San Francisco Chronicle - Saturday, November 6, 1993
Clare Nullis, Associated Press

Evidence that a German company distributed plasma products tainted with the AIDS virus has spread panic and sent other European countries scurrying to check their stocks.

A recent scandal in Colombia set back South American efforts to improve safety. Patchy testing of blood supplies in Africa has hindered attempts to stem the spread of the fatal disease in the most seriously affected continent.

And tainted blood given to orphans during the communist era resulted in 2,376 infected children in Romania.

The risk of contracting the AIDS virus through contaminated blood is relatively low in wealthy countries and high in parts of the Third World.

Developing countries rely heavily on paid donors, who may include prostitutes or drug addicts needing money. Countries such as India and Pakistan and Russia rely on paid donors.

Parts of Africa and Latin America use family replacement donors -- a scheme that, in practice, allows paid donors to pose as relatives of the patient.

The World Health Organization estimates that there have been about 2.5 million cases of full-blown acquired immune deficiency syndrome since record-keeping began in 1981. Around 14 million people worldwide have been infected with the human immunodeficiency virus that leads to AIDS.

"Globally, between 5 to 10 percent of cases are estimated to be due to transfusion-transmitted infection through blood and blood products," said Dr. Jean Emmanuel of WHO's global program on AIDS.

WHO estimates that about 75 percent of the cases worldwide are from heterosexual intercourse. The rest are from homosexual intercourse, contaminated needles or from mother to child, the organization says.

Emmanuel stressed that industrialized countries have the technology to destroy viruses in products such as plasma, the resources to test all blood supplies for HIV and the infrastructure to ensure a reliable blood supply.

In the United States, health authorities estimate that the risk of patients becoming infected with HIV from blood transfusions is about one in 250,000, compared with one in 2,500 in 1985.

About half the 20,000 hemophiliacs in the United States were infected with HIV before testing for the virus was introduced in 1985. Similar tragedies unfolded in Japan, Canada, Britain, Spain, Italy and Switzerland.

In France, four senior health officials last year were convicted of knowingly allowing hemophiliacs to receive blood-clotting products tainted by HIV in 1985. The government later adopted strict blood screening policies.

"The risk is now subsiding for hemophiliacs," said Sheila Brading of the Montreal-based World Federation of Hemophilia. "But that's in countries with the money."

In poorer parts of the world, the risk of contracting HIV through blood remains a problem, Emmanuel says. This is largely due to inconsistent testing procedures, lack of technology and expertise and the high cost of sterilizing blood products.

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AIDS AND BLOOD

Countries affected by the spread of AIDS in blood:

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AMERICAS

-- Brazil: An estimated 2,200 of 5,500 hemophiliacs have been infected with HIV. A campaign by relatives of a famous hemophiliac cartoonist inspired a cleanup of blood banks and a ban on paid donors.

-- Canada: Health authorities admitted this year that they knew that blood distributed to hemophiliacs in the early 1980s was tainted.

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EUROPE

-- Italy: One in four hemophiliacs is infected with HIV. There are allegations that the former health chief allowed unscreened blood products nearly a year after testing became required.

-- Russia: There are an estimated 30,000 or more people infected with HIV. A big increase is feared because of the outdated health system and the rise in prostitution and drug abuse.

-- Spain: The government has agreed to pay $87,000 to 1,200 hemophiliacs who were infected before 1985.

-- Britain: The government paid compensation to 1,200 hemophiliacs infected by imported American products before 1985.

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AFRICA

-- Zaire: About one in five HIV-positive children were reportedly infected by contaminated blood.

-- Uganda: One of most badly affected countries in Africa -- HIV infection rates reach 60 percent in some villages, mostly from heterosexual intercourse.

-- Kenya: Most reported AIDS cases are from heterosexual intercourse. The country relies on a family donor system for blood products.

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ASIA

-- China: In a population of 1.1 billion, about 1,100 people have tested positive for the AIDS virus. Blood testing is patchy. The country relies heavily on a paid blood-donor system.

-- Japan: About 2,000 hemophiliacs were infected with HIV before 1985. Lawsuits pending in 112 cases. Paid blood-donor system stopped three years ago.

-- Thailand: Approximately 600,000 Thais are HIV-infected. Most cases were transmitted sexually. A government campaign is trying to improve the safety of the blood supply. Only 28 people are reported to have contracted AIDS through the blood supply.

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