Health Agency Says Justice Dept.’s Memo on AIDS Ignores Evidence

Federal health officials, responding to the medical judgments on AIDS transmission contained in a controversial Justice Department memorandum issued a day earlier, said Tuesday that the memo “does not reflect new scientific or medical information on AIDS transmission.”

Apparently angry with the Justice Department’s comments on AIDS transmission--which imply the possibility of casual spread of the disease--the Health and Human Services Department took the highly unusual action of challenging the statement of another federal department.

“The evidence is overwhelming that there is no danger of this virus being transmitted through such common exposures as handshaking, sharing meals, sneezing, coughing or through other casual school and workplace contacts,” said a statement issued by Dr. Robert E. Windom, assistant secretary for health.

Officials Unhappy

Although the Health and Human Services statement did not condemn the Justice Department memorandum, one health agency official, who requested anonymity, described federal health officials as universally unhappy with the Justice Department’s medical remarks regarding AIDS.

“For over a year we have been trying to allay groundless fears through the dissemination of sound scientific information on the lack of easy transmissiblity of AIDS,” he said. “A document like the Justice Department memo serves to inadvertently undermine that effort.”

On Monday, the Justice Department ruled that all employers who receive federal funds--such as government agencies, contractors, public hospitals, schools, etc.--cannot be challenged under U.S. civil rights laws if they fire people with AIDS based on fear of contagion. The health agency did not comment on the legal implications, saying only that they were “under study.”

In its memorandum, the Justice Department compared AIDS to the “highly contagious” common cold. But, by contrast, the consequences of exposure to cold viruses “are typically temporary and not severe,” it added.

Cites Contagion Factor

However, the memo continued, “on the other end of the spectrum would be a contagious disease that is incurable, highly painful and ultimately fatal.” The “typical human response is to take substantial measures to avoid exposure to even the slightest risk of infection,” the memo said.

“The state of medical knowledge concerning it is still in an early stage of development, and the mechanisms of the disease’s transmission are not fully understood,” the Justice Department document said.

Federal health officials, countering that assertion, said that studies of more than 20,000 AIDS patients, as well as investigations in Africa, “support lack of transmission of the virus by casual contact.”

Dr. James O. Mason, director of the federal Centers for Disease Control, also cited “intensive” studies of more than 350 family members of adults and children with AIDS that “have not found any evidence of transmission of infection, even in such intimate environments as within the family.”

Few Exceptions

The only exceptions, Mason said, were the sexual partners of AIDS patients, children born to infected mothers, or those already at risk, such as intravenous drug users.

AIDS is transmitted through intimate sexual contact or the sharing of unsterilized hypodermic needles. It has also been spread through transfusions of blood and blood products, although a blood-screening procedure has now made that risk slight.

Also, Mason said, “the accumulated experience of health-care workers caring for and in close contact with AIDS patients,” including many who have been clinically followed and tested for exposure to the AIDS virus, “documents lack of transmission in the medical workplace, except in rare instances of severe needle injury, or prolonged unprotected exposure to blood excretions or secretions.”

During the last two years, the U.S. Public Health Service has issued a series of recommendations urging that people with AIDS not be barred from the workplace or the classroom. Windom said Tuesday that “these guidelines clearly state that employees, employers and others can be assured that the AIDS virus is not transmitted by casual contact whether in the workplace or schools.”

Undocumented Notion

The Justice Department memo has been attacked by civil and homosexual rights groups who argue that it reinforces the undocumented notion that AIDS can be spread by casual contact.

Other critics of the ruling predicted that it might hamper some efforts to curb the epidemic. For example, they said, members of high-risk groups would probably now refuse to undergo the AIDS antibody test--which detects exposure to the AIDS virus--for fear of employment discrimination.

The Public Health Service has recommended that high-risk individuals--male homosexuals and bisexuals, intravenous drug users, prostitutes and their sexual partners--voluntarily undergo the test. But gay rights groups and others--concerned about the potential abuse of test results--have opposed testing.