Tainted-Blood Scandal Has Germans in an AIDS Panic : Health: Over the past decade, the number exposed to the accused firm’s supplies may run into the millions.

The quivering voice was that of a middle-aged woman turning to a radio talk show for advice. “My husband was in the hospital and received two blood transfusions,” she confided over the air this week. “I am worried. What do I do?”

The reply was as simple as it was startling: Tell him to get an AIDS test--now.

Not long ago, such advice would have seemed absurd in a country of 81 million where only a small fraction of the population, consisting almost entirely of gays and intravenous drug users, carries the virus that causes acquired immune deficiency syndrome. But concern about AIDS is sweeping Germany like wildfire, due to one of the biggest--and potentially most deadly--health scandals in this country’s history.

Health officials say anyone who received donated blood in the past decade may have contracted the human immunodeficiency virus (HIV) from tainted products supplied by a company that allegedly tried to save money by not properly testing its blood donations.

At least three cases of AIDS already are being investigated for possible links to the company, authorities say. And the number of patients who may have been exposed to the tainted supply may range into the millions.

The warning has set off a nationwide panic as thousands of blood recipients fear the worst, and countless others put off surgery and refuse blood transfusions. It also has prompted a flurry of political finger-pointing as Germans ask how such apparent avarice could go unchecked in a country renowned for its efficiency and exacting standards.

Scares involving contaminated blood supplies have occurred worldwide, but until now Germany had emerged relatively unscathed.

“There is an obvious hysteria,” said Friedrich-Ernst Dueppe of the German Red Cross, the country’s largest operator of blood banks. “In some states, even blood donations have dropped off because people have the fear, however irrational, that they may get infected.”

Hospitals, health clinics, doctors’ offices and government agencies have been swamped with inquiries from former patients wanting to know if they were exposed to the tainted blood.

The answer is often agonizingly unclear: Some hospitals estimate only a fifth of patient files indicate the source of blood products used in treatment. Others say it could take weeks--and millions of dollars in overtime pay--to sort through records.

Health ministries in several states have been forced to install additional phone lines to handle the volume of calls, while newspapers and television stations have set up hot lines for readers and viewers to speak directly with health experts. Federal officials have offered a free AIDS test for anyone who wants one.

“We have never seen anything like it,” said Maria Voelker of the Federal Health Ministry in Bonn. “And all of the facts still have not come out.”

Authorities insist the risk of infection for most Germans is small--somewhere between one in 100,000 and one in 1 million--but public confidence in official pronouncements has fallen precipitously amid revelations that federal and state health officials knew about the company’s poor track record and did little about it.

A former employee of the Koblenz firm reported to local health authorities in 1987 that tainted blood was being distributed; a federal health agency in Berlin was alerted in 1991 that blood products from the company marked “negative” were subsequently found to be positive.

Even so, the Koblenz prosecutor--who closed the firm last week--said he first learned about its problems last month through newspaper stories about several of the firm’s blood donors who had tested positive for HIV, which causes AIDS.

“This disaster was only possible because of carelessness, slackness, indifference and negligence on the part of the responsible authorities,” said Klaus Kirschner, parliamentary health expert for the opposition Social Democrats in Bonn. “What this company did was criminal, but it was able to get away with it because the controls failed.”

The scandal comes just weeks after the government acknowledged, in a separate incident, that the Federal Health Office in Berlin had covered up 373 cases in which people--mostly hemophiliacs--may have contracted AIDS through donated blood before mandatory testing of blood products began in 1985.

As a result, the agency has been disbanded, two of its senior officials fired and criminal and parliamentary investigations launched. Two former federal health ministers have also been sued for failing to exercise proper oversight of the office.

Comparisons have been drawn with a recent blood scandal in France, in which several top health officials were convicted last year of knowingly allowing hundreds of hemophiliacs to receive blood-clotting products tainted by HIV.

“I understand the public’s concerns and fears,” said Horst Seehofer, the current federal health minister who has rejected calls for his resignation. “The fastest and most foolproof way to re-establish a feeling of security is by undergoing an AIDS test.”

At the center of the unfolding affair is UB Plasma, a blood-products company located on the top floor of a shopping center in this Rhine Valley military town, about 35 miles southeast of Bonn. Authorities say the firm had sold untold thousands of potentially tainted blood products--mostly plasma--to at least 88 hospitals and laboratories in 14 of Germany’s 16 states and several other European countries since 1982.

Although none of the products were exported to the United States, American military officials in Washington said health records will be reviewed to determine if soldiers or their families in Germany used UB Plasma products; those in doubt are being advised to take an AIDS test.

The financially strapped firm, in an apparent effort to cut costs, pooled its blood donations before testing them for HIV, Koblenz authorities said. Health officials say pooled testing sharply reduces the chances of detecting the virus and violates German law.

