MORE than 1,100 patients across Worcestershire and Birmingham have been warned they may be at risk of HIV or Hepatitis B after a healthcare worker was diagnosed with the infections.

Health chiefs in the West Midlands have sent letters to 71 patients who were treated at Evesham Community Hospital, 62 at Kidderminster Hospital, 430 at the Alexandra Hospital in Redditch and 590 at the Orthopaedic Hospital in Birmingham over the last six years inviting them for blood tests.

No patient who has been in contact with the healthcare worker, who worked in orthopaedics at the hospitals, has been diagnosed with either infection and all have been told there is a very small risk of transmission.

It is hoped that all those affected will have their blood test results back within three weeks. A confidential helpline has been set up to offer advice and support.

Since the healthcare worker was diagnosed with Hepatitis B and HIV - picked up in a recent occupational health assessment - he or she has not been involved in any work that potentially places patients at risk.

The worker had no symptoms and was unaware of the infections.

Dr Sue Ibbotson, of the Health Protection Agency (HPA), said that following national guidelines, the worker would have been screened for hepatitis B when employed by the NHS.

But she said no such guidelines existed for HIV screening.

She said: "There is draft guidance dated 2003 which, if it were implemented, would require staff to demonstrate immunity to HIV, but that is still in draft form." Instead, she said new staff are asked if they fall into a high risk category for the virus. If they do, they are tested, but this test is a one-off, and is not repeated regularly during their employment.

Dr Rashmi Shukla, regional director of public health at NHS West Midlands, said every effort has been made by the hospitals involved to trace patients who may be at risk.

"This is a highly unusual, if not unique, set of circumstances in that the healthcare worker is infected with both HIV and Hepatitis B," she said. "There is no recorded case of transmission of HIV from an infected healthcare worker to a patient in the UK and the chance of an infected healthcare worker passing Hepatitis B to a patient is low.

"However, there is a small risk of infection and I would recommend patients to take the tests if they have received a notification letter."

Dr Charles Ashton, medical director at Worcestershire Acute Hospitals NHS Trust, which runs the Alexandra Hospital and Kidderminster Hospital, said: "We fully appreciate and are sorry for the distress and anxiety felt by those patients contacted.

"However, it is important that patients are given the opportunity to be fully informed of the risks and be offered tests for the viruses."

The exercise has been carried out in accordance with expert advice from the UK Advisory Panel for health care workers infected with blood-borne viruses.

Only those identified as being at possible risk have been contacted by the hospitals. Patients who have not received a letter and may have concerns should contact NHS Direct on 0845 46 47.

FACT FILES: HEPATITIS B AND HIV

Hepatitis B

* Hepatitis B is a virus that is carried in blood and other bodily fluids and causes inflammation of the liver.

* It spreads when there is a transfer of one person's blood or bodily fluids to another.

* The risk of an infected healthcare worker passing it to a patient is very small. Where there is a risk, such as major surgery, proper precautions are taken to minimise risk.

* Many people have no symptoms at all, others experience tiredness and can feel generally unwell.

* Nine out of 10 people infected with Hepatitis B will recover completely.

HIV (Human Immunodeficiency Virus)

* HIV is a viral infection carried in blood and bodily fluids which if left untreated eventually lead to a weakening of the immune system leaving sufferers vulnerable to serious illness.

* When first affected some people may experience flu-like illness, fever, headache, muscle weakness or rash. The infection remains for life.

* It is spread in blood and other bodily fluids and not through normal social contact.

* The risk of an infected healthcare worker passing it to a patient is very small. Where there is a risk, such as major surgery, proper precautions are taken to minimise risk.