Fear that the nation's blood supply has been contaminated with the blood of AIDS victims is causing patients in the Washington area to postpone surgery or arrange to donate their own blood for their operations, according to surgeons and directors of hospital blood banks.
"People have been frightened by it to the point where they're refusing to get transfusions necessary for them," said Dr. Paul McCurdy, director of the Washington Regional Blood Program of the American Red Cross, which supplies 90 percent of the blood to area hospitals.
Dr. Glenn Geelhoed, a surgeon at George Washington University, said, "I've had three people in the course of this week want to postpone surgery because of a fear of AIDS. They don't want blood under any circumstances."
AIDS, Acquired Immune Deficiency Syndome, is a fatal disease that destroys the body's disease-fighting system and has no known treatment. For the general population, the risk of contracting the disease under any circumstances is extremely remote, and doctors say no direct link has been proved between blood transfusions and incidents of the disease.
"The odds of being hit by lightning are greater than getting AIDS from the blood supply," said Mark Davis, director of the 40-member Metropolitan Washington Blood Banks.
Nonetheless, the fear persists. "There is AIDS anxiety caused by unfavorable publicity," said Dr. Richard DiGioia, cochairman of the Washington AIDS task force. "It's idiotic paranoia."
Of the 1,450 Americans thought to be AIDS victims, only one person, an infant in San Francisco, is believed to have contracted AIDS after receiving a single-donor transfusion.
An additional 15 people, all suffering from hemophilia, the inability of the blood to clot, have contracted AIDS. In 13 of those cases, according to Alan Brownstein, director of the National Hemophilia Foundation, suspicion does point to the blood products they used, which are composed of the blood of thousands of donors. The other two hemophiliacs had other conditions that could have accounted for the disease, he said.
"We're not sticking our heads in the sand and saying it's not the blood, but we strongly urge patients not to withhold treatment," Brownstein said of the nation's 20,000 hemophiliacs. "The consequence of withholding is far worse than AIDS."
Figures on the number of patients delaying or postponing operations are not available and the Red Cross and hospital blood banks say it's too early to tell if blood use has decreased. "What is known is that we've had many, many patients and doctors ask us about the safety of the blood supply," said Harvey Klein, assistant director of the blood bank at the National Institutes of Health.
Precautions to protect the nation's blood supply from AIDS have been instituted in recent months. Since April 1, people in the Washington area wanting to donate blood to the Red Cross and other blood banks must sign a form saying they have read a pamphlet that asks them to refrain from donating if they have symptoms of AIDS, are sexually active homosexuals, recent arrivals from Haiti, abuse intravenous drugs or have a sexual partner at risk of AIDS. Other longstanding disqualifying conditions for blood donors include syphilis, hepatitis or recent trips to countries where malaria exists.
DiGioia said homosexual leaders approved the Red Cross's method because persons need not state the specific reason they decide not to donate. "Some people are semicoerced at office blood drives. They donate even if they're at risk because they're embarrassed not to," said DiGioia. "This way they can just say the nurse found I had a slight temperature."
As a result of the fear, some doctors are encouraging patients to donate their own blood, following the long-standing medical advice that one's own blood is the safest. But this option is not possible for emergency surgery or for seriously ill patients who are frequent users of blood, such as those suffering from cancer or anemia.
"Our auto-tranfusion program was practically nonexistent before this scare," said Dr. Walter Lawrinson, director of the blood bank at the Washington Hospital Center, the area's largest user of blood. In the last two months, at least 20 patients have donated their blood in advance of their operations, he said.
Nationally, McCurdy said his colleagues in Red Cross blood operations across the country also have reported that patients are delaying or canceling operations because of anxiety about the purity of the public blood supply. "In several cases, people have moved from one part of the country to another for medical treatment , and are still delaying needed operations." said McCurdy.
Fear of AIDS contamination of the blood supply is sparking new interest in the development of new forms of blood, including artificial blood, a synthetic fluid that duplicates many of the properties of blood, and in using complicated machines that recycle blood lost during surgery. This spring, the Food and Drug Administration approved a process to pasteurize one form of the blood used by hemophiliacs.
The large number of AIDS fatalities, 558, has prompted European countries to consider banning American blood products. No embargo has been imposed, but France is using a priority system, including whether AIDS exists in exporting countries, to rank the sources of the blood it imports, according to a spokesman for the FDA.