මේක කියවපු ගමන් මට මතක් උනේ කලකට පෙර මෙල්බර්න් වල වෙච්ච සිද්ධියක් . මේ තියෙන්නේ ඒ පුවත.
Australian schoolgirl contracts HIV via blood transfusion
Kaye Tucker
13 August 1999
The tragic news of a young girl infected with HIV via a blood transfusion has exposed serious problems in blood screening procedures in Australia. The girl, a primary school student, was given a transfusion during surgery at a major children's hospital in Melbourne. It is the first reported case of such an infection since blood products began being tested for HIV in 1985.
The girl's parents went public in July, raising fears about the safety of current blood products being distributed through the Australian Red Cross Blood Services (ARCBS). Her father, a Melbourne surgeon, had been so concerned at the time of his daughter's surgery at Melbourne's Royal Children's Hospital, that he had volunteered his own blood.
"I was aware of the slim chance that the blood testing that is taken out by the Blood Bank can miss the patients who are just in the very first weeks of their (HIV) infection. The impression (the authorities gave me) was that it was an unnecessary hassle. The word I would use would be ‘complacent'," he said.
The authorities and the media have immediately gone into damage control mode. While admitting that the incident is shocking for the family involved, they have defended current blood testing procedures. Health officials have claimed that the infection was unavoidable and, in an attempt to prepare the public for worse, warned that it is unlikely to be the last such case.
ARCBS said the infected blood had slipped through the control system because the donor's blood was tested before antibodies to HIV could be detected. Health officials rushed to reassure a worried public, saying that the risk of receiving infected blood was minimal, around one in 1.2 million.
"There was no fault in any of the procedures carried out by the blood bank or the hospital. All the appropriate infection control measures were observed," said Dr Patrick Coghlan, a spokesman for the ARCBS.
"Almost 14 million donations have been collected and screened by the ARCBS in the past 14 years. This is the first such case in Australia since the introduction of testing," said Victoria's state chief health officer, Dr Graham Rouch.
Since then, the Red Cross has revealed that a new test is available, which would halve the window period for undetectable transmission of HIV from the current 22 days to 11 days. The ARCBS had planned to introduce the new form of screening, called nucleic acid testing (NAT) next April, but the government minister raised objections to the millions of dollars such a procedure would cost.
Currently the ARCBS has an annual budget of $150 million, of which 90 percent is required to run the day-to-day services of the blood banks—including blood collection, processing and transportation. NAT testing would cost around $30 million.
Federal Health Minister Michael Wooldridge had been increasingly critical of expensive testing. In May, he announced a 12-month review of blood banking and plasma products, citing concerns about burgeoning costs. "The international trend is for increasingly stringent testing of blood that yields marginal gains in safety but often at a high cost,” he said.
This argument was outlined more crudely and explicitly in a recent article in the
Sydney Morning Herald by Julie Robotham entitled
Blood Count: "For the huge cost, the NAT (Nucleic Acid Testing) technology may prevent one extra HIV case for every 1.2 million blood donations, according to the theoretical figures, or one case for 14 million donations, according to the actual incidence. And HIV is no longer a death sentence, with many people now living long and relatively well lives with HIV, thanks to new therapies. By the usual standards of cost-benefit calculations in a cash-strapped health service, NAT is an almost incomprehensible luxury."
It is hard to imagine a more callous comment, yet it is just such an attitude that underlies current government policy. Instead of calls for a major injection of funds into what is a beleaguered blood bank system, the introduction of new technology that will save lives is considered a "luxury" that cannot be justified. We are advised that the risk of contracting a serious, life-threatening infection from a blood transfusion is a reasonable risk when calculated on a cost-benefit ratio!
In fact, some in the media are taking this one step further by placing the onus on the family and the individual to provide blood for their own operations. They argue that directed donations of blood, such as that requested by the father of the young girl infected, should be considered because they represent a cheaper alternative.
Scientific research, however, has shown that donations from family members are more likely to carry viruses, and family members are less likely to reveal risky behaviours such as drug use or sexual contacts. In addition, a rare condition called graft-versus-host disease, where the transfusion takes over and rejects the recipient's original blood, is more likely among family transfusions.
As people have become more concerned about the safety of blood transfusions, there has been a trend to find a less risky option. It has become common place, for example, for people to store their own blood for their personal use.
A review panel has been established into Victoria's policy on directed blood donations, but both the girl's father and the Australian Medical Association have raised concerns about the independence of the panel. Two out of three medical specialists on the panel have direct connections to the Royal Children's Hospital, where the operation on the young girl was performed.
The real issue, however, is the running of the blood bank itself. Since the scandal erupted, the federal government has approved the funding for the NAT blood screening technology. This is ahead of the major review due next May, set down to investigate costs as well as the shortfall in supply of blood products. Currently the New South Wales branch of the ARCBS is almost running on empty with at most two days' blood supplies.
The Australian College of General Practitioners broke ranks with others in the medical profession and issued a public statement accusing both surgeons and the Red Cross of failing the young schoolgirl and saying that the blood banks had become "a little slack" with their donor screening procedures.
Dr Colin Hughes, the chair of the West Australian branch, also commented that "surgeons haven't really explained the patient options nearly as well as they should" because they were often in too much of a hurry to do so. He stated that several alternatives to blood transfusions had been developed over the years, including bloodless surgical techniques and artificial blood transfusions, but most patients went into surgery unaware of their options.
The Australian blood bank itself is facing major legal action. The service became a national operation in 1996 in line with international trends to establish a consistency in screening procedures and to consolidate services. The problems confronting the old state-based Red Cross Blood Banks, however, still persist. Three hundred people who believe they contracted hepatitis C from blood transfusions between 1985 and 1991 are suing blood banks around Australia.
mokuth karalath na,,,eth danne nane 
gedara awith thibba ara booklet ekai blood type ewa okkoma...mokuth cse ekak na...eth ithin thibbanam e weddi gedara minissu danagena iwarai matath kalin 
