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Johnetta J. v. Municipal Court for San Francisco Judicial District

3/20/1990

y low," "remote," "exceedingly low," "clearly remote," or "highly remote."


Dr. Gerberding declared that "the number of cases to date involving incidents of bites is not sufficient to enable me to conclude that HIV cannot be transmitted by a bite that breaks the skin. Similarly while the risk of such transmission is clearly low, there is insufficient information to determine precisely how low." Both Dr. Gerberding and Dr. Sande agreed that the possibility of saliva transfer is greater when the saliva is placed in contact with broken skin, as in a bite. In Dr. Sande's words: "The possibility of transmitting HIV through a bite is probably greater than the possibility of its transmission through touching, eating off the same plate, or sharing a toothbrush. . . . The possibility of transmission would likely increase if the bite is deep. . . . Studies to date indicate that the risk of transmission is highly remote. However, it cannot be said, based on currently available information, that HIV could not be transmitted through a bite. The possibility that HIV could be transmitted continues to be a subject of inquiry in the medical community."


Dr. Gerberding noted that a bitten health care worker, and by parity of reasoning a bitten public safety officer or bailiff, "finds little solace or comfort in medical opinion that the chances of infection are extremely remote."


Petitioner presented the declaration of Dr. Fannin, who gave his expert opinion that, "There is no evidence whatsoever that HIV is transmitted through saliva or biting. In the tens of thousands of cases of AIDS and the many more infections, there has not been a single documented case. [para.] There is lots of evidence that HIV is not transmitted by saliva. We have looked diligently for HIV infection in persons who would be infected if HIV were transmitted by saliva. We have not found it."


Dr. Fannin noted studies of households including a person infected with AIDS. In household setting where other saliva-transmitted diseases are "transmitted indiscriminately," the studies showed no instance of AIDS transmission. According to Dr. Fannin, this makes it "possible to virtually eliminate saliva as a route of HIV transmission. . . . There is a maxim in epidemiology that if an event can happen, it will happen." The doctor states that tens of thousands of AIDS cases have not revealed a documented case


of saliva transmission. "Given the amount of information we now have, the only rational conclusion is that transmission by saliva and biting does not occur."


Dr. Conant presented an additional declaration, stating: "In my opinion, HIV is not transmitted by saliva. . . . In the history of this disease, there has never been a single documented case of HIV transmission by saliva. During this period of time, there have been hundreds of thousands of contacts between HIV-infected individuals and uninfected individuals involving the transfer of saliva. These contacts range from sharing utensils to intimate kissing to bites. If HIV was transmitted by saliva, a documented case of transmission should have presented itself by this time. . . . [para.] A different question from whether HIV is in fact transmitted by saliva, is the question whether it is theoretically possible that HIV could be transmitted by saliva in some circumstances. In my opinion, the answer to the latter question is maybe."


Dr. Conant opined that the possibility of transmission "is so slight that a person who was exposed to the saliva of an HIV infected person through a bite has no reason to fear that HIV might have been transmitted through the bite." Dr. Conant further stated that, "When I use the term 'theoretically pos

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