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Germain M, Grégoire Y, Custer BS, Goldman M, Bravo M, Kamel H, Davison K, Field S, van den Hurk K, van de Laar TJW, Irving DO, Jones A, Liumbruno G, Morley S, O'Brien SF, Pillonel J, Steinsvåg CT, Takanashi M, Tsuno NH, Vesga Carasa MA, Wendel S, Vassallo RR, Tiberghien P. An international comparison of HIV prevalence and incidence in blood donors and general population: a BEST Collaborative study. Vox Sang 2021; 116:1084-1093. [PMID: 33835513 DOI: 10.1111/vox.13107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Efficiency in mitigating HIV transmission risk by transfusion may vary internationally. We compared HIV prevalence and incidence in blood donors across different jurisdictions in relation to those rates in the general population and differences in deferral practices. MATERIALS AND METHODS Data from 2007 to 2016 were collected in Australia, Brazil (São Paulo), Canada, England, France, Italy, Ireland, Japan, the Netherlands, New Zealand, Norway, Spain (Basque Country), USA (Vitalant) and Wales. For each country/region, the number of HIV antibody-positive donations and nucleic acid testing (NAT)-only-positive donations was broken down according to first-time or repeat donor status, along with the relevant denominators. RESULTS There is a modest correlation between HIV prevalence among first-time donors and HIV prevalence in the general population. However, rates of HIV-positive donations in repeat donors, a proxy for incidence, do not correlate with incidence rates in the general population. Rates in donors from Italy and Basque Country, where deferral criteria for men having sex with men are less stringent, are higher compared with most other jurisdictions. Rates of NAT-only-positive donations are extremely low and do not differ significantly after adjustment for multiple comparisons. CONCLUSION Donor HIV rates are only weakly associated with those observed in the general population. Countries with less stringent deferral criteria have higher HIV rates in their donor population, but the rates remain very low.
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Affiliation(s)
- Marc Germain
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Yves Grégoire
- Medical affairs and Innovation, Héma-Québec, Québec, Canada
| | - Brian S Custer
- Vitalant Research Institute, Vitalant, San Francisco, CA, USA
| | - Mindy Goldman
- Donor and Clinical Services, Canadian Blood Services, Ottawa, Canada
| | | | - Hany Kamel
- Medical Affairs, Vitalant, Scottsdale, AZ, USA
| | | | | | | | | | - David O Irving
- Research and Development, Australian Red Cross Blood Service, Melbourne, Australia
| | | | | | - Sarah Morley
- New Zealand Blood Service, Auckland, New Zealand
| | - Sheila F O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Ottawa, Canada
| | - Josiane Pillonel
- Direction des Maladies Infectieuses, Santé Publique France, Saint-Maurice, France
| | | | | | | | | | | | | | - Pierre Tiberghien
- Établissement Français du Sang, La Plaine Saint-Denis, France.,Inserm UMR 1098 RIGHT, Université de Franche-Comté, Établissement Français du Sang, Besançon, France
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2
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Kiely P, Hoad VC, Seed CR, Gosbell IB. Severe acute respiratory syndrome coronavirus-2: implications for blood safety and sufficiency. Vox Sang 2020; 116:155-166. [PMID: 32965726 PMCID: PMC7537511 DOI: 10.1111/vox.13009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023]
Abstract
Background and Objective Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is a novel coronavirus, first identified in China at the end of 2019 and has now caused a worldwide pandemic. In this review, we provide an overview of the implications of SARS‐CoV‐2 for blood safety and sufficiency. Material and Method We searched the PubMed database, the preprint sites bioRxiv and medRxiv, the websites of the World Health Organization, European Centre for Disease Prevention and Control, the US Communicable Diseases Center and monitored ProMed updates. Results An estimated 15%–46% of SARS‐CoV‐2 infections are asymptomatic. The reported mean incubation period is 3 to 7 days with a range of 1–14 days. The blood phase of SARS‐CoV‐2 appears to be brief and low level, with RNAaemia detectable in only a small proportion of patients, typically associated with more severe disease and not demonstrated to be infectious virus. An asymptomatic blood phase has not been demonstrated. Given these characteristics of SARS‐CoV‐2 infection and the absence of reported transfusion transmission (TT), the TT risk is currently theoretical. To mitigate any potential TT risk, but more importantly to prevent respiratory transmission in donor centres, blood centres can implement donor deferral policies based on travel, disease status or potential risk of exposure. Conclusion The TT risk of SARS‐CoV‐2 appears to be low. The biggest risk to blood services in the current COVID‐19 pandemic is to maintain the sufficiency of the blood supply while minimizing respiratory transmission of SARS‐CoV‐19 to donors and staff while donating blood.
