Emerging Infectious Diseases and Blood Safety: Modeling the Transfusion-Transmission Risk

Abstract

While the transfusion-transmission (TT) risk associated with the major transfusion-relevant viruses such as HIV is now very low, during the last 20 years there has been a growing awareness of the threat to blood safety from emerging infectious diseases, a number of which are known to be, or are potentially, transfusion transmissible. Two published models for estimating the transfusion-transmission risk from EIDs, referred to as the Biggerstaff-Petersen model and the European Upfront Risk Assessment Tool (EUFRAT), respectively, have been applied to several EIDs in outbreak situations. We describe and compare the methodological principles of both models, highlighting their similarities and differences. We also discuss the appropriateness of comparing results from the two models. Quantitating the TT risk of EIDs can inform decisions about risk mitigation strategies and their cost-effectiveness. Finally, we present a qualitative risk assessment for Zika virus (ZIKV), an EID agent that has caused several outbreaks since 2007. In the latest and largest ever outbreak, several probable cases of transfusion-transmission ZIKV have been reported, indicating that it is transfusion-transmissible and therefore a risk to blood safety. We discuss why quantitative modeling the TT risk of ZIKV is currently problematic.

Reflections on Dry Eye Syndrome Treatment: Therapeutic Role of Blood Products

“…Emerging viruses, like West Nile virus, Dengue virus, Chikungunya virus, Ebola virus, and Zika virus, may also be a potential threat ( 77 ). However, efficient safety measures in place in blood establishments, namely donors’ screening and donation testing, dramatically restrict the risks of viral transmissions in a regulated blood collection jurisdiction ( 78 ). Particular future attention may need to address the pathological consequences of risks of transmission of other blood-borne viruses, such as the Herpes simplex virus, that may lead to ocular complications and affect vision ( 79 ).…”

Estimation of mosquito-borne and sexual transmission of Zika virus in Australia: Risks to blood transfusion safety

“…EUFRAT has a webbased interface and was commissioned by the European Centre for Disease Prevention and Control (ECDC) to quantify the transmission risk through blood transfusion during outbreaks of emerging infectious diseases (EIDs) [63][64][65][66][67]. The conceptual basis of the EUFRAT is further described in Kiely et al (2017) [68]. Several assumptions were made to perform the analyses with EUFRAT: (i) blood donors had the same risk as any other individual; (ii) there was no effect of infection on donation behaviour; (iii) infections were evenly distributed over the interval considered; iv) the duration of infectivity was constant and fixed at 14 days; v) blood components (red blood cells, platelets, and plasma products) from viraemic blood donors transmit infection with 100% efficiency.…”

Modeling the West Nile virus transfusion transmission risk in a nonoutbreak country associated with traveling donors

“…Differences in TT risk estimates between models, even using the same data set, is to be expected due to differences in methodology and input/output parameters. 32,33 While the two models incorporated the same viral input parameters, there were differences in donor and donation input parameters. For example, input parameters incorporated into the EUFRAT but not the Lifeblood model include the number of individual blood components, donor numbers for each donation type, duration of period of observation, and number of donors visiting per day.…”