TAINTED TRANSFUSION

Sunita Mishra, a21-year-old student from Ahmedabad, met with a car accident in 2012 on her wayto grandparents' home in Vadodara. She was admitted to a private hospital in acritical condition. She was discharged a few days later. However, every month,her parents have to go to civil hospital to collect her medicines. Reason: Sunita had been infected with HIV after being administered tainted blood during treatment.

While Gujarat is peddling med ical tourism to the world, as many as 2,500 people in the state have contracted HIV through blood transfusion in six years. In reply to an application filed under the Right to Information Act, the Union ministry of health and welfare revealed that the state stood highest with 271 cases of HIV infections caused by blood transfusion. The shocker is that Gujarat has continuously recorded the highest number of cases in past six years. Experts attribute infections to medical negligence and rampant malpractice among blood banks.

The application was submitted to the health ministry that passed it on to National AIDS Control Organisation (NACO). Section Officer and CPIO (blood safety) VK Govil, in his reply dated December 24, provided data related to all states from the year 2008. As per the data, Gujarat recorded 192 such cases in 2008. It shot to 563 in 2009 and has been on a steady decline since then.However, it does not change the fact that with 271 cases in 2013, Gujarat still has the highest number of cases in the country. It is followed by Uttar Pradesh with 230 cases, Maharashtra with 198 cases, and Delhi with 143 cases.

MEDICAL NEGLIGENCE

Experts blame medical negligence, malpractice in blood banks and and hasty oversight on part of the recipient for the occurrence of such cases.Gujarat's unregulated blood banks came to the spotlight after 23 kids tested positive for HIV after undergoing repeated blood transfusion at Junagadh civil hospital as part of thalassaemia treatment. The blood was supplied by Sarvodaya Blood Bank.

“Till a while ago, blood banks relied heavily on professional donors.Drug addicts also used to sell blood for money. With awareness, this practice is no longer followed in urban centres.In rural areas, the story is different.During emergency or when there is a demand for a donor with a rare blood group, such checks are overlooked.Many a time, doctors keep l pressure from patient's family and transfuse blood from a readily available donor who is usually a kin or a close friend,“ said Shweta Parikh, an AIDS activist.

TESTING METHOD

According to the Drug and Cosmetic Act of 1940, blood is considered a drug and all blood banks need licence to store it. Also, it is mandatory to conduct five tests on blood received: HIV, Hepatitis B, Hepatitis C, Malaria and Syphilis. “If the report is negative, then only is the sample sent to bank for transfusion,“ said Ashok M Shilu of Ahmedabad Red Cross Society.

However, labs in the state do not have adequate facilities to detect the virus if the blood donor has just got infected. This means that a patient is at a risk of being given tainted blood during the window period (time between the first infection and when tests can reliably detect the infection). “For HIV, the window period is six months. If an HIVpositive person donates blood in this period, the virus will be transferred to the recipient through the blood. The Nucleic Acid Test which can detect the virus in the window period isn't available in most labs,“ said Parikh. “Recent advances take lesser time to identify new infection but it is extremely costly so not many banks or hospitals use it,“ said an expert.

VOLUNTARY DONORS

Interestingly, most medical experts along with WHO believe that it is possible to control HIV infection caused by blood transfusion through 100 per cent voluntary blood donation. The WHO website states, “Voluntary non-remunerated blood donors are the foundation of a safe, sustainable blood supply.Without a system based on voluntary unpaid blood donation, particularly regular voluntary donation, no country can provide sufficient blood for all patients who require transfusion.“

Agreeing, Shilu said, “In Gujarat, 80 per cent of blood is donated by voluntary unpaid donors. In such cases, it is rare to find HIV-tainted blood.“

REFUTING DATA

Meanwhile, government has refuted the figures. M D Gajjar, joint director of Gujarat State Council for Blood Transfusion, said, “The RTI reply contains wrong data. HIV infection through blood transfusion is below .02 per cent.These kind of cases are rare in the state.“

Health Minister Nitin Patel said, “It is impossible. There is no such case in Ahmedabad or across the state. It happened when there were no proper regulations but now everything is scrutinised. No blood is given to any patient without performing the HIV test.“

ANOTHER CASE

Nilesh Shah was infected with HIV two years ago. He caught the infection from his wife who had been given HIV infected blood during her pregnancy.

“She had lost a lot of blood due to a complication. So, a relative of mind who had the same blood group donat ed blood. The hospital did not test his blood as he was a family member and we became infected,“ said Shah.