Blood Safety by Hua Shan & Roger Y. Dodd

Author:Hua Shan & Roger Y. Dodd
Language: eng
Format: epub
ISBN: 9783319944364
Publisher: Springer International Publishing

This report would have a lasting impact on the patient populations identified as being at risk for AIDS and initiating the discussion of the involvement of blood products in disease transmission. AIDS soon carried a label as the “4H disease” and with it the social stigma for homosexuals, Haitians, hemophiliacs, and heroin addicts.

Transfusion-Transmissible Disease

Early in the epidemic, it was estimated that approximately 5% of patients with symptoms consistent with AIDS did not fit within any of the recognized risk groups. It wasn’t until an infant with erythroblastosis fetalis developed the disease that a blood-borne infectious agent with the ability to be transmitted by transfusion was given credence [17]. The infant showed laboratory evidence of hypergammaglobulinemia, T-cell depletion and dysfunction, and autoimmune thrombocytopenia. These findings were not characteristic of any known congenital syndromes at the time, and a retrospective review of the patient’s exchange transfusions was initiated [18]. One unit of platelets was identified that came from a male donor who was asymptomatic at the time of donation but subsequently was diagnosed with AIDS. This report was a pivotal moment in the epidemic because it not only identified the possibility of a transfusion-transmitted etiology but also suggested that the incubation period for the infectious agent may be relatively long. There was general consensus that AIDS was caused by an infectious agent and was tentatively referred to as the “AIDS agent.” There was enough anecdotal evidence at this point for the Assistant Secretary for Health to gather an advisory committee to discuss the situation at hand. The Blood Product Advisory Committee (BPAC) would meet for the first time in 1982 and continue to monitor events through the epidemic.

This epidemic could not have occurred at a more inopportune time. President Ronald Reagan and his administration were brought into office due to their campaigns for reducing government regulations, and major public health organizations were undergoing changes in leadership. The country had lost confidence in the CDC after the swine flu epidemic in 1976, during which time the federal government initiated a mass immunization campaign for an infection that failed to be substantial. The effort was successful in immunizing 40 million Americans against swine flu, but the disease never spread, and links to Guillain-Barré cast a shadow on public health officials, with a loss of credibility that would spill over into the emergence of HIV [19].

The CDC held its first public meeting in Atlanta on January 4, 1983. The meeting was attended by the National Institute of Health (NIH); the Food and Drug Administration (FDA); blood bank organizations including the American Association of Blood Banks (AABB), the American Red Cross (ARC), and the Council of Community Blood Centers (CCBC); the National Hemophilia Foundation (NHF); the American Blood Resources Association (ABRA); and the National Gay Task Force. Dr. Donald Francis from the CDC, one of the first scientists to suggest an infectious etiology for AIDS, presented the epidemiology of the disease and suggested that blood banks question donors about their sexual history and defer those who fall into high-risk groups.

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