A man who developed hepatitis C from a Blood Transfusion Service Board clotting agent in October 1990 was given the treatment at a time when a safe product to prevent transmission of the virus was in stock at Pelican House, it emerged yesterday.
The man with mild haemophilia, whose name has been given to the tribunal, was infected by just one dose of factor 9 BTSB blood-clotting agent. The factor had been issued by the BTSB in 1989 but by early 1990 the blood bank ordered only clotting agents which had been virally inactivated.
BTSB factor 9 also infected three children, two from the same family, the BTSB's deputy medical director Dr Emer Lawlor said in evidence yesterday. The mother of these two children gave evidence to the tribunal on May 10th using the pseudonym Felicity.
Felicity believed three of her children, all haemophiliacs who developed hepatitis C, were infected by the BTSB product but according to Dr Lawlor one of them has a very rare type of hepatitis C only found in the Middle East and Egypt. She added that this child had been exposed to imported bloodclotting agents as well as BTSB products and given the rare genotype of his hepatitis, she believed commercial concentrates were the source of his infection. She did not think it likely that his particular strain of hepatitis C came from a product made from Irish plasma.
She believed Felicity's other two sons were infected by Pelican House Factor 9. It all belonged to batch number 9558 and was made by Armour Pharmaceuticals from plasma collected in Ireland. The BTSB heat-treated it when it arrived at Pelican House from Armour.
The third child infected with hepatitis C from BTSB factor 9 was not related to Felicity's children, Dr Lawlor said.
She added that all three children who developed hepatitis C from batch number 9558 were infected in 1989.
Dr Lawlor said she had looked at the records of all children born with haemophilia since 1985 and found four of the 15 children with haemophilia B - the children mentioned above who needed factor 9 - had developed hepatitis C. Three of the 22 children born with haemophilia A since 1985 had shown past exposure to the virus, she said.
Counsel for the tribunal Mr John Finlay SC said the tribunal had received information from the National Haemophilia Treatment Centre that since a test became available to detect hepatitis C, 191 people had tested positive. Asked by counsel if she had a view on how the 191 would have become infected, Dr Lawlor pointed to their exposure to non-virally inactivated products since the early 1970s to when solvent detergent treated products became available. These would include imported concentrates and the BTSB's own cryoprecipitate.
Mr Finlay asked if it was possible to identify the precise product which infected them. "It's possible to determine in some cases I think," Dr Lawlor said.
She explained there would have to be an analysis of the type of hepatitis C the infected haemophiliacs had and explained it could be any one of six genotypes. Products they received would have to be looked at. "It's not as simple as the HIV story," she said.
She added that the level of hepatitis C in the Irish blood donor population at the time would have been one in every 2,000 people. They would have appeared healthy and had no symptoms when giving blood, she said.