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Affiliation(s)
- Philip Kiely
- Cinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, Australia.,Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Veronica C Hoad
- Cinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, Australia
| | - Clive R Seed
- Cinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, Australia
| | - Iain B Gosbell
- Cinical Services and Research, Australian Red Cross Lifeblood, Melbourne, VIC, Australia.,Western Sydney University, Penrith, NSW, Australia
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3
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Vermeulen M, Chowdhury D, Swanevelder R, Grebe E, Brambilla D, Jentsch U, Busch M, Van Zyl G, Murphy EL. HIV incidence in South African blood donors from 2012 to 2016: a comparison of estimation methods. Vox Sang 2020; 116:71-80. [PMID: 32762088 DOI: 10.1111/vox.12987] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Measuring incidence is important for monitoring and maintaining the safety of the blood supply. Blood collected from repeat-donors has provided the opportunity to follow blood donors over time and has been used to estimate the incidence of viral infections. These incidence estimates have been extrapolated to first-time donors using the ratio of NAT yield cases in first-time versus repeat-donors. We describe a model to estimate incidence in first-time donors using the limiting antigen (LAg) avidity assay and compare its results with those from established models. METHODS HIV-positive first-time donations were tested for recency using the LAg assay. Three models were compared; incidence estimated for (1) first-time donors using LAg avidity, (2) first-time and repeat-donors separately using the NAT yield window period (WP) model and (3) repeat-donors using the incidence/WP model. RESULTS HIV incidence in first-time donors was estimated at 3·32 (CI 3·11, 3·55) and 3·81 (CI 3·07, 4·73) per 1000 PY using the LAg assay and NAT yield WP models, respectively. Incidence in repeat-donors was between 2·0- and 2·5-fold lower than in first-time donors estimated at 1·56 (CI 1·37, 1·77) and 1·94 (CI 1·86-2·01) per 1000 PY using the NAT yield/WP and incidence/WP models, respectively. CONCLUSION Testing HIV-positive donations using the LAg assay provides a reliable method to estimate incidence in first-time donors for countries that collect the majority of blood from first-time donors and do not screen with NAT.
