Chicago Tribune (CT) - SUNDAY February 28, 1988 Edition: FINAL EDITION Section: TEMPO Page: 1 Word Count: 2,778
Lynn Emmerman

During a routine search of a prostitute in January, 1987, the policewoman accidentally was jabbed by the drug-addicted woman's hypodermic needle. A subsequent court-ordered blood test showed that the prostitute had acquired immune deficiency syndrome.

Because introduction of infected blood into a healthy person's bloodstream is one of two principal ways that the fatal disease is transmitted, doctors at Cook County Hospital said the patrolwoman risked infection. They told her to report to Cook County Hospital every three months to have blood drawn for AIDS testing. They gave her brochures explaining the disease and advised her to refrain from sex (the other principal means of transmission) and hope for the best.

Since then she has had to fill out stacks of police reports detailing her medical condition and the circumstances of the prostitute's arrest. She has had to tell her superiors that she may have been exposed to AIDS and find the words to explain to her mother and father, a retired police officer, with whom she lives on the Southwest Side. She has had to cope with a barrage of questions from everyone who knows. And she has had to confront her own wrenching anxiety about contracting some form of the virus.

The human immunodeficiency virus (HIV), which causes AIDS, has infected more than a million Americans, according to the Centers for Disease Control in Atlanta. HIV infection causes a spectrum of reactions, which can range from carrying the virus with no visible symptoms to developing AIDS, which cripples the body's immune system and leaves it open to opportunistic infections and malignancies.

The centers estimate that 25 percent to 50 percent of HIV-infected Americans fall somewhere in the middle. They develop AIDS-related complex (ARC) and exhibit symptoms that include sudden weight loss, night sweats, fever, fatigue and diarrhea. Though ARC is not fatal, for some it appears to be a precursor to AIDS.

No one really knows how long AIDS incubates in the body. A recent report by the National Academy of Sciences estimates that as many as half of the people who have ARC will develop AIDS within 5 to 10 years of infection. Of those who test HIV-positive, the Centers for Disease Control estimate that 20 percent to 30 percent will develop AIDS within five years of infection. Other studies say the incubation period is longer, six to seven years.

The police officer said that perhaps the most agonizing part of the last year has been having to wait two to three hours for each of her quarterly AIDS test results. The test detects the presence of antibodies to the HIV virus, evidence that the immune system has tried to fight off infection. But a positive test result cannot pinpoint the date of infection or determine whether a person remains infected.

So far the verdicts on her tests have been good. Her blood has remained healthy with no evidence of AIDS antibodies. Last month, a year after the needle incident, her doctors told her that according to working criteria established by the disease centers, she could be considered negative.

"They told me that I was probably going to be fine," said the officer, her lips curling into a grin.

But what of researchers' uncertainty about the incubation period for AIDS? The officer's grin faded and her gaze dropped to the floor. "I can't . . ." she murmured. "I don't even want to think about that."

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Police across the country are thinking about AIDS, and they're worried. Street cops commonly deal with a population, including junkies and prostitutes, that is at high risk for contracting the disease.

According to the disease centers, in 1987, 17 percent of the more than 35,000 confirmed AIDS patients in the country were intravenous-drug users. Homosexual and bisexual males account for 66 percent of AIDS patients. Though the disease centers do not keep statistics on the number of prostitutes with AIDS, police say prostitutes' high freqency of sexual contact and common intravenous-drug use greatly increase their chances of contracting or carrying AIDS.

Police officers increasingly fear accidental hypodermic punctures or handling of injured or dead AIDS victims, say officials such as John Dineen, president of Chicago Lodge 7 of the Fraternal Order of Police.

Last year in some cities, their fears ran wild. In Montgomery, Ala., police compiled a secret list of citizens, supposed AIDS victims, to watch out for. In Washington, officers assigned to a demonstration in which picketers demanded that more funds be allocated for AIDS research wore yellow rubber gloves, presumably to protect against infection. Nearer to home, police in Elgin referred to a police wagon that had transferred an offender with AIDS as "the deathmobile." After the suspect was removed, they doused the wagon and the area in their station where he was held with chlorine bleach and furiously scrubbed away phantom germs.

The AIDS virus is so fragile that it can't survive outside the human body. According to the disease centers, it can be transmitted only through blood, semen or vaginal secretions.

