The growing demand upon existing reserves of blood requires a more efficient use of this limited resource. Numerous regional medical centers have shown the current practice of type and crossmatch to be highly inefficient, whereas the proven, safe type and screen method for reserving blood units effectively increases the available blood pool and decreases costs of maintaining a blood bank. Approaches other than the crossmatch to transfusion ratio are proposed to provide objectivity for establishing procedures to be converted to type and screen and the appropriate number of units for patients requiring a type and crossmatch. Cumulative blood ordering recommendations are provided.
We report that a calicivirus of oceanic origin, San Miguel sea lion virus serotype 5 (SMSV-5), is a human pathogen. This biotype was isolated originally from blisters on the flippers of northern fur seals (Callorhinus ursinus) and replicates readily in primate and human cell lines. It infects a phylogenetically diverse array of hosts (poikilotherms to primates) and induces type-specific neutralizing antibodies in exposed humans. Group antibody against a pooled antigen of SMSV-5 and two other serotypes was also observed in 18% of 300 blood donors from a population in the northwestern United States. The human calicivirus isolate designated SMSV-5 Homosapien-1 (SMSV-5 Hom-1) was recovered from a laboratory worker with systemic illness, including vesicular lesions on all four extremities. We believe this newly described human disease represents a paradigmatic shift in calicivirus disease recognition.
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