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Affiliation(s)
- Marion Vermeulen
- The South African National Blood Service, Roodepoort, South Africa
| | | | | | - Eduard Grebe
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - Ute Jentsch
- The South African National Blood Service, Roodepoort, South Africa
| | | | - Gert Van Zyl
- Stellenbosch University, Cape Town, South Africa
| | - Edward L Murphy
- Vitalant Research Institute, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
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4
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Vermeulen M, Sykes W, Coleman C, Custer B, Jacobs G, Jaza J, Kaidarova Z, Hlela C, Gessain A, Cassar O, Poole C, Ingram C, Murphy EL, Reddy R. The prevalence of human T-lymphotropic virus type 1 & 2 (HTLV-1/2) in South African blood donors. Vox Sang 2019; 114:451-458. [PMID: 30950074 DOI: 10.1111/vox.12778] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Donated blood is not currently screened for human T-cell lymphotropic virus (HTLV) in South Africa. Several small studies have detected HTLV-1 in South Africa, but prevalence by geographic region or population group is unavailable. MATERIALS AND METHODS We performed a large seroprevalence study of South African blood donors during 3 months in 2013. All geographic regions except the Western Cape were included, and Black and Coloured (local term for mixed race) donors were oversampled. Identity-unlinked plasma samples were screened with the Abbott Prism HTLV-1/2 assay, and repeatedly reactive samples were tested by the Inno-LIA HTLV-1/2 Score confirmatory assay. Odds ratios were calculated with multivariable logistic regression. RESULTS Of 46 752 donors tested, 133 (0·28%) were initially reactive, 111 (0·24%) repeatedly reactive and 57 (0·12%) confirmed positive for HTLV-1; none were HTLV-2 positive. Prevalence was 0·062% weighted to annual blood donations but highly concentrated in the Black population group (OR = 20·24 CI: 2·77-147·88); higher in females than males (OR = 1·81 CI: 1·06-3·08); and in donors aged >50 years compared to ages 16-19 (OR = 6·4 CI: 2·95-13·86). After controlling for age, sex and population group, there was no difference in prevalence between new and repeat blood donors or among geographic regions within South Africa. CONCLUSIONS We conclude that HTLV-1 infection is widespread among the Black population of South Africa and its epidemiology is similar to other endemic areas. Because South Africa is increasing its recruitment of Black blood donors, the implications for blood screening require further consideration.
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Affiliation(s)
| | - Wendy Sykes
- South African National Blood Service, Roodepoort, South Africa
| | - Charl Coleman
- South African National Blood Service, Roodepoort, South Africa
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
| | | | - Jabulisile Jaza
- South African National Blood Service, Roodepoort, South Africa
| | | | - Carol Hlela
- Red Cross Children's Hospital, Cape Town, South Africa
| | - Antoine Gessain
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, Paris, France.,CNRS, UMR3569, Paris, France
| | - Olivier Cassar
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, Paris, France.,CNRS, UMR3569, Paris, France
| | - Colwyn Poole
- South African National Blood Service, Roodepoort, South Africa
| | | | - Edward L Murphy
- Vitalant Research Institute, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
| | - Ravi Reddy
- South African National Blood Service, Roodepoort, South Africa
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5
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Brailsford SR, Tossell J, Morrison R, McDonald CP, Pitt TL. Failure of bacterial screening to detect Staphylococcus aureus: the English experience of donor follow-up. Vox Sang 2018; 113:540-546. [PMID: 29799121 DOI: 10.1111/vox.12670] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/27/2018] [Accepted: 05/05/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Between February 2011 and December 2016, over 1·6 million platelet units, 36% pooled platelets, underwent bacterial screening prior to issue. Contamination rates for apheresis and pooled platelets were 0·02% and 0·07%, respectively. Staphylococcus aureus accounted for 21 contaminations, including four pooled platelets, one confirmed transfusion-transmitted infection (TTI) and three 'near-miss' incidents detected on visual inspection which were negative on screening. We describe follow-up investigations of 16 donors for skin carriage of S. aureus and molecular characterisation of donor and pack isolates. MATERIALS AND METHODS Units were screened by the BacT/ALERT 3D detection system. Contributing donors were interviewed and consent requested for skin and nasal swabbing. S. aureus isolates were referred for spa gene type and DNA macrorestriction profile to determine identity between carriage strains and packs. RESULTS Donors of 10 apheresis and two pooled packs screen positive for S. aureus were confirmed as the source of contamination; seven had a history of skin conditions, predominantly eczema; 11 were nasal carriers. The 'near-miss' incidents were associated with apheresis donors, two donors harboured strains indistinguishable from the pack strain. The TTI was due to a screen-negative pooled unit, and a nasal isolate of one donor was indistinguishable from that in the unit. CONCLUSION Staphylococcus aureus contamination is rare but potentially harmful in platelet units. Donor isolates showed almost universal correspondence in molecular type with pack isolates, thus confirming the source of contamination. The importance of visual inspection of packs prior to transfusion is underlined by the 'near-miss' incidents.
