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Is HIV a Nosocomial Infection?

The Irish Times reports the suspension of a dentist in the employ of the Health Service Executive. He felt ill and on consulting his doctor it was found he was HIV positive.

Some of his patients (schoolchildren mostly) have been contacted by the HSE and offered testing.

The HSE are adamant that the likelihood of him having infected any of his patients is very remote.

On significantly different facts there has been an earlier case of an infected health care worker featuring some consequences.

In 1994, in the UK, Dr. Imesh Gaud was prosecuted and convicted of public nuisance in circumstances where he continued as a surgeon knowing he was a Hepatitis B carrier.

The General Medical Council guidelines lay down that it is imperative that doctors suffering from infections such as Hepatitis B and HIV should seek advice on how to protect patients from cross-infection.

Notwithstanding this, Dr. Gaud transferred to another hospital, concealing his previous posting and, on an occasion he was asked for a blood sample, took one from a patient and represented it as his.

Public nuisance is a crime.

It may also be the basis of a private action where the Plaintiff can show that s/he has suffered particular damage, above and beyond the rest of the public. Unlike the tort of private nuisance, it is not necessary for the Plaintiff to show damage in the enjoyment of his/her property. Indeed, as Dr. Gaud’s case shows, property may have nothing to do with the case.

Dr. Gaud, discovered he was a carrier in 1990. Between 1992 and 1993 (when the facts were discovered), he performed 323 cardio-thoracic operations. He was uncovered after nineteen of his patients contracted Hepatitis B. Of five of these it was shown the strain they had was identical to the strain of which he was the carrier.

A public nuisance has been defined as follows: “Every person commits a common nuisance who does anything which endangers the health, life or property of the public or any part of itâ€?.