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One man led to 260 cases of AIDS

Published Oct. 9, 2005

Forty percent of all AIDS cases reported in Russia have been traced to one man, a radio engineer from the city of Elista.

But the epidemic wasn't his fault. Blame hospitals for using the same syringe on several patients. Most of them were babies.

The disaster began in 1980, when the engineer, who has not been named, left his city in the steppes between the Black Sea and the Caspian Sea for a year's work in the Congo.

He returned to Elista in 1981 carrying the AIDS virus. It is not clear how he got it.

He married. The virus spread to his wife. She had a child. The child was infected, became sick and in 1988 was sent to the hospital. Doctors did not know the child carried the virus.

The child received various drug injections. And here is where the epidemic began.

If the same drug was to be given to several children, doctors and nurses "would use the same syringe, because they would think children are sterile," said Marina Savelyeva, a molecular biologist with the AESOP Resource Center in Moscow, an AIDS education and training center. Needles were discarded, but not syringes.

The virus spread to other hospitalized children. Some got sick and were transferred to larger regional hospitals.

At each of those hospitals, the pattern was repeated. New cases appeared 300 miles away in hospitals in Volgograd, Rostov-on-Don and Stavropol. "It's an incredible story," Savelyeva said.

It was some time before Russian medical authorities realized what was happening. There had not been a single case of AIDS infection in the area before. As soon as authorities recognized the disease, they began exhaustive medical detective work to track the epidemic to its source.

In 1989, more than 140,000 people were tested for evidence of infection. The investigation turned up many infected children, some infected mothers and one infected man: the Russian engineer.

"Now there are about 260 infected children of various ages," said Dr. Alexandre Gromyko of the World Health Organization's AIDS program.

The engineer's child died without ever leaving the hospital. Many others died later.

The cases represent 40 percent of the 637 cases reported in Russia, said Dr. Johannes Hallauer, European coordinator of the World Health Organization's AIDS program.

The existence of the epidemic became public shortly after it began, but new details were disclosed this week during the Ninth International Conference on AIDS.

The tragic episode deeply embarrassed Russian health officials, who have taken steps to assure that it will not be repeated, said the WHO's Gromyko.

"This was really a stimulus to national authorities to revise practices in the medical institutions," Gromyko said Friday.

The epidemic has attracted new attention with the easing of travel restrictions and the social and economic upheaval in Russia and Eastern Europe. The former communist countries face an explosive rise in AIDS cases if prevention is not begun immediately, World Health Organization officials said.

A similar children's epidemic broke out in Romania about the same time as the Russian epidemic. In Romania, more than 2,000 children and infants were infected. But the source of the virus was tainted blood, not a single infected individual.

The numbers in Eastern Europe still pale in comparison to the United States. The U.S. Centers for Disease Control in Atlanta had recorded 289,320 cases of AIDS in the nation, with 182,275 deaths as of March.

The unusual nature of the Russian epidemic has skewed the population's attitudes toward AIDS, leading many to conclude that they are not at risk.

"They believe it is a Western disease, that if you are taking drugs or being promiscuous or homosexual, then you would get it," said Hallauer, the WHO official. "They are not realizing this is a threat to the general population."

Authorities have changed many of the practices that led to the epidemic. Disposable needles and syringes are now widely available.

No new cases have been reported in the region for 1 1/2 years.