Rumania's Other Tragedy

By ANDREW PURVIS

The sight is sickening and terrifying. In crib after crib lie babies and toddlers who look like old people, their skin shriveled, their skeletal faces bearing the unmistakable mark of approaching death. These pitiful children at a clinic in Bucharest are AIDS patients, the tiniest victims of the brutal, backward regime of Rumania's fallen dictator, Nicolae Ceausescu.

Last week Western doctors working in Rumania revealed a mysterious epidemic of AIDS among the country's youngsters. The full extent of the outbreak is not yet known, but continuing tests of sick children at hospitals and orphanages have identified 706 who are infected out of 2,184 examined so far. Scores have already died. "It is worse than anything I have seen," said Dr. Jacques Lebas, president of the Paris-based medical-relief organization Medecins du Monde, which helped conduct the tests.

Until last year, Ceausescu's government considered AIDS a capitalist disease that hardly existed in Rumania. But the dictator had raised the odds that it would become a problem by outlawing birth control and sex education -- two mainstays of AIDS-prevention efforts elsewhere in the world -- in an attempt to boost his country's population. In January 1989, Dr. Ionel Patrascu, of Bucharest's Stefan S. Nicolau Institute of Virology, decided to test a handful of patients for the virus as part of a research project. Amazingly, the first child screened, a twelve-year-old girl, was infected. Of 14 more children examined at the same pediatric clinic, six harbored the virus. Working clandestinely, Patrascu went on to test children in three other cities, where the rate of infection appeared to be just as bad. In August, concerned that the epidemic was spreading out of control, he notified the Ministry of Health. To his dismay, he was told to halt testing immediately. A scheduled meeting on children and AIDS was canceled, and the programs were withdrawn from the presses.

After Ceausescu's fall, Patrascu resumed testing with the help of Medecins du Monde. As he uncovered more and more cases, the doctor was puzzled by the unusual concentration of infections in children from one to three years old. Ordinarily, babies are exposed to the AIDS virus only through their mothers, but the mothers of these children were found to be free of infection.

The researchers now have two theories about how the disease spread. The first suspect is a traditional medical practice in Rumania of injecting minute quantities of adult blood into young babies who look thin or anemic. Part of this blood supply, some of which is imported, could have been contaminated. The other likely pathway for infection is the reuse of dirty needles. As in most East European countries, disposable syringes are in short supply, and hospital staff members are often poorly trained in sterilizing techniques.

The World Health Organization dispatched a public health team to Rumania to determine the scope of the epidemic. If infection is limited mainly to the children, a large supply of sterile needles and blood-testing kits could halt the spread almost immediately, said Dr. Jonathan Mann, head of WHO's Global Program on AIDS. But Mann is concerned that the new mobility of Eastern Europe's populations could lead to faster dissemination of the virus. Citing reports of prostitution in Rumania and heroin use in Poland, Mann called Eastern Europe "the new frontier for the AIDS epidemic."

With reporting by Margot Hornblower/Paris