Child, 2, Transmits AIDS Virus to Mother : CDC Says Case, First of Its Kind, Involves Unusual Circumstances

Federal health officials Thursday reported the first known case of transmission of the AIDS virus by a child to his parent but emphasized that the situation was an unusual one and did not contradict overwhelming evidence that AIDS is not spread through normal household contact.

The Centers for Disease Control, in its weekly health report, said that a 2-year-old exposed to the virus through a blood transfusion apparently passed the virus to his 32-year-old mother, a nurse described by the agency as “closely involved in the child’s care during hospitalization and at home.”

Neither Has Disease

Although the mother and her child both have tested positive for exposure to HTLV-III, the virus that causes AIDS, neither has developed the disease.

“We are very concerned that people do not misinterpret this case,” said Dr. Harold Jaffe, chief of the epidemiology branch of CDC’s AIDS programs. “I would hate to think somebody would see this and no longer stay in the same household with an AIDS patient.”

CDC officials said that the child suffered from a serious gastrointestinal disorder and his mother did not take the recommended precautions when caring for him, such as wearing gloves or washing her hands.

In Contact With Blood

The nature of her care extended well beyond that of the typical parent and brought her into frequent contact with her child’s blood, the agency said. She often performed extensive medical procedures on him, such as drawing blood and changing feeding tubes, intravenous lines and bags of wastes, the CDC said.

“This is not the kind of situation that we would see in most households with AIDS patients,” Jaffe said. Jaffe said he did not know why the woman did not take protective measures but speculated that “perhaps people are more careful about following precautions when caring for patients in a hospital than they are with members of their own families.”

CDC officials said that the route of transmission to the mother was unclear, because she did not recall having open cuts or unusual skin conditions on her hands. Also, the agency said, it was unlikely that she had been exposed elsewhere, because she was not a member of any of the high-risk AIDS groups, which include male homosexuals and bisexuals and intravenous drug users.

The CDC said that the child’s father tested negative for exposure and remains healthy.

Can’t Isolate Virus

Although the mother and child repeatedly tested positive for exposure to the virus, the CDC said, the actual virus could not be isolated from blood samples.

“I don’t know what that means,” Jaffe said. “But we believe that they are both infected, even though we didn’t get any virus.”

Jaffe said this case did not weaken evidence that there is no danger of contracting AIDS through casual or household contact.

However, he said, the case “does reinforce the need to take certain minimal precautions any time you are exposed to somebody else’s blood. The same precautions you would follow in a hospital also apply at home.”

The New England Journal of Medicine reported this week that a four-year study of 101 people who were close family members of 39 AIDS patients showed no evidence of their contracting the disease, despite sharing toilets, baths, showers and kitchen utensils.

Furthermore, the CDC said, none of the family members of the more than 17,000 reported AIDS victims have contracted the illness, except for a small number of sexual partners of patients, children born to infected mothers or those who were also members of high-risk AIDS groups.

Although transmission in the health care setting has been reported, “such transmission has been extremely rare,” the agency said.

Precautions Urged

Previous CDC guidelines have recommended that, in hospitals and home-care settings, health care workers and others caring for AIDS patients should wear gloves routinely during direct contact with blood and other secretions. The CDC has also recommended that special precautions be taken in classrooms and day care centers with children suffering from AIDS who lack control of their body functions.

AIDS, or acquired immune deficiency syndrome, destroys the body’s immune system, leaving it powerless to resist infection. It is transmitted through sexual contact--with the exchange of bodily fluids such as semen and blood--and through the sharing of unsterilized hypodermic needles. It has also been spread through transfusions of contaminated blood or blood products, although a blood-screening procedure begun last year has now made that risk slight.

As of Monday, there were 17,001 reported cases and 8,801 deaths.

A national foundation urges cities to establish programs emulating San Francisco’s successful effort to hold down the cost of treating AIDS. Part V, Page 1.