The real problem facing police departments may not be AIDS but officers' fear of it, according to a 1987 report by the National Institute of Justice, a research branch of the federal Justice Department.

The report said there are no documented cases of police officers, firefighters or paramedics contracting AIDS or AIDS-related syndromes in the performance of their duties. But two-thirds of the 35 police agencies surveyed said their staffs voiced concern about contracting AIDS through casual contact, despite the fact that the virus cannot be transmitted this way. The disease's lengthy incubation period lingers in their minds.

Unchecked, law-enforcement officers' fears could lead them to avoid arresting offenders who they suspect may be infected, thereby affecting the quality of police work, the report said. The report is intended to help dispel officers' fears and to help police departments develop responsible policies for educating their people and protecting them from infection.

In Chicago, as in many big cities, the Police Department has distributed a training bulletin to each of the city's 12,500 officers. Attempting to calm fears about AIDS, it contains information about how the disease is transmitted as well as advice about avoiding exposure. The department also developed a procedure for reporting suspected on-the-job exposure and is offering a seminar on AIDS for police officers conducted by the Northwestern University Medical School staff.

Basically, the seminars relay the same information most of us have been exposed to in the news media. Seminar leaders advise officers to employ simple measures, such as covering their own cuts, wearing department-provided gloves when handling suspects with open lesions, frequently washing their hands and avoiding physical confrontations during arrests to cut down the risk of infection.

Seminar leaders also explain that except for a few health-care workers- the disease centers report that only 3 of 666 known accidental punctures among health workers had resulted in HIV infection through 1987-there are no cases on record of anyone contracting AIDS or AIDS-related syndromes on the job.

The trouble is, some veteran Chicago street cops don't believe those figures. In a dozen or so interviews, without exception officers said they feared contracting AIDS more than getting shot.

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The constant tingling in what's left of his little finger won't let him forget. Every time he fumbles in his pocket for his car keys or strokes his little girls' hair, the 21-year veteran Englewood District police officer remembers the tavern melee about a year ago when a suspect bit off a chunk of his right pinky.

Three reconstructive operations later, he still worries that the 25-year- old woman who bit him also may have infected him with AIDS. But the patrolman, who has received numerous awards for bravery while hunting down criminals, is terrified to visit his doctor and undergo a blood test to determine if he was exposed to the disease.

Research strongly suggests that his chances of contracting the disease from the bite are practically nonexistent. The disease centers have not recorded any case of AIDS being transmitted through saliva. Besides, the woman never was tested and could have been uninfected with AIDS.

"I go out and face death every day on this job," he said in an interview in January. "In my time I've been in 31 gunfights. I guess you could say I have this bad habit of not backing down. But if I test positive for AIDS, that would mean I have a few years to live. I wouldn't get to see my kids grow up. I don't know if I could handle that."

The officer's attitude illustrates all too well how fear about AIDS can overcome current medical knowledge. In some cases, that fear can be paralyzing.

The officer refused to undergo an AIDS test even though he could be exposing his wife to the disease if he somehow had been infected. In other examples, 4 of the 35 police departments questioned in the National Institute of Justice survey reported incidents in which officers refused to perform certain duties-transporting or searching a prisoner or handling evidence- because of their fears about AIDS.

In no department, including Chicago's, are officers excused from duties because of their worries about the disease. The report by the National Institute of Justice contends that any officer's claim to the contrary would be difficult to sustain in court: ". . . first, because the research is so clear on the unlikelihood of viral transmission through the types of contacts likely to be experienced by police officers, assuming standard precautions are taken; and second, because the officer assumes certain risks in accepting the job."

Despite all the reassuring research, the South Side officer and many of his peers remain concerned about AIDS. Chain smoking and drinking cup after cup of coffee, he said, "What if she bit her tongue and was bleeding when she bit my finger? What if she had open sores in her mouth? This is my life I'm talking about. How much do these so-called experts really know about AIDS?"

When the patrolman returned to work after the finger injury, he said he got a desk assignment for several months; he was so angry about his possible exposure to the disease that he worried he would react violently if anyone gave him trouble during an arrest on the street. He returned to patrol duty in January.

"Now when I arrest and search somebody, I tell 'em right off the bat, 'If you got any needles on you, take 'em out now!' " he said. "If I got pricked by a needle, I don't know what I'd do."

