Five children suffering from thalassemia and undergoing blood transfusions in Jharkhand’s Chaibasa have tested positive for the human immunodeficiency virus, PTI reported on Saturday.

The infections were detected during an investigation by a five-member medical team from Ranchi, which was sent after the family of a seven-year-old thalassemia patient alleged that the Sadar Hospital blood bank in Chaibasa had supplied HIV-infected blood for a transfusion.

Following the complaint, the Jharkhand Health Department constituted a medical team to determine how the infected blood was administered. During their inquiry, they discovered that four more children had tested positive for HIV.

District Civil Surgeon Sushanto Majhee confirmed that the seven-year-old patient had tested HIV-positive over a week ago. He added that while contaminated blood could be one cause, exposure to infected needles or other sources could not be ruled out at this stage.

However, Dinesh Kumar, the director of Jharkhand’s health services, who is heading the probe team, said that “initial investigation indicates that contaminated blood was transfused to a thalassemia patient”.

“Some discrepancies were detected in the blood bank during the probe, and officials have been directed to address them immediately,” PTI quoted Dinesh Kumar as saying.

Deputy Commissioner Chandan Kumar said that the authorities are working to “to trace the database of blood donors, and to verify whether infection could be due to undetected HIV-positive donors”, The Indian Express reported.

He added that the children had different blood groups, suggesting the infections came from multiple sources, not a single donor.

Chief Minister Hemant Soren ordered the suspension of the civil surgeon of West Singhbhum and other concerned officials. Soren also announced that the state government will provide financial assistance of Rs 2 lakh each to the families of the affected children and cover the full cost of their medical treatment.

In a separate post on social media, Soren said “lax arrangements in the health process will not be tolerated under any circumstances”.

He also ordered the health department to conduct an audit of all blood banks in the state within five days.

Blood transfusion guidelines

Blood banks are supposed to follow guidelines issued by the National AIDS Control Organisation, which state that each unit of blood donated from a person must undergo a screening test to detect HIV and hepatitis. Elisa is the most commonly used test for this purpose.

However, if donors have been freshly infected with either HIV or hepatitis, their bodies may not have generated enough antibodies against the virus for them to be detected in screening tests.

The Elisa test can only detect antibodies against these viruses 45 days after the patient is infected. A more sensitive method – the nucleic acid amplification test – reduces the window period to 10-15 days. However, this too cannot totally eliminate the chances of missing out on identifying an infection.

Experts say most cases of blood transfusion-related infections are caused when such tests miss detecting infections, or tests are not carried altogether.

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