Abstract
Zusammenfassung. Bis Anfang der 1990er Jahre waren Blutprodukte nicht selten mit HIV oder HCV kontaminiert, was zu vielen transfusionsbedingten Infektionen führte. Seither wurde die Sicherheit von Blutprodukten in Bezug auf die Infektionsübertragung mit aufwendigen Massnahmen stark erhöht. Aktuell stehen sogenannte (re)emerging-Infektionserreger im Fokus, beispielsweise West Nile-, Zika- und Hepatitis-E-Viren. Ob und wie sich neue Massnahmen, die eine Übertragung dieser Viren verhindern sollen, kosteneffizient einführen lassen, muss mit klar definierten Vorgaben abgeklärt werden. Der entsprechende Entscheid muss gemeinsam mit den involvierten Stakeholdern und auch aufgrund von Kosten-Nutzen-Überlegungen getroffen werden. Grundsätzlich gilt, dass es eine 100-prozentige Sicherheit in Bezug auf die Übertragung von Infektionserregern mit Blutprodukten nie geben wird.
Abstract. Until the early 1990s, blood products were often contaminated with HIV or HCV, resulting in many transfusion-related infections. Since then, the introduction of elaborate measures has greatly increased the safety of blood products in relation to the transmission of infections. The current focus is on so-called (re)emerging infectious agents, such as West Nile, Zika and Hepatitis E viruses. Whether and how new measures to prevent transmission of these viruses are introduced must be clarified using clearly defined specifications. The appropriate decisions must be made together with the various stakeholders involved based on clear cost-benefit considerations. In practice however, a 100 % certainty that all transmission of infectious agents with blood products may be prevented is unlikely to be achieved.
Résumé. Au début des années 1990, il n’était pas rare de voir des produits sanguins contaminés avec le VIH ou le VHC avec, comme conséquence, un nombre important d’infections d’origine transfusionnelle. Depuis, des mesures drastiques ont été prises et la sécurité des produits sanguins, en ce qui concerne la transmission d’infections, a été fortement améliorée. Actuellement, nous focalisons notre attention sur des agents infectieux (ré)émergents comme, par exemple, les virus du Nil Occidental, du Zika, et de l’hépatite E. Il est maintenant nécessaire d’élaborer des prescriptions claires pour définir si et comment introduire de nouvelles mesures pour empêcher la propagation de ces virus de manière économiquement judicieuse. La décision doit être prise de concert avec les parties prenantes et en tenant compte du rapport coûts-bénéfices. Fondamentalement, il ne sera jamais possible d’éliminer à 100 % le risque d’une transmission d’agents infectieux par les produits sanguins.
Bibliografie
For the NHLBI Retrovirus Epidemiology Donor Study. International application of the incidence rate/window period model. Transfusion 2002; 42: 966–972.
:International survey on NAT testing of blood donations: expanding implementation and yield from 1999 to 2009. Vox Sang 2012; 102: 82–90.
:
andInternational NAT Study Group : Prevalence of human immunodeficiency virus RNA and antibody in first-time, lapsed, and repeat blood donations across five international regions and relative efficacy of alternative screening scenarios. Transfusion 2013; 53: 2399–2412.Blood transfusion: control of infectious risks. Presse Med 2015; 44: 189–99.
:Relative efficacy of nucleic acid amplification testing and serologic screening in preventing hepatitis C virus transmission risk in seven international regions. Transfusion 2015; 55: 1195–1205.
:Residual risk of HIV, HCV and HBV in Canada 2017; 56: 389–391.
:Incidence of viral markers and evaluation of the estimated risk in the Swiss blood donor population from 1996 to 2003. Euro Surveill 2005; 10: 14–16.
:Suitability of European climate for the Asian tiger mosquito Aedes albopictus: recent trends and future scenarios. J R Soc Interface 2012; 9: 2708–2717.
:Emerging mosquito species in Germany-a synopsis after 6 years of mosquito monitoring (2011–2016). Parasitol Res 2017; 116: 3253–3263.
:Mosquito-borne diseases: advances in modelling climate-change impacts. Trends Parasitol 2017; 4922: 30280–30285.
:Increased detection of Aedes albopictus in Belgium: no overwintering yet, but an intervention strategy is still lacking. Parasitol Res 2015; 114: 3469–3477.
:Successful overwintering of Aedes albopictus in Germany. Parasitol Res 2016; 115: 3245–3247.