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The patrolwoman's jaw tightened as she told her story: "My partner and I were working in plainclothes on the midnight shift on a Friday a year ago January. Just before midnight, a man drove up alongside us and said he'd been solicited by a prostitute a few blocks away. From his description, we knew she was a regular."

The officer paused and sighed. "We told the man to wait to I.D. the hooker. We found her in a couple of minutes. She was bone-thin and in her 20s. You could tell she must have been pretty before (she became addicted to) drugs.

"I asked her if she had anything on her that might hurt me. She was so high that she was incoherent. So I started patting her down. Her coat was open. There was nothing in her pockets. I ran my hand along it against her ribs. At her waistband I stuck my thumb on a syringe needle. It had been hidden in her waistband."

The officers handcuffed the woman and put her in the back seat. When they returned to find the man who complained, he was gone. They took the woman into the station for the possession of drug paraphernalia, and the patrolwoman informed her boss of the needle puncture.

"I knew she was scuzzy, but I didn't think anything of it," said the officer. "I figured I'd go to County (Cook County Hospital) for a couple shots (penicillin for possible bacterial infections)." But in her cell, the prostitute announced that she had AIDS. The police informed the judge who heard the woman's case. The judge ordered her to submit to a blood test as a condition of her release on bond.

"As I watched her getting tested at County that Saturday, I started to get a little leery," the officer remembered. "Everyone who handled her was wearing gloves. . . . On Monday they called me down and said she was positive. They wanted to test me and counsel me about AIDS."

The prostitute was charged with battery because her hidden needle had injured the officer. She was released on bond. She never called the hospital for her test results. The patrolwoman said she doesn't know whether the woman actually knew she had the disease; prostitutes commonly announce that they have AIDS and then spit at officers in an attempt to intimidate them into backing down on an arrest.

Three weeks after the incident, while on patrol, the patrolwoman encountered her again.

"She was a suspect in a robbery. My knees were shaking, but I searched her. I didn't get stuck that time, and I found another needle. This time she'd hidden it in a pack of filter cigarettes. I told her about her test results, but I don't know if she was straight enough to understand me." The officer smiled grimly.

"I haven't seen her since. But I'm glad I got to face her again," she said. "I decided that whatever was going to happen, I couldn't let her beat me."

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At police headquarters, Capt. Ray Risley, administrative assistant to the superintendent of police, is well aware of the patrolwoman's situation and her fellow officers' fears of AIDS.

"You don't want to sit in an ivory tower saying it's all b.s. while the officers take all the risks," he said. "The department has a moral obligation to disseminate information and take whatever precautions are indicated, but the fact is that there's an inappropriate concern about contracting this disease."

Risley said-and many officers agreed-that the department is doing what it can to protect them. "There's an absence of a uniform legal mechanism to force an arrestee (who may have exposed an officer to AIDS) to voluntarily give a blood sample for testing," Risley continued.

The patrolwoman who was stuck with the needle doesn't blame the department for what happened. But she and other officers interviewed are angry about a legal system that often returns known offenders with AIDS to the streets to reinfect others. At the very least, the patrolwoman said, if a known offender has AIDS or carries the virus, that information should be included in his arrest file.

"Police officers have rights, too," she said. "We have to deal with these people. . . . Many of them are regulars in the district. . . . We have to watch out for their needles and worry what will happen if we get into a fight and they get cut and we get cut. We have a right to know if a bleeding guy we're carrying has AIDS."

She said she would be extra careful when searching or transporting someone she knew had been infected with AIDS.

Currently, the system doesn't agree with her. To reveal medical information is considered a violation of privacy under the law.

In her own case, the patrolwoman said she took matters into her own hands. "At the hospital, they told me I could get the prostitute's test results because that was part of the court order. But the doctor warned me that if I disclosed her results to anyone else, she could sue me.

"Here was this woman with an 11-page arrest record working in our district, an addict who carries hidden needles and has AIDS." The patrolwoman chuckled bitterly.

"I told everyone in the station. I figured if anyone had a problem with that, I'd see them in court."

CAPTION: Photo: (color) (Policeman wearing gloves and face mask.) Tribune photo by Bill Hogan. Photo: As part of a program to relieve officers anxiety about dealing with AIDS patients, a policeman in Fresno, Calif., learns to use a resuscitator that would prevent passage of the HIV infection.

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Always watch for outdated information. This article first appeared in 1988. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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