Vyas, however, said that the letter signed by Union Health Minister Dr Anbumani Ramadoss coming during the outbreak is only incidental.

According to Sabarkantha Chief District Health Officer H S Patel, the first official death reported on February 6 took place about three days before being nailed down as a Hepatitis B case.

A copy of the letter dated January 25, 2009, which is in possession with Newsline reads: “The India CLEN programme evaluation network study carried out during 2002-05, jointly by the Ministry of Health and Family Welfare, Government of India, and the World Bank, had found that about 2/3rd injections are administered in an unsafe manner and 1/3rd carry the risk of transmitting blood-borne infections.”

It adds: “Acting on the above cited report, the Ministry of Health and Family Welfare, Government of India, introduced Auto-Disabled (AD) syringes in all kinds of immunisation programmes. It has already been decided to extend it to all Central government hospitals. Considering the risks associated with the re-use of syringes, I would request you to kindly issue appropriate directives to the concerned officials to strictly use alternative injection methods as suggested above.”

On his part, Vyas said: “The letter only narrates broad guidelines and it is something that is absolutely ideal to talk of. When we have not yet reached a stage of using disposable needles, how do we achieve the use of auto-disabled syringes and that too in a state which has a tribal belt from Umargaon to Ambaji?”

He added that the supply of AD syringes is much less than the requirement with which “we can only cater to the elite populace of cities like Ahmedabad”. “But we have to deal with the psyche of the rural population who believe that doctors who give injections or IV drips are good,” he said.

Dr M M Anchalia, Medical Superintendent of the Ahmedabad Civil Hospital, explained about AD syringe. “It cannot be used for a second time. After the first use, the plunger (lock) breaks automatically, which creates a vacuum by not allowing the syringe to be reused. But we have not received any such letter or communication advocating the use of AD syringes.”