentist is more evidence that the man's practice must have been particularly unsafe, a top AIDS official said Thursday. "Whatever happened in this practice must be very unusual," said Dr. Harold Jaffe, deputy director for science in the HIV-AIDS division at the Centers for Disease Control.
Federal health officials assume there are hundreds of dentists and surgeons in the United States infected with the AIDS virus, just as there could be hundreds among any occupation. Several practices have been investigated for possible doctor-to-patient transmission in the wake of the first three Florida cases.
"But in all the other investigations we're aware of, we have not found any other instances of dentist or surgeon transmission to a patient," Jaffe said.
The CDC confirmed Thursday that two more patients of the Florida dentist who died of AIDS, identified elsewhere as Dr. David Acer of Stuart, were apparently infected by him, bringing the total to five. All had the same AIDS-virus strain, and none were known to be at risk of the disease from any other source. Two other Acer patients have been shown to be infected with HIV, but investigators believe they had "other risk factors" and acquired the infection somewhere else.
CDC investigators say they will never know exactly how the five patients became infected. It is possible the dentist could have cut himself and bled while working on patients, but some reports have suggested his instruments could have been contaminated from work done on himself.
"Perhaps these additional cases make it more likely that at least some of the transmissions did involve contaminated equipment or instruments," Jaffe said. "I find it hard to believe that he could have injured himself so many times that he would have exposed all these people to his blood directly."
"His practice was a disaster waiting to happen," said Philip Weintraub, spokesman for the American Dental Association. "We've got this one practice where all of this problem is coming from."