Miami Herald - Saturday, July 20, 2002
David Cisneros, dcisneros@herald.com

But experts say you are more likely to get hit by lightning than receive tainted blood.

Florida Blood Services, which processes donations for Hillsborough and Pinellas counties, said it discovered that a May donation was infected with HIV, the virus that causes AIDS. The blood was discarded before any hospitals received it.

But the same donor had given blood four previous times, starting Sept. 12 -- when Americans rushed to give after the terrorist attacks. All four previous donations had tested clean.

To be safe, hospitals tracked down the seven patients who received transfusions from the earlier donations. Five tested negative for the human immunodeficiency virus, which causes AIDS.

Two tested positive: One a young adult, another in the mid-60s. Both had received transfusions from a March donation.

The donor, whose identity and sex were not released, and both infected patients have been notified.

Health officials said it was likely the donor contracted HIV days before the March donation. There were probably too few virus cells to show up on screening tests -- the same tests used on blood donations nationwide. Called nucleic acid testing, or NAT, it is the most advanced screening available. NAT was mandated in 1999 by the Food and Drug Administration in an attempt to standardize blood handling and ensure safety.

LOCAL FACILITY CLOSED

Coincidentally, the FDA on Thursday shut down a small Miami blood bank because of what it called shoddy donor-screening practices. The United States Blood Bank allowed certain people to give blood when their backgrounds suggested they should have been excluded, the FDA said.

However, the agency found no fault with the actual testing of the donated blood, so officials do not believe any recipients are in danger of infection. The blood bank provides about 10 percent of Jackson Memorial Hospital's blood.

The company's president, Julio Villegas, said the blood bank is working with the FDA to correct the problems.

The likelihood of contracting HIV is one in two million to three million transfusions, experts say.

"Your chance of being killed in a car wreck . . . or hit by lightning is much greater," said Dr. Charles Rouault, the president of the Community Blood Centers of South Florida, one of the primary blood banks in the region.

In February, a San Antonio man was the first person to get infected from a blood transfusion under the new testing rules. Now there are three.

The problem lies in the "window of infection" -- the seven to 14 days that HIV lurks in the blood stream before building up enough to be detected.

The most famous person to contract HIV from a transfusion was tennis star Arthur Ashe, who received tainted blood during a 1983 heart operation. He died of complications from AIDS in 1993.

About 9,000 people in the United States have developed AIDS through transfusions, according to the San Francisco AIDS Foundation. The vast majority of those were infected before 1985, when the government first mandated HIV screening for blood donations, according to the U.S. Centers for Disease Control and Prevention.

Since then, researchers have steadily improved the effectiveness of lab tests. And the FDA mandates rigorous and personal questioning of donors.

Questions include: Do you have tattoos? Have you ever been jailed? Have you had sexual contact with a hemophiliac? Has anyone ever paid you for sex? Have you had intercourse with a member of the same sex?

The Tampa Bay donor's answers did not raise any flags, the blood bank said.

The previous blood screening test, which could pick up the virus after about 20 days, was less effective because it searched for the antibodies the body produces to battle HIV.

Rouault said NAT, though not perfect, "is the most recent and the most sensitive."

At Cerus Corp of Concord, Calif., researchers say they have developed a method to effectively eradicate viruses, bacteria and parasites from donated blood.

POSSIBLE METHODS

Researchers developed a chemical compound called amotosalen that when combined with ultraviolet light is supposed to leave just the essential elements needed for a successful transfusion. The company is applying for FDA approval and has received initial approval in Europe for a method that cleanses blood platelets, said chief executive officer Steve Isaacs.

Clinical tests for plasma are complete and tests for red cells are under way, he said.

"We really think all blood will be treated with these systems," Isaacs said. "It's the only way to protect the whole blood supply from HIV or the new agents."

Experts say the new procedure would be ideal if it can wipe away contaminants from donated blood without damaging the blood. Some worry about the cost.

"Theoretically, it would eliminate all viruses from the blood supply, but it's enormously expensive," Rouault said. "It will double the cost of every blood product."

This report was supplemented with information from The Associated Press.

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