I believe he was referring to a 27 July 1996 editorial by Dr Paul V. Holland, which mentioned that "the risk of infection with the human immunodeficiency virus (HIV), the danger of most concern to transfusion recipients, was estimated as 1 in 493,000 -- remarkably close to the figure of 1 in 450,000 to 1 in 660,000 estimated by Lackritz et al. (2) on the basis of more than 9 million blood donations".

This NEJM editorial confirms what many lay readers had rightly surmised: that the Star news report had confused the low risk associated with competently screened HIV-negative blood with the risk associated with HIV-contaminated blood transfusion, which is very much higher.

The residual risk is partly due to false negative test results (no medical lab test is completely foolproof) plus blood donated during the "window-period" when a person recently infected with HIV has as yet undetectable presence of antibodies against the virus. (The routine "HIV test" actually tests for the presence of antibodies against HIV, rather than directly for the virus itself.)

Blood donated by an HIV-infected person (within the first month or so after infection) may therefore test negative for HIV-antibodies, but nonetheless contain the virus. It is for this reason that blood banks strongly discourage persons who engage in high-risk activities from volunteering as blood donors, to minimise the risk of HIV-contaminated blood slipping through the screening procedure via the window-period. When this is effective, and routine screening is done conscientiously, the residual risk of HIV transmission via contaminated blood is almost negligible.

(Getting blood donors to sign statutory declarations that they are free from disease however is an ill-conceived ploy to divert attention. It would greatly exacerbate the chronic shortage of donated blood without significantly improving the safety of blood supply).

The most urgent need now, for restoring the confidence of blood donors and recipients alike, is for the Health Ministry to be transparent about the ongoing inquiry, and to provide the public with unambiguous details about routine procedures in our blood banking system and the circumstances leading to the Jitra and earlier Raub tragedies. Worse even than the possibility of human error, irresponsibility, or criminal negligence is uncontrollable rumour-driven damage to the credibility of institutions crucial for our national well-being.

The unfortunate woman and her family, whose spirits were temporarily lifted (Star, 20 May 2000) by the erroneous news report will soon realise that her condition remains serious. Heartening news, even if mistaken may boost resolve and resistance, but it would be wrong to leave such confusion uncorrected.

The last thing we would want is to leave the impression that the exchange of blood and other bodily fluids—a few drops in shared dadah injection, an ml. or two of genital fluids—can't be that hazardous if getting a whole bag of HIV-contaminated blood carries so little risk.