:The invasive Asian tiger mosquito Aedes albopictus (Diptera: Culicidae) in Germany: Local reproduction and overwintering. Acta Trop 2017; 166: 186–192.
:Transfusion transmittable infections – seroprevalence among blood donors in a tertiary care hospital of Dehli. Asian J Transfus Sci 2013; 7: 116–118.
:Transfusion-transmitted malaria in Canada. CMAJ 2001; 164: 377–379.
:Documented cases of post-transfusion malaria occurring in England: a review in relation to current and proposed donor-selection guidelines. Vox Sang 2005; 89: 77–80.
:Malaria and blood transfusion. Vox Sang 2006; 90: 77–84.
:Overview of revised measures to prevent malaria transmission by blood transfusion in France. Vox Sang 2008; 95: 226–231.
:A case of transfusion transmitted malaria in Switzerland. Swiss Med Wkly 2001; 131: 320.
:Selective Testing of at-risk Blood Donors for Trypanosoma cruzi and Plasmodium spp. in Switzerland. Transfus Med Hemother 2016; 43: 169–176.
:American trypanosomiasis (Chagas disease). Infect Dis Clin North Am 2012; 26: 275–291
:WHO 2010 : First WHO report on neglected tropical diseases: Working of overcome the global impact of neglected tropical diseases (WHO/HTM/NTD/2010.1) 2010 [cited 2012 March 20]; http://whqlibdoc.who.int/publications/2010/9789241564090_eng.pdf, letzter Zugriff: 15.02.2018.Epidemiology of Chagas disease in Europe: many calculations, little knowledge. Clin Res Cardiol 2014; 1031: 1–10.
:Chagas’ disease and blood transfusion: a New World problem?Vox Sang 1993; 64: 1–12.
:Epidemiology of Chagas disease in non-endemic countries: the role of international migration. Mem Inst Oswaldo Cruz 2007; 102: 75–85.
:Transfusion-transmitted Chagas’ disease. Cur Opin Hem 1998; 5: 406–411.
:Blood transfusion and iatrogenic risks in Mexico City. Anti-Trypanosma cruzi seroprevalence in 43 048 blood donor, evaluation of parasitemia and electrocardiogram findings in seropositive. Mem Inst Oswaldo Cruz 2005; 100: 111–116.
, :A case of possible Chagas transmission by blood transfusion in Switzerland. Transfus Med Hemother 2016; 43: 415–417.
:
:Arboviren . In: Werner E, GerabekHrsg.. Enzyklopädie Medizingeschichte. Berlin; De Gruyter2005. S. 93.West Nile virus and its emergence in the United States of America. Vet Res 2010; 41: 67.
:Blood Centers begin implementing WNV donor screening tests. ABC Newsletter. June 20, 2003:1–3 (Washington, DC; America’s Blood Centers).
Transmission of West Nile virus through blood transfusion in the United States in 2002. N Engl J Med 2003; 349: 1236–1245.
:West Nile Virus preparedness plan to ensure safe blood components in Switzerland: a risk-based approach. Vox Sci Series 2016 online; DOI: 10.1111/voxs.12300.
:Prevention of transfusion-transmitted infections: dilemmas. Front Med (Lausanne) 2017; 4: 221.
:Transfusion-associated hepatitis E, France. Emerging infectious diseases 2007; 13: 648–649.
:Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet 2014; 384: 1766–1773.
, :Unique clinical courses of transfusion-transmitted hepatitis E in patients with immunosuppression. Transfusion 2017; 57: 280–288.
:An analysis of the benefit of using HEV genotype 3 antigens in detecting anti-HEV IgG in a European population. PloS One 2013; 8: e62980.
, :Hepatitis E virus seroprevalence among blood donors in southwest Switzerland. PloS One 2011; 6: e21150.
, :Seroprevalence of Hepatitis E virus in Swiss blood donors originating from the canton of Zürich. SGM-Jahrestagung; Interlaken: 2013.
:Current hepatitis E virus seroprevalence in Swiss blood donors and apparent decline from 1997 to 2016. Euro Surveill 2018(accepted for publication).
, :Hepatitis E and blood donation safety in selected European countries: A shift to screening?Euro Surveill 2017; 22: pii: 30514.
, :Pathogen inactivation of cellular blood products – an additional safety layer in transfusion medicine. Front Med; 2017: doi: 10.3389/fmed.2017.00219.
:Hepatitis E transmission by transfusion of intercept blood system treated plasma. Blood 2014; 123: 796–797.
, :