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    Is blood supply safe?

    By Times staff writers
    © St. Petersburg Times
    published July 19, 2002

    Q: What happened Thursday?

    A: Florida Blood Services, which is the primary supplier of blood in Hillsborough, Pinellas and Pasco counties, announced that blood transfusions from one donor infected two Tampa Bay area residents with HIV.

    Q: So is the blood supply safe in Pinellas, Hillsborough and Pasco?

    A: Experts say yes. While there is always a risk in receiving blood, it is extremely small. Officials say all of the infected donor's blood is gone and they have accounted for it.

    Q: Do we know whose blood donation was contaminated and who received the transfusions?

    A: No. Florida Blood Services says the identities of the blood donor and the two infected recipients are confidential. The two infected recipients received the blood at hospitals in Pinellas and Hillsborough counties. The hospitals were not identified.

    Q: How often does someone get infected with HIV through a blood transfusion?

    A: It is extremely rare. Experts estimate the chance of getting HIV from donated blood is less than 1 in 2-million transfusions.

    Q: Where has this happened before?

    A: This is believed to be the second U.S. case of HIV being transmitted through donated blood since rigorous new tests began in 1999. In August 2000 a Texas man undergoing surgery was infected.

    Q: I am going into the hospital next week but don't want to receive donated blood. Do I have any other options?

    A: Yes. If you know that you have to go into the hospital, you can donate your blood in advance. You could ask your family members to donate blood for you, but some experts discourage that for two reasons. A family member might be keeping something hidden from you about their medical history but feel pressured to donate. Or sometimes a relative's blood can be so similar to your blood that it might cause complications.

    Q: What about donating blood? Is that safe?

    A: Yes. You can't be infected from donating blood in the United States. The kits used to collect blood are disposable and only used once.

    Q: What test is used to detect HIV in blood?

    A: Florida Blood Services and other blood banks have used nucleic acid amplification testing, considered the most effective way to screen blood, since 1999. The test detects the presence of nucleic acids that make up RNA and DNA of the virus. Essentially, it copies tiny pieces of a virus or any other organism several million times, allowing identification by current technology.

    Q: Why wasn't HIV detected in this case?

    A: HIV might not be detected if a person has been infected within seven to 10 days before they donate blood. That's because the virus hasn't had enough time to multiply for the test to detect it.

    Q: Then why don't blood banks hold on to the blood longer and test it again before sending it out to hospitals?

    A: That won't help. HIV will not grow in the donated blood.

    Q: Then why does the person who received the infected blood later test positive for HIV?

    A: The virus resumes growing after the blood enters another person's body. Eventually, it multiplies enough to be detected.

    Q: Can we expect further improvements in the testing procedure to reduce the risk?

    A: Experts say new technology might be available within five years that will "clean" donated blood before it is distributed. But there are questions about whether it will be affordable. Florida Blood Services is involved in a study of one new technique.

    Q: Could I have been affected by the tainted blood and not know it?

    A: No. Florida Blood Services and area hospitals have notified all recipients of the donor's blood. All seven people who received the donor's blood were tested. Five received blood from earlier donations by the donor, which were clean. Two received blood from a March donation, when the test of the blood did not detect that the donor had been recently infected. All leftover blood from the infected donor expired before it was used.

    Q: Has Florida Blood Services been cited for its handling of blood?

    A: In 1997, 1998 and 1999 the federal Food and Drug Administration sent "warning letters" to Florida Blood Services about improper procedures, including two letters criticizing its handling of blood being tested for HIV. The blood bank says those problems were quickly corrected.

    Q: The FDA requires blood centers to be inspected every two years. What were the results of the last FDA inspection of Florida Blood Services?

    A: An inspection from September 2000 showed the inspected areas to be in "substantial compliance with applicable requirements," according to a letter from the FDA to Florida Blood Services. "Some adverse practices/conditions were observed during the inspection" but didn't warrant followup consideration.

    Q: How does Florida Blood Services track where blood goes?

    A: Donated blood is separated into three components: red blood cells, plasma and platelets. Each component is given a special number and shipping document when released from the blood bank. Some records are computerized but most are paper. Records show which hospital received components but not who the recipients are. Only hospitals keep those records.

    Q: How do blood companies test for tainted blood?

    A: First, they require donors to fill out a form with specific and direct questions about risk factors that could indicate possible infection with a transmissible disease. This "upfront" screening eliminates about 90 percent of unsuitable donors, according to the FDA. Second, the FDA requires blood centers to maintain lists of unsuitable donors to prevent the use of collections from them. Third, blood donations are tested for different diseases.

    Q: How large is Florida Blood Services?

    A: It is the largest blood services center for the Tampa Bay area, providing blood to 34 hospitals, including Bayfront Medical Center and Tampa General Hospital and dozens of other facilities such as surgery centers. The organization has a $42-million annual budget and 500 paid employees.

    Q: Has Florida Blood Services changed its procedures after this incident?

    A: No. Officials say there is nothing that could have been done to prevent the tainted blood from being donated or distributed. That's because even the most effective tests can't detect the virus if a person was infected within seven to 10 days.

    Q: Where can I call if I have concerns or questions?

    A: Call Florida Blood Services at (727)-568-5433.

    -- Times staff writers Anita Kumar and Wes Allison contributed to this report.

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