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An article in The Lancet was published on the occurrence of AIDS in an infant who had had a blood transfusion at birth and the possibility of contracting AIDS in such a way.

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Dr Mark Winter (who regularly read the Morbidity and Mortality Weekly Report) told the Inquiry that: "Any clinician looking at this data would have to believe that AIDS was a transmissible disorder and that it could be transmitted by blood and by blood products."

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Ed Cutter wrote a memo to J Ryan, Carolyn Patrick, Wayne Johnson, Ralph Roussell and George Akin advising them to include an AIDS warning in their literature and on its packaging of its Factor 8 and Factor 9 products

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Sir Joseph Smith, former director of the NIBSC and thereafter the PHLS, provided a written statement to the Infected Blood Inquiry.

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Dr Charles Rizza published an epidemiological study of AIDS in patients with coagulation disorders in the UK and its relationship to transfusion with blood products.

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Cornelis Smith, coordinator of the Netherlands Haemophilia Society, provided a written statement to the Infected Blood Inquiry.

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The CDC published a report on "Immunodeficiency among Female Sexual Partners of Males with Acquired Immune Deficiency Syndrome (AIDS)".

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I Marshall, of Alpha Therapeutic, wrote to Professor Bloom in relation to AIDS and precautionary steps being introduced to minimise the risk of the disease being transmitted via donors to people with haemophilia, including donor screening and leafleting.

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Lederman et al published a report in the New England Journal of Medicine titled "Impaired cell-mediated immunity in patients with classic hemophilia".

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It was asserted in a meeting with Immuno that "it is not known if AIDS is caused by a virus or an attacker inimical to T cells".

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People with haemophilia who were without symptoms of HIV but who had received factor concentrates had abnormalities in their T cells, but those who had received cryoprecipitate did not.

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Medical News published an article entitled "Preventing AIDS transmission: should blood donors be screened?" reporting on the connection between AIDS and the infusion of blood and blood products.

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The Centers for Diseases Control published an article in its Morbidity and Mortality Weekly Report, which reported over 1,200 cases of AIDS from 34 states since June 1981, explained statistics and made reference to the parallel between AIDS and Hepatitis B.

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According to Dr Kingdon, the United States plasma collection centres tended to be located near areas where there was likely to be a population willing to spend 2-3 hours donating plasma for a small payment (near universities, army bases and in the lower socio-economic sections of a city).

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The size of pool used by Hyland/Travenol appears to have increased over time as, in his draft statement of 1990, Dr Kingdon referred to "start pool" sizes of up to 15,000 donations. He did not provide further details of when, how and why the pool size had changed.

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Dr Kingdon recorded that:"All importation stopped following the FDA direction that source plasma and the centres producing source plasma be licensed; the FDA would not inspect offshore sites which meant that imported plasma would not be approved plasma and therefore could no longer be used in the manufacture of blood products. As a result, since approximately 1978, all plasma used for the production of concentrates in the United States has been obtained from donors in the United States."

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There was a single centre in Belize, which was also licensed for fractionation (and hence should have been inspected) by the FDA.

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A meeting was held at the National Institute for Biological Standards and Control ("NIBSC") between civil servants, American and British fractionators, clinicians and scientists. Among the issues discussed was the size of donor pools.

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At an NIBSC meeting the National Hemophilia Foundation's position that products should be automatically recalled where a donor was diagnosed with AIDS or characteristics strongly suggestive of AIDS was explained.

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The WHO Resolution urged Member States to promote national self-sufficiency on the basis of voluntary donations and to "enact effective legislation governing the operation of blood services and to take other actions necessary to protect and promote the health of blood donors and of recipients of blood and blood products."

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