Emerging Infectious Disease and Transfusion Medicine: Time to take Action with Proactive Measures
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 2
Abstract
One of the concerns throughout the history of transfusion medicine has been the transmission of infectious diseases through the transfusion of allogeneic blood. Since the identification of post transfusion hepatitis in the 1940s [1], the AIDS epidemic in the 1980s [2], the discovery of hepatitis C in 1989 and its role in blood donation and transmission of HCV [3], and most recently -between 1980 and 1996 the delivery of the variant of Creutzfeldt- Jakob disease by blood transfusion [4,5], transfusion medicine had to implement stronger and more secure measures in the selection of blood donors and in the diagnosis of Transfusion-transmissible diseases (TTD) in order to avoid post-transfusion transmission of infectious agents, mainly HBV, HCV and VIH. A new scenario has arisen in recent years with the increase of emerging infectious agents (EIA), being possible by several factors [6,7]:Emerging pathogens can be defined as new, reemerging, migratory or drug resistant infectious agents whose incidence have increased over the past two decades or threaten to increase in the near future. Climate change and globalization has created favorable conditions to the increased incidence of EAI, with different epidemics in different areas of the planet. Therefore, Europe through the ECDC has listed a range of 11 pathogens with potential risk to the population and blood support (West Nile virus, Dengue, Leishmaniasis, Chikungunya fever, Malaria, Tick-borne encephalitis, Lyme disease, Crimean-congo hemorrhage fever, Usutu virus fever, Babesiosis and Chagas) [8]. Measures to avoid post-transfusion transmission of infectious agents include the adequate selection of donors based on international or local guidelines [9-11], distinguishing those who are in high risk, as well as the screening and testing of donated blood by serology and molecular biology for the TTE pathogens required by law [10] or in specific circumstances as epidemics. The increase of the TTE tests has augmented the cost of donated blood analysis [12], and it will increase even more in the future to the point of becoming a pressing problem for the different health services. With these strategies, it can take several months or years since the moment the transmission of a disease is known to occur via blood transfusion to the discovery of the causal agent and the development of adequate screening tests, possibly allowing it to spread without control. Therefore, it is necessary to take proactive measures. In fact, in the consensus conference of Toronto in 2007 [13] the emergence and risk of new emerging pathogens was recognized, concluding that this situation could undermine the trust of the safety of the blood supplied and determining the urgent need to take proactive measures, such as inactivation. Methods of Pathogen Inactivation aim to prevent TTD by means of disruption of his DNA/RNA, making the infectious agent inactive or unable to replicate in the different components obtained from blood donation, avoiding its post-transfusion transmission. To date there are different methods approved to inactivate pathogens [14].
Authors and Affiliations
Angel Luis Pajares Herraiz
Keywords
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- EP ID EP566324
- DOI 10.26717/BJSTR.2017.01.000167
- Views 295
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