TIME: Almanac 1993/TIME Almanac 1993.iso/time/060391/0603130.000

Text File | 1992-08-28 | 5.6 KB | 115 lines

                                                                                HEALTH, Page 56

AIDS Moves in Many Ways


Headlines about tainted transplants and infected dentists stir
public anxiety, but there is no cause for panic

By ANASTASIA TOUFEXIS -- Reported by Barbara Dolan/Chicago and
Andrea Dorfman/New York


    For medical experts, steering the public through an
epidemic is a precarious balancing act: they must maintain a
healthy level of fear in people and yet keep them from slipping
into either complacency or terror. That job is especially
difficult in these days of the AIDS plague, which has become the
most frightening and confusing health problem since the polio
panic of the 1950s. While some Americans have smugly assumed
they are perfectly safe, others have mistakenly fretted that
they could pick up HIV (the AIDS virus) from toilet seats or
mosquito bites. Throughout the crisis, specialists have offered
strong reassurance: if people are careful about sex and avoid
shooting drugs with dirty needles, their chances of contracting
AIDS are extremely small. But now a series of incidents is
renewing public nervousness about the ease with which the virus
can be transmitted.

    The latest tremor came last week when the American Red
Cross announced it was totally revamping its facilities and
procedures for handling blood donations -- an admission that the
current system is not as safe as it should be. Confidence in the
U.S. blood supply has been shaky since the early days of the
AIDS epidemic when there were frequent reports that
hemophiliacs and other patients were being infected from
transfusions. To date, more than 4,100 blood recipients have
contracted AIDS. Fearful Americans increasingly are banking
their own blood in advance of scheduled operations or giving
donations earmarked for family and friends. The caution is
understandable: in the past few years the Food and Drug
Administration has cited the Red Cross, which provides half the
U.S. blood-bank supply, for not following safety procedures
designed to guard against the use of HIV-infected blood, for
inadvertently releasing blood contaminated with hepatitis and
for failing to report accidents and errors.

    The Red Cross announcement followed by days word that the
FDA and the Centers for Disease Control (CDC) are tracking down
recipients of organs and tissues taken from a Virginia man
infected with the AIDS virus who was killed during a robbery in
1985. His organs and tissues, which had tested negative for the
virus, were distributed among 56 patients in 16 states. Six of
them have tested positive for HIV.

    While the public may have been disturbed by such news,
there is in fact little danger from transfusions and
transplants. Blood and donated organs and tissues are routinely
screened for the AIDS virus. Still, there is no way to remove
all threat from these procedures. One problem is that there is
a lag of up to six months from the time a person is infected
with HIV until blood tests can detect antibodies. Since blood
banks began screening for the virus in 1985, 15 people of the
estimated 24 million who have had transfusions have been
infected from blood that had passed all the tests. Some 3
million transplants have been performed during that time; only
one patient has developed AIDS and eight others have tested
positive for the virus.

    Far more troubling are indications that some doctors and
hospitals may be lax in protecting patients against exposure to
the AIDS virus. Chicago's Illinois Masonic Medical Center has
temporarily closed its adult clinic following two alarming
incidents. In April a physician taking a Pap smear from a woman
unwittingly used a swab that had previously been used to take
a culture from an HIV-positive patient. The doctor thought the
testing kit, which had been left out unlabeled on a table in the
hallway, had been prepared for his use. Just weeks later, two
toddlers who had accompanied a woman into a clinic examining
room pricked themselves with a syringe that is believed to have
been used on an AIDS patient. The youngsters plucked the needle
from the covered red bucket into which dirty syringes are
tossed; the pail was on an open shelf under a sink.

    Public anxiety about medical professionals is already
running high. The CDC reported earlier this year that a Florida
dentist with AIDS had somehow infected three patients.
Undoubtedly, precautions need to be tightened, but the
possibility of contracting AIDS through mishaps or from infected
doctors remains remote. Only 3 of 1,000 cases involving jabs
with contaminated needles result in HIV transmission, according
to the National Institutes of Health. And medical professionals
face a greater risk of getting AIDS from patients than vice
versa. About 40 workers have been infected by patients' blood.
The three patients who caught the virus from the Florida dentist
are the only documented cases of worker-to-patient transmission.

    That is not likely to mollify the public, which craves
absolute safety, not just in medicine but in all facets of life.
"People have to think of the alternatives," says Dr. David
Sutherland, a transplant surgeon at the University of Minnesota.
"If your heart is failing and you're given one month to live
without a heart transplant, are you going to say, `I'm not going
to have it because there's a 1-in-10,000 chance I'll get AIDS'? I
doubt it." One positive side effect of AIDS is that it has
forced major improvements in the U.S. health-care system. The
strange truth is that most Americans may be safer now than they
were before the coming of AIDS.