16 : From Prions to Parasites: Issues and Concerns in Blood Safety

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In recent years, blood safety has been the focus of increased attention. Blood safety issues have been numerous and varied and have encompassed a wide range of microorganisms and concerns. This chapter illustrates a variety of issues and challenges in this area, including those posed by emerging infections that may be transmissible by blood. Human immunodeficiency virus (HIV) strains are classified into different groups based on nucleic acid sequence analysis. HIV-I and HIV-2 are at the extreme of this diversity. Hepatitis G virus (HGY) and human herpesvirus 8 (HHY-8) are two newly discovered viruses that pose very different challenges to blood safety. HGY, a flavivirus, is fairly prevalent among blood donors; 1 to 2% of healthy blood donors have evidence of infection. Creutzfeldt-Jakob disease (CJD) is a rare, invariably fatal degenerative disease believed to be caused by an unconventional, disinfection-resistant infectious agent. Bacterial contamination can occur at one or more points in the collection, processing, pooling, and transfusion of blood. Several parasitic agents have recently caused concern for blood safety. The same approaches that have contributed to improved blood safety, including donor selection, testing, viral inactivation procedures, improved transfusion practices, and surveillance, are expected to continue to play a major role in dealing with these challenges and other potential threats to blood safety.

Citation: Khabbaz R, Chamberland M. 1998. From Prions to Parasites: Issues and Concerns in Blood Safety, p 295-310. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch16
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Figure 1

Worldwide diversity of HIV isolates (reprinted from reference 40). HIV-1 group M subtypes A through I are represented on the map by letters A through I, and group O is represented by the letter O. The map is not an exhaustive list of all reported subtypes, nor does it include isolated reports or recently imported cases.

Citation: Khabbaz R, Chamberland M. 1998. From Prions to Parasites: Issues and Concerns in Blood Safety, p 295-310. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch16
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Table 1

Estimated risk and window period of infectivity for transmission of HIV, HBV, and HCV through transfusion

Citation: Khabbaz R, Chamberland M. 1998. From Prions to Parasites: Issues and Concerns in Blood Safety, p 295-310. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch16
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Table 2

CJD deaths and death rates by age group in the United States, 1979 to 1994

Citation: Khabbaz R, Chamberland M. 1998. From Prions to Parasites: Issues and Concerns in Blood Safety, p 295-310. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch16

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