Koblenz police have arrested four UB Plasma employees, including its top manager and founder, on charges of fraud and causing grievous bodily harm. If convicted, they could face 10 years in prison.

In an interview with the Cologne Express before his arrest, founder Ulrich Kleist denied the company took shortcuts in testing donated blood, although he professed little knowledge of the firm’s laboratory procedures.

So far three cases of AIDS have been linked to UB Plasma products--one of the patients died last spring from an unrelated illness--but some officials fear the worst is yet to come.

“I don’t want to cause further panic, but it can’t be ruled out that there will be more cases,” said Koblenz prosecutor Norbert Weise. “This is a very serious situation.”

The scandal has also caused anxiety among some gay organizations and AIDS support groups, who fear the public hysteria could further ostracize people with AIDS. The German AIDS-Help organization has condemned as “irresponsible and reckless” the call for widespread AIDS tests, saying it contributes to the sense of panic and ignores the need for proper counseling before testing.

Michael Lenz, who is gay and works for German AIDS-Help, said there is a growing fear that the scandal has divided people with AIDS into two groups: the guilty and innocent. Gays fall into the first category, he said, and recipients of tainted blood transfusions into the second. “That could be a very dangerous development,” he said.

Already many Germans are wondering aloud whether they even want to know if they have AIDS, in large part because of the stigma in a society where the disease is relatively uncommon--there are 60,000 HIV-infected--and associated almost exclusively with gays and drug addicts. About 5,000 Germans have died of AIDS, including 400 hemophiliacs infected by tainted blood.

An elderly woman shopping in downtown Koblenz said she underwent surgery in the 1980s but did not intend to be tested, fearing rejection if she is found to be HIV positive. “It is not worth losing my family,” she said.

Problems with donated blood tainted with HIV have struck virtually every corner of the globe, with inadequate testing a particular problem in hardest-hit Africa. The World Health Organization estimates that as many as 10% of the HIV cases worldwide have resulted from tainted blood and blood products.

Tainted blood given to orphans in Romania led to more than 2,300 infections there, and a recent scandal in Colombia involved blood donations from a drug-addicted bisexual with AIDS; 12 patients received the man’s tainted blood, eventually infecting 200 others through sexual contact.

In Germany, health officials report 462 cases of HIV infection have been caused by blood transfusions, with an additional 1,800 hemophiliacs infected through blood-clotting products.

Troubled Blood Supplies

In the U.S., effective screening procedures have cut the risk of getting the AIDS virus from blood transfusions to 1 in 250,000. Other nations have not been as effective. Here are countries affected by the spread of AIDS in contaminated blood:

AMERICAS

* Brazil: Estimated 2,200 of 5,500 hemophiliacs contracted HIV. Campaign by relatives of famous hemophiliac cartoonist inspired cleanup of blood banks and ban on paid donors.

* Canada: Health authorities admitted earlier this year they knew blood distributed to hemophiliacs in early 1980s was tainted.

EUROPE

* Italy: One in four hemophiliacs infected with HIV. Allegations that former health chief allowed unscreened blood products nearly one year after mandatory testing.

* Russia: Estimates of more than 30,000 HIV carriers. Big increase feared because of rise in prostitution, drug abuse and outdated health system. Blood products screened.

* Spain: Government has agreed to pay the equivalent of $87,000 to 1,200 hemophiliacs infected before 1985. Nearly half of hemophiliacs reportedly contaminated.

* France: Several top health officials were convicted last year of knowingly allowing hundreds of hemophiliacs to receive blood-clotting products tainted by HIV.

AFRICA

* Zaire: Health system was dependent on Western funding, which has now stopped. Fears that HIV screening of blood also has stopped. About one in five HIV-infected children said infected by contaminated blood.

* Uganda: One of worst-affected countries in Africa, with HIV infection rates reaching 60% in some villages. Mostly from heterosexual intercourse. Trying to switch to voluntary blood donor system.

* Kenya: Most reported AIDS cases from heterosexual intercourse. Relies on family donor system.

* Nigeria: In populous Lagos state, a new law imposes a stiff fine or prison sentence if a doctor transfuses untested blood into a patient.

ASIA

* China: In population of 1.1 billion, about 1,100 people tested HIV positive. Blood testing patchy. Estimated one-fifth of Chinese who receive blood come down with hepatitis, indicating potential risk of HIV infection from blood, but few instances reported so far.

* Japan: About 2,000 hemophiliacs infected with HIV before 1985. Lawsuits pending in 112 cases. Paid blood donor system stopped three years ago.

* India: High-risk paid donor system that government is trying to discourage. Blood screened in urban areas but not villages.

* Thailand: Explosion in the disease expected. Estimated 600,000 HIV carriers, mainly from sexual intercourse.

Sources: Associated Press, World Health Organization