The first British child to die of complications from Acquired Immune Deficiency Syndrome (AIDS) may have contracted the disease through one of several blood transfusions he received during a three-month stay in two Washington hospitals in 1983.
Anthony John Thorpe, age 20 months, died Wednesday in a London hospital and was diagnosed as having AIDS. He had entered the hospital three weeks ago for treatment of pneumonia.
His death raises new worries about the illness developing from past transfusions. It also comes at a time when blood banks have just acquired a new test to help assure the safety of the nation's blood supply.
The infant was born 14 weeks prematurely at George Washington University Medical Center on Aug. 6, 1983 and weighed only two pounds, according to a hospital spokeswoman. He received several transfusions from several blood donors at that hospital and two transfusions from one donor at Children's Hospital, according to a spokesman for Children's Hospital.
"The strong assumption is the baby acquired it [AIDS] through a transfusion," said Harold Krantz, spokesman for Children's Hospital. "The parents are not known to be part of any of the risk groups."
Both hospitals receive their blood from the American Red Cross Blood Services-Washington region, which obtains blood from volunteers in 37 counties in Maryland, Virginia, the District of Columbia and West Virginia. The Red Cross is now tracing some 30 people who are believed to have donated the blood the infant received, according to spokeswoman Lucy Srabstein.
"In this case there were multiple donors," she said. "We'll report the information to the Centers for Disease Control, and they'll make a decision whether it was indeed a transfusion-related case [of AIDS]."
Srabstein added, "The incidence [of AIDS from blood transfusions] is extremely remote. There have been only 116 cases of transfusion-associated AIDs cases since the CDC began tracking them three years ago." This figure includes 15 infants who have died nationwide, she said.
She said the CDC is investigating other reports of Washington-area infants who have developed AIDS following transfusions, but said she is unaware of any infant deaths that have occurred.
Officials of both hospitals emphasized that in mid-1983, when the Thorpe infant was treated, blood donors were not routinely asked if they belonged to one of the population groups that are at high risk for AIDS.
Also, "Unlike today, a test was not available to check the blood for the presence of AIDS," Krantz said.
Dr. William Marsh, director of blood services for George Washington University Medical Center, said that the local Red Cross began on March 19 to test all donated blood for AIDS with a special test that won approval March 2 from the U.S. Food and Drug Administration.
"You don't like to have it happen in your institution," said Marsh. "You feel bad, but I don't know what we could do. It is just chance where the Red Cross sends the blood."
As is common with some premature infants, the baby was given blood transfusions by the Washington hospitals to combat anemia. The infant was transferred to Children's Hospital on Sept. 15 for four days to undergo surgery to correct a congenital heart defect, Krantz said.
The infant did not require blood during the surgery, he said, but was given three portions of the same pint of blood before and after the surgery because of his anemia. "It was all from one donor," Krantz said of the blood the infant received at Children's Hospital.
Krantz said the baby received blood from multiple donors at George Washington University Medical Center because of the length of time the child was there.
Marsh, a pathologist who directs George Washington's blood services, said the director of newborn services at George Washington University was called by a British doctor "seven to ten" days ago and told the Thorpe infant had contracted AIDS.
Both local hospitals searched their transfusion records and reported the numbers of the blood units used on the Thorpe baby to the Red Cross, Marsh said. Other blood from that time period is outdated and no longer in use, Marsh said.
Srabstein, of the Red Cross, emphasized that the half-million units of blood distributed in the Washington region each year are "extremely safe." She added, "This is certainly a very unfortunate incident . . . . We've been taking maximum precautions all along and we'll continue to take them."
News reports from London said the father, Gerald Thorpe, broke down weeping during an inquest for his son. His mother works as a radiology technician in a London hospital, according to Krantz.
Krantz said it is believed that the couple were in Washington while Gerald Thorpe was on business in the city.
The child's death is sure to heighten fears that parents already are expressing to doctors, Krantz said. Because so many parents with children facing elective surgery are worried about the safety of blood transfusions, Children's Hospital is planning to set up a hotline and several community lectures on the risk involved in blood transfusions. "It is ironic that just as we've got a good tool to calm people down, we get an unfortunate incident that makes everyone more jittery."