Blood Safety and Emerging Infections: Balancing Risks and Costs
Authors: Katherine D. Ellingson, Matthew J. Kuehnert
Journal: Annals of Internal Medicine (2019)

Editorials5 February 2019Blood Safety and Emerging Infections: Balancing Risks and CostsKatherine D. Ellingson, PhD and Matthew J. Kuehnert, MDKatherine D. Ellingson, PhDThe University of Arizona, Tucson, Arizona (K.D.E.)Search for more papers by this author and Matthew J. Kuehnert, MDMTF Biologics, Edison, New Jersey (M.J.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3527 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail To reduce the vulnerability of the blood supply to emerging and reemerging pathogens, public officials have responded to newly discovered transfusion-transmitted infections (TTIs) with recommendations for donor deferrals, antibody and nucleic acid test (NAT) screening, and use of approved pathogen reduction technology. Successes and failures in the implementation of these strategies have led the public to expect near-zero acceptable risk for TTIs. Maintaining such low levels of risk comes at a substantial cost, as illustrated in this issue by Russell and colleagues' cost-effectiveness analysis of blood screening policies for preventing transfusion-transmitted Zika virus (ZIKV) infection (1).Russell and colleagues (1) ...References1. Russell WA, Stramer SL, Busch MP, Custer B. Screening the blood supply for Zika virus in the 50 U.S. states and Puerto Rico. A cost-effectiveness analysis. Ann Intern Med. 2019;170:164-74. doi:10.7326/M18-2238 LinkGoogle Scholar2. U.S. Food and Drug Administration. Nucleic acid testing (NAT) for human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV): testing, product disposition, and donor deferral and reentry. 2017. Accessed at www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM210270.pdf on 11 December 2018. Google Scholar3. Marks PW, Petersen LR. Decision making in the face of uncertainty: the challenge of emerging infectious diseases [Editorial]. Transfusion. 2017;57:723-8. [PMID: 28345226] doi:10.1111/trf.14037 CrossrefMedlineGoogle Scholar4. Monaghan AJ, Morin CW, Steinhoff DF, Wilhelmi O, Hayden M, Quattrochi DA, et al. On the seasonal occurrence and abundance of the Zika virus vector mosquito Aedes aegypti in the contiguous United States. PLoS Curr. 2016;8. [PMID: 27066299] doi:10.1371/currents.outbreaks.50dfc7f46798675fc63e7d7da563da76 CrossrefMedlineGoogle Scholar5. Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K, Berry H, et al. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet. 2018. [PMID: 30503045] doi:10.1016/S0140-6736(18)32594-7 CrossrefMedlineGoogle Scholar6. Yuma Sun. 29 October 2018:A1, A5. Google Scholar7. Nem de Oliveira Souza I, Frost PS, França JV, Nascimento-Viana JB, Neris RLS, Freitas L, et al. Acute and chronic neurological consequences of early-life Zika virus infection in mice. Sci Transl Med. 2018;10. [PMID: 29875203] doi:10.1126/scitranslmed.aar2749 CrossrefMedlineGoogle Scholar8. van Leeuwen N, Lingsma HF, Vanrolleghem AM, Sturkenboom MC, van Doorn PA, Steyerberg EW, et al. Hospital admissions, transfers and costs of Guillain-Barré syndrome. PLoS One. 2016;11:e0143837. [PMID: 26859880] doi:10.1371/journal.pone.0143837 CrossrefMedlineGoogle Scholar9. Centers for Disease Control and Prevention (CDC). HIV and AIDS—United States, 1981-2000. MMWR Morb Mortal Wkly Rep. 2001;50:430-4. [PMID: 11475378] MedlineGoogle Scholar10. Laughhunn A, Santa Maria F, Broult J, Lanteri MC, Stassinopoulos A, Musso D, et al. Amustaline (S-303) treatment inactivates high levels of Zika virus in red blood cell components. Transfusion. 2017;57:779-89. [PMID: 28164306] doi:10.1111/trf.13993 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: The University of Arizona, Tucson, Arizona (K.D.E.)MTF Biologics, Edison, New Jersey (M.J.K.)Disclaimer: The views and opinions expressed in this article are solely those of the authors and do not necessarily reflect the policy or position of their affiliated institutions.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3527.Corresponding Author: Katherine D. Ellingson, PhD, The University of Arizona, Drachman Hall, 1295 North Martin Avenue, Campus PO Box 245163, Tucson, AZ 85724; e-mail, [email protected]arizona.edu.Current Author Addresses: Dr. Ellingson: The University of Arizona, Drachman Hall, 1295 North Martin Avenue, Campus PO Box 245163, Tucson, AZ 85724.Dr. Kuehnert: MTF Biologics, 125 May Street, Edison, NJ 08837.This article was published at Annals.org on 8 January 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening the Blood Supply for Zika Virus in the 50 U.S. States and Puerto Rico W. Alton Russell , Susan L. Stramer , Michael P. Busch , and Brian Custer Metrics Cited byLaboratory Testing of Donated BloodSupplemental findings of the 2017 National Blood Collection and Utilization SurveyReacción transfusional bacteriana por concentrado plaquetario contaminado con Klebsiella oxytoca: ¿una complicación transfusional prevenible? Reporte de un casoPathogen ReductionZika screening of donated blood not cost effective in USA 5 February 2019Volume 170, Issue 3Page: 203-204KeywordsBloodBlood banksFood and Drug AdministrationHIVPathogensPopulation statisticsPrevention, policy, and public healthQuality adjusted life yearsSafetyZika virus ePublished: 8 January 2019 Issue Published: 5 February 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...