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Affiliation(s)
- S R Brailsford
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - J Tossell
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - R Morrison
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - C P McDonald
- Microbiology Services, NHS Blood and Transplant, London, UK
| | - T L Pitt
- Microbiology Services, NHS Blood and Transplant, London, UK
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6
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Seed CR, Hewitt PE, Dodd RY, Houston F, Cervenakova L. Creutzfeldt-Jakob disease and blood transfusion safety. Vox Sang 2018; 113:220-231. [PMID: 29359329 DOI: 10.1111/vox.12631] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/16/2017] [Accepted: 12/19/2017] [Indexed: 01/09/2023]
Abstract
Transmissible spongiform encephalopathies (TSEs) are untreatable, fatal neurologic diseases affecting mammals. Human disease forms include sporadic, familial and acquired Creutzfeldt-Jakob disease (CJD). While sporadic CJD (sCJD) has been recognized for near on 100 years, variant CJD (vCJD) was first reported in 1996 and is the result of food-borne transmission of the prion of bovine spongiform encephalopathy (BSE, 'mad cow disease'). Currently, 230 vCJD cases have been reported in 12 countries, the majority in the UK (178) and France (27). Animal studies demonstrated highly efficient transmission of natural scrapie and experimental BSE by blood transfusion and fuelled concern that sCJD was potentially transfusion transmissible. No such case has been recorded and case-control evaluations and lookback studies indicate that, if transfusion transmission occurs at all, it is very rare. In contrast, four cases of apparent transfusion transmission of vCJD infectivity have been identified in the UK. Risk minimization strategies in response to the threat of vCJD include leucodepletion, geographically based donor deferrals and deferral of transfusion recipients. A sensitive and specific, high-throughput screening test would provide a potential path to mitigation but despite substantial effort no such test has yet appeared. The initial outbreak of vCJD appears to be over, but concern remains about subsequent waves of disease among those already infected. There is considerable uncertainty about the size of the infected population, and there will be at least a perception of some continuing risk to blood safety. Accordingly, at least some precautionary measures will remain in place and continued surveillance is necessary.
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Affiliation(s)
- C R Seed
- Australian Red Cross Blood Service, Perth, WA, Australia
| | | | - R Y Dodd
- American Red Cross Scientific Affairs, Gaithersburg, MD, USA
| | - F Houston
- The Roslin Institute, University of Edinburgh, Midlothian, Scotland
| | - L Cervenakova
- The Plasma Protein Therapeutics Association (PPTA), Annapolis, MD, USA
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7
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Checchi M, Hewitt PE, Bennett P, Ward HJT, Will RG, Mackenzie JM, Sinka K. Ten-year follow-up of two cohorts with an increased risk of variant CJD: donors to individuals who later developed variant CJD and other recipients of these at-risk donors. Vox Sang 2016; 111:325-332. [PMID: 27432362 DOI: 10.1111/vox.12426] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/26/2016] [Accepted: 05/26/2016] [Indexed: 12/23/2022]
Abstract
BACKGROUND Transmission of variant Creutzfeldt-Jakob disease (vCJD) through blood transfusion is implicated in three deaths and one asymptomatic infection. Based on this evidence, individuals assessed to be at increased risk of vCJD through donating blood transfused to individuals who later developed vCJD, or through being other recipients of such donors, are followed up to further understand the risks of vCJD transmission through blood. OBJECTIVES To provide a ten-year follow-up of these at-risk cohorts. METHODS Blood donors to patients who later died from vCJD were identified by the Transfusion Medicine Epidemiological Review (TMER) study. A reverse risk probability assessment quantified the risk of blood transfusion or exposure through diet as the source of vCJD in the recipients. Donors to these recipients, and these donors' other recipients, with a probability risk above 1%, are classified as at increased risk of vCJD for public health purposes. These cohorts are monitored for any vCJD occurrences. RESULTS A total of 112 donors and 33 other recipients of their donated blood have been classified as at increased risk. After 2397 and 492 vCJD-free years of follow-up, respectively, no deaths in either at-risk cohort were of vCJD-related causes. CONCLUSIONS The at-risk cohorts have survived disease-free far longer than the estimated incubation time for dietary-acquired vCJD (donors) and transfusion-acquired disease (other recipients). However, due to our still limited understanding of, and a lack of a reliable test for, asymptomatic vCJD infection, public health follow-up is necessary for continued monitoring of at-risk cohorts.
