Occupational infection in health care. The century-old lessons from syphilis.

The dangers of occupational infection (where the infectious agent was acquired during the provision or receipt of a medical service) have received renewed interest in the era of the human immunodeficiency virus. The dilemmas raised by this phenomenon, however, are far from novel and were the subject of considerable debate in the medical literature at the turn of the century with regard to syphilis. After recognition of the problem, it took time to manage syphilis effectively through technical innovation, personal prophylaxis, education, and regulation. These efforts led to the development of a strategy remarkably similar to that of the "universal precautions" approach applied to human immunodeficiency virus today.