In connection with the HBV infections by a cardiothoracic surgeon at a universitary hospital in Germany it must be clarified whether the detected omissions (no HBV vaccination of the surgeon, parts of the medical staff lacking health checks) indicate generally relevant problems in occupational and patient health protection. This is very necessary because in international literature more than 40 cases of HBV transmission from doctors to patients are documented and a high rate of undetected cases must be supposed. The case under reference shows up weak points with regard to the established legal mechanisms of control and refers to a problem of insufficient coordination between hospital hygiene and occupational health protection. Local health departments and occupational cooperative societies should urgently draw the necessary conclusions: A quantified report (with specified numbers) is required stating the health checks and non-performance of vaccinations in hospitals; defaults in this regard must be remedied without delay. The work which infectious employees can do must be defined by guide lines at every hospital. Expert committees considering the circumstances of the individual cases should determine the necessary safety measures.
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