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Affiliation(s)
- M Checchi
- Centre for Infectious Disease Surveillance and Control, National Infection Service, Public Health England, London, UK
| | - P E Hewitt
- Transfusion Microbiology, National Health Service Blood and Transplant, London, UK
| | - P Bennett
- Department of Health, Public and International Health Directorate, London, UK
| | - H J T Ward
- Health Protection Scotland, NHS National Services Scotland, Edinburgh, UK
| | - R G Will
- National CJD Research & Surveillance Unit, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - J M Mackenzie
- National CJD Research & Surveillance Unit, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - K Sinka
- Centre for Infectious Disease Surveillance and Control, National Infection Service, Public Health England, London, UK
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8
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Greinacher A, Lubenow N. Predonation finger lancet punctures: a potential risk factor for interdonor pathogen transmission in the blood donor clinic. Vox Sang 2016; 111:3-7. [PMID: 26890279 DOI: 10.1111/vox.12379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/22/2015] [Accepted: 12/22/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Point-of-care testing using capillary blood from a finger prick is widely used for predonation haemoglobin testing of blood donors. It is common practice to cover the finger prick with a cotton swab and to instruct the donor to press for few minutes. The finger prick can cause blood contamination of surfaces in contact with the lanced finger, especially door handles, risking infectious disease transmission, particularly if another person touching the contaminated door handle also has a punctured fingertip. MATERIALS AND METHODS First, we investigated contamination by blood (benzidine assay) of the door handles of our blood donor clinic, taking 175 samples 3 h after opening of the donation centre (baseline). We then introduced band-aids to cover the finger prick and started an information campaign using educational flyers to sensitize blood donors and staff to this problem (period-1). Thereafter, the staff was instructed to use the non-dominant hand for blood sampling and mandated to replace any discarded band-aids immediately (period-2). RESULTS At baseline, 82% of the nurse room door handles showed contamination with blood. This decreased somewhat (10-40%) after period-1, but only after immediate mandatory band-aid replacement on any donor finger without a band-aid (period-2), no further blood contaminations were detected. CONCLUSION Blood contamination of shared surfaces can occur after finger prick for capillary blood sampling. Application of a band-aid and use of the non-dominant hand for fingertip incision are easy to apply and effective in reducing this iatrogenic health hazard.
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Affiliation(s)
- A Greinacher
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin, Greifswald, Germany
| | - N Lubenow
- Institut für Immunologie und Transfusionsmedizin, Universitätsmedizin, Greifswald, Germany
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9
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Rubio JM, Jiménez Del Bianco AI, Cervera-Alonso Y, Fernandez-Garcia MD, Lanza M, Ta Tang TH, Sevil Puras F, Blanco L. Vivax malaria in a blood donor in Spain, relapse or a new infection in a malaria non-endemic country? Vox Sang 2015; 110:193-5. [PMID: 26509738 DOI: 10.1111/vox.12352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/03/2015] [Accepted: 09/03/2015] [Indexed: 10/22/2022]
Abstract
Malaria is a vectorborne disease caused by protozoan of the genus Plasmodium, which can also be transmitted by the transfusion of infected red blood cells. One year after return from a travel to Honduras, a Spanish traveller developed vivax malaria. Prior to the onset of symptoms, the donor made a donation that tested non-reactive using an immunological test for malaria. Samples from the donor taken before donation and tested by serological and molecular methods were negative but positive at the time of hospital admission. The possible sources of the donors' infection, imported versus locally acquired, are discussed.
