Most Mumbai blood banks not equipped to detect infected blood
Blood transfusion gives 28 thalassemia patients Hepatitis at St Georges hospital, reveals RTI report. Experts say most blood banks aren't equipped to conduct the foolproof Nucleic Acid Test
A Right To Information (RTI) query has revealed that 28 of the 86 registered patients at the Thalassemia Blood Transfusion Centre at St Georges Hospital at Fort have tested positive for hepatitis B (HbsAg) and hepatitis C (HCV). Three patients have also tested positive for HIV.
St Georges Hospital at Fort. Family members of at least two patients in the thalassemia unit of the hospital allege that their kin, who were registered with the blood bank since eight to 10 years, had suddenly tested positive for hepatitis B and hepatitis C respectively
With the figures further revealing that 36 per cent of the patients at the hospital tested positive for diseases that mainly spread through regular blood transfusions, experts have raised serious concerns about many government-run blood banks still using the outdated Enzyme-Linked Immunosorbent Assay (ELISA) test to detect viruses in the blood. The more effective and latest method of testing blood samples for virus, bacteria and diseases, the Nucleic Acid Testing (NAT) is followed only by a handful of private players such as the Hinduja Hospital.
The blood bank at St Georges hospital. Pic/Emmanual Kharbhari
“Of the registered thalassemia patients at the hospital, 22 tested positive for hepatitis C and six more contracted hepatitis B,” said a doctor who filed the RTI, requesting anonymity.
Not trained to test blood
While the state-run hospital has a regional blood bank which is responsible for supplying blood bags free of cost to thalassemia patients, a routine inspection by Food and Drug Administration (FDA) authorities last year found that the staff there was not qualified to conduct necessary tests on collected blood samples.
The FDA had then instructed the blood bank officials to hire a qualified technician. “The blood collected should be tested for several diseases so that the infected blood is discarded. This must be done in the presence of a blood transfusion officer (BTO), who should also be present in the blood bank 24x7. These rules are not followed in the hospital,” added the doctor, who worked at the hospital’s blood bank earlier.
When Sunday MiD DAY visited the thalassemia unit of St Georges the family members of at least two patients alleged that their kin who were registered with the blood bank for the last eight to 10 years, had suddenly tested positive for hepatitis B and hepatitis C respectively.
“My sister has been undergoing blood transfusions in this hospital since eight years. However, four years ago, she tested positive for hepatitis B following a routine blood transfusion,” said Jaya, the patient’s sister. Another patient, 24-year-old Hemangi Suryavanshi, contracted hepatitis C last year and is now undergoing treatment in the ICU of the hospital for jaundice and pneumonia. “She keeps getting jaundice now,” said Vikas, her father.
Dr Avinash Deo, haematologist at SL Raheja Fortis hospital said, “Patients can contract these diseases if the BTO fails to notice infected blood because the viral load present in a particular blood sample is low. I don’t know of any case of patients contracting hepatitis after transfusions. But, it cannot be ruled out.”
Dr Samir Shah, consultant haematologist at Parel’s Global Hospital said, “If the NAT testing is instituted regularly in licenced blood banks, chances of patients contracting such diseases will drastically come down.” Dr DN Lanjewar, in-charge of JJ hospital’s blood bank said that NAT is conducted only in a few privately-run blood banks. This is because the National AIDS Control Organisation (NACO) supplies material for the ELISA tests and the organisation has not yet made it mandatory for government blood banks to conduct NAT.
A ray of hope
Dr Lanjewar added that a team of doctors from Karnataka are conducting a pilot study where blood samples will undergo the NAT process for an year. “This pilot study will be presented to NACO to study its effectiveness in detection of viruses in blood samples. The association will then decide whether to completely replace ELISA in government-run blood banks across the country,” he said.
The other side
Dr Jagdish Bhavani, medical superintendent at St Georges hospital however denied that any of the 28 patients who had contracted hepatitis had been infected after a blood transfusion at the hospital. He said all these patients must have contracted the disease earlier. “When these patients first registered with us, we were aware they had these diseases. Private hospitals usually refuse these patients. However, we take required precautions and ensure that the diseases are not transmitted to other patients,” he said He, however, admitted that a blood transfusion officer is not present in the blood bank round the clock as per FDA rules. “I have appointed another BTO and we have three BTOs who have completed their MD in pathology to deal with the workload,” he added.
>> The JJ Metro blood bank collects 7,200 units of blood annually
>> St Georges hospital’s blood bank collects 5,000 units of blood in a year
>> There are 122 registered private and government-run blood banks in Mumbai and Thane.
>> Most of these blood banks do not conduct Nucleic Acid Test (NAT) before accepting blood from donors
>> Not conducting the test exposes patients seeking blood transfusion to a higher risk of infections
ELISA versus NAT
The ELISA test uses antibodies and colour change to identify a substance. It determines whether a particular protein is present in a blood sample and if so, how much. A Nucleic Acid Test is a molecular technique used to detect a virus or bacterium present in the blood.