United States nosocomial outbreak investigation
Dental patients infected, late 1980s: During 1990-92, the Centers for Disease Control and Prevention (CDC) report an investigation of HIV infections among among dental patients in Florida. The investigation began when a woman with no identified risk found she was HIV-positive. She suspected she may have gotten HIV from her dentist, who was ill. The investigation tested circa 1,100 former patients of the suspected dentist. “Five of the eight HIV-infected patients [identified during the investigation] had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P > 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified… Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.”
Ciesielski C, Marianos D, Ou C-Y, t al. Transmission of human immunodeficiency virus in a dental practice. Ann Int Med 1992; 116: 798-805. Available at: http://annals.org/aim/article-abstract/705514/transmission-human-immunodeficiency-virus-dental-practice?volume=116&issue=10&page=798 (accessed 4 January 2019).