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Affiliation(s)
- J M Rubio
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - A I Jiménez Del Bianco
- Serology and Biochemistry Department, Centro de Hemoterapia de Castilla y León, Valladolid, Spain
| | - Y Cervera-Alonso
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - M D Fernandez-Garcia
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain.,European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M Lanza
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - T H Ta Tang
- Malaria & Emerging Parasitic Diseases Laboratory, National Microbiology Centre, Instituto de Salud Carlos III, Madrid, Spain
| | - F Sevil Puras
- Blood Bank Unit, Santa Barbara Hospital, Soria, Spain
| | - L Blanco
- Serology and Biochemistry Department, Centro de Hemoterapia de Castilla y León, Valladolid, Spain
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10
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Patel P, Tuke P, Tettmar K, Cloutman-Green E, Hartley J, Klein N, Veys P, Tedder RS. No evidence of transfusion transmission of Adenovirus and Epstein-Barr virus infections in paediatric recipients post-bone marrow transplant. Vox Sang 2015; 109:95-7. [PMID: 25827634 DOI: 10.1111/vox.12256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 12/16/2014] [Accepted: 01/12/2015] [Indexed: 11/30/2022]
Abstract
Adenovirus and Epstein-Barr virus can cause significant morbidity and mortality in paediatric patients post-bone marrow transplant. The source of infection is thought to be either reactivation of latent viruses or primary infection. We have investigated whether transfusion of blood components from viraemic donors could provide a route of primary infection in these patients and sought the prevalence of viraemia in the blood donor population from England. In 32 linked donor/recipient samples and 300 unselected blood donors, we found no evidence to suggest that these infections in paediatric bone marrow transplant recipients had been acquired from transfused blood components.
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Affiliation(s)
- P Patel
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - P Tuke
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - K Tettmar
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
| | - E Cloutman-Green
- Camelia Botnar Laboratory, Great Ormond Street Hospital, London, UK
| | - J Hartley
- Camelia Botnar Laboratory, Great Ormond Street Hospital, London, UK
| | - N Klein
- Infectious Diseases and Microbiology, Institute of Child Health, London, UK
| | - P Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital, London, UK
| | - R S Tedder
- R & D Transfusion Microbiology, NHS Blood and Transplant, London, UK.,Blood Borne Virus Unit, Public Health England, London, UK
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11
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Offergeld R, Kamp C, Heiden M, Norda R, Behr-Gross ME. Sexual risk behaviour and donor deferral in Europe. Vox Sang 2014; 107:420-7. [PMID: 25040600 DOI: 10.1111/vox.12179] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 06/06/2014] [Accepted: 06/13/2014] [Indexed: 11/26/2022]
Abstract
One of the most controversial policies in blood transfusion worldwide is the permanent deferral from donating blood of men with sexual contacts to other men (MSM). This policy was implemented for safety reasons as sex between men is known to be a high risk factor for acquiring severe infectious diseases transmissible by blood transfusion. Sexual contacts among heterosexual persons may hold similar risks but a clear-cut discrimination between different individual risks is impossible. Nevertheless, the current blood donor deferral periods defined by European Union (EU) legislation depend on a distinction of different grades of risk with respect to sexual behaviour. Under the aegis of the Steering Committee on Blood Transfusion (CD-P-TS) of the Council of Europe (CoE), an international working group evaluated epidemiological and behavioural data, modelling studies on residual risk and spread of infections, and studies on adherence to donor selection criteria. The aim was to distinguish sexual behaviour of different risk categories. It was concluded, that existing data confirm that MSM and commercial sex workers (CSW) are groups at high risk. Any further grading lacks a scientific data base. Modelling studies indicate that adherence to deferral policies is of major relevance suggesting that good donor adherence may outweigh the small negative effects on blood safety postulated for changing from permanent to temporary deferral periods for high risk sexual behaviours. The fact that a considerable percentage of donors are MSM - despite the permanent deferral policy - demonstrates the need to increase donor understanding and adherence.
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