One does not inject an unsterilized needle in or near the heart of a cardiac patient.
Transmission has been attributed to reuse of unsterilized needles and close personal contact.
As you note, unsterilized needles and syringes were the probable means by which the lethal virus was spread from baby to baby in the Elista hospital.
Some risks, such as the spread of infections through the use of unsterilized needles, have long been known.
This has led to a serious problem of disease spread through health care as patients received too many injections and injections by unsterilized needles.
But there is bad news, beyond the well-publicized risks of contracting illnesses like hepatitis from unsterilized needles.
Blood transfusions using infected blood or injections with unsterilized needles can lead to HIV infection and AIDS in children.
Because more women than men use health services, especially during pregnancy, they are more likely to come across unsterilized needles for injections.
The suspected causes were unscreened blood transfusions, given to boost nutrition, and unsterilized needles.