Was a foreign policy scandal behind the alleged HIV outbreak at a Virginia hospital?

The parents of all but the youngest cases presented at the conference, including the father and mother of 12-month-old twin brothers, whose inquiry into the infants’ condition after a blood transfusion confirmed the infection was HIV positive. They also reported that the child’s father underwent tested positive for HIV.

“No doctors would ever let their babies be infected,” said the father of one of the twins. “You know that saying, ‘the unborn child in utero gets the tip of the spear’?”

The father, who asked to remain anonymous, described being told that his son’s lymph node was swollen, that it was inflamed, and that his son may need a blood transfusion. The insurance company agreed to the transfusion. In 2009, an expert panel convened by the Joint Commission recommended against transfusions for pediatric patients. But this expert group is accused of having ignored the provider’s instructions, who insisted on a transfusion for the two infants whose parents had sued.

The neurologist Dr. Robert Reffkin, who examined the twins in the ambulance, said that the neurology “was a race against time.” There were three leads in the twins’ blood: The circulation was unstable, signaling the need for blood products. The first line in the bloodstream was infected. The second had blood contracted from an unknown source. The third had a low platelet count indicating the possibility of rejection.

“If he hadn’t come to the hospital quickly,” said Reffkin, a child would have died. “If you did not start the infusion right away, the family’s insurance company would have picked up this crisis, had they not found him in this ambulance.”

The National HIV/AIDS Strategy said that approximately 40 percent of new infections among adolescents and young adults ages 13 to 24 involved blood transfusions.

Dr. Julius Nair, president of the American Association of Blood Banks, said that while it is difficult to find the reason for the actual infection, “we can speculate that most people who suffer from hemophilia, a coagulation disorder, are at higher risk for acquiring HIV, AIDS or other infections.”

Between 2002 and 2011, 120 infants received heart and liver transplants. The number of such transplants that occurred from 2006 to 2008 totaled 300.

Just as the world responds to an HIV epidemic abroad, it is often the actions of one human being that moves a society’s response to a specific tragedy like AIDS. It is those individuals who so often choose to call attention to themselves and their suffering, lest no one else address the problem.

Many Americans say their first reaction to the 1983 arrest of Oliver North was a visceral fear that all Americans would be tainted by the person who had called them from a different country.

They worried about contagion to all Americans and not just the innocent, naive protagonist. They wondered what country would attack them next and how they might defend themselves.

Paul Abrams is a Washington Post writer.

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