A seven-month investigation has yielded no evidence that any patients contracted the AIDS virus from a Johns Hopkins doctor who performed surgery while infected and later died of the disease, state health officials said yesterday.
Although officials could not absolutely rule out the possibility, they said available evidence strongly suggests that the late Dr. Rudolph Almaraz infected no one during a medical procedure.
"When you put it all together, you have an overwhelming amount of evidence to support this conclusion," said Dr. Audrey S. Rodgers, chief of the health department's center for AIDS epidemiology.
The study looked into the medical histories of 954 patients who underwent "invasive procedures" such as cancer operations. It raises to four the number of U.S. studies of infected doctors and their patients; none has found a case of doctor-to-patient transmission.
Besides the Maryland study, similar investigations have occurred in Tennessee, Minnesota and in the U.S. military. All told, they involve more than 8,000 patients.
Investigators with the federal Centers for Disease Control remain confounded by the case of a Florida dentist, Dr. David Acer, who died of AIDS and left five patients infected with the virus. Genetic studies revealed that the patients all carried a viral strain that was strikingly similar to his, but investigators have been at a loss to explain how the dentist may have infected them.
In Maryland, the study of Dr. Almaraz's practice did turn up two patients who tested positive for the human immunodeficiency virus after the surgeon operated on them. One of the patients died of AIDS in 1989, while the other lives today with HIV.
But officials said further investigation turned up strong evidence that the two contracted the virus from contaminated blood transfusions during medical procedures that weren't performed by Dr. Almaraz.
Dr. Almaraz, a respected cancer surgeon who specialized in treating women with breast cancer, died Nov. 16, 1990, at his home in Parkton. Two weeks after his death, The Sun reported he had died from complications of AIDS and had apparently practiced for several years while infected with the virus.
Around the same time, officials with Johns Hopkins Hospital mailed letters to 1,800 patients he had treated, offering them free HIV testing and counseling. Public fears that he may have infected someone during surgery also prompted the state health department to seek answers through a comprehensive study. Although Dr. Almaraz treated 1,800 patients while working at Hopkins, the health department limited its study to patients who had undergone "invasive procedures" and had known addresses.
While citing evidence that the two infected patients contracted the virus from blood transfusions, Dr. Rodgers said she hopes that sophisticated "DNA matching" tests will make it possible for her to reach a definitive conclusion. Blood specimens from Dr. Almaraz and the patients have been submitted to a laboratory recommended by the CDC, and results are expected in the spring of 1992, she said.