The FDA and our federal health authority among many others have recently asked for a four weeks deferral period for blood donors coming back from regions infested by the vector and the virus.
However, since infections may be asymptomatic in blood donors, how is it guaranteed that infected donors do not harbour the virus in third spaces and in danger of a long lasting viraemia?
Do you have any specific thoughts regarding this topic?
Thank you very much in advance!
It is my understanding that the 28 day deferral was chosen because it is about twice as long as know carriage period. Canada, for example, only defers 21 days.
http://healthycanadians.gc.ca/publications/diseases-conditions-maladies-affections/risks-zika-virus-risques/index-eng.php see ref #25,26 above
We generally avoid collecting blood from third spaces! (Das ist eine kleine Witze...)
We have adopted in Brazil the 4-week deferral a few weeks ago, based on the fact that viremia is short lived and that there are no data concerning chronic asymptomatic carriers. There are two cases in Brazil related to viral transmission (but not disease transmission) to recipients who were transfused last May 2015, all coming from an area where no zika was noticed at that moment. Both recipients were asymptomatic and these cases are a little bit nebulous, pending peer-reviewed publication. To my understanding, all related policies concerning Zika and blood transfusion are quite appropriate and based on scientific facts. It is our duty to avoid hysteria based on absence of scientific grounds.
Dear Jed,
Thanks a lot.
You´re speaking German? Great.
The "third spaces" were meant as reservoirs for viruses, not for direct access to our needles :-)
Best,
Markus
Thanks Silvano,
I can only fully agree to your Statement, that we Need to avoid hysteria.
However, a scientific online discussion is appropriate in order to share latest facts and our assessment.
Best,
Markus
Gee!!! A good mind-boggling question! Never thought about that!
I fully agree with Silvanos comments. Although not scientific sound, but I raise a question if there is any chronic asymptomatic flavivirus tickborne- or mosquito-related disease (with the exception of quite related Hepaciviruses). I might be very naive, but never heard about chronic Dengue, TBE, West-Nile, JEV, MVEV you name it, They all cause neurological symptoms, which are usually acute. So maybe this analogy helps.
But take this comment by caution, as nobody ever might have thought that a flavivirus is also sexually transmissible. And: there is a possibility, that Dengue related GBS is not an autoimmune disease. see this abstract
http://stm.sciencemag.org/content/8/326/326ec28.full
We see now a lot of puzzling issues, but I also would suggest, that chances of asymptomatic chronic Zika disease might be very low.
Waiting for the next surprise ......
Cheers to you all!
Christian
http://stm.sciencemag.org/content/8/326/326ec28.full
Exactly!
Thanks a lot Christian! Especially for your additional thoughts: Analogies to other related viruses vs. the next surprise .... It reamins interesting.
Best,
Markus
My dear friends. I think that high commited blood transfusion specialists like ourselves are actually paying attention very carefully and closely about the insurgence of this quite unknown virus. There is no doubt that it is very important, particularly for pregnant women, and for them, all attention must be driven from authorities in order to avoid new cases. But most importantly, if we do not fight the real culprit, the mosquito, we will certainly lose not only this battle, but the whole war. Unfortunately, this I haven´t seen not only in my country, but in several places. This is a great forum for discussion. Regards
Dear Silvano,
You are absolutely right: The vector is key to the problem.
I think, your country Brazil is very active in fighting the Aedes mosquitos; however, there are so many war zones around the world and uninhabilable places, where the mosquitos can easily grow. It really gives me the creeps ....
Best,
Markus
Congratulations Markus for this forum.
Actually, one month could be a razonable time to invite to our donors to wait.
My concern is really the possible relationship with Guillan Barre-like syndrome. We need more information from local Hemovigilance systems. Maybe we need a look back study of receptors from donors who present forward symptoms or infections.
In this global and mediatical world, doctors must keep calm and help all each others
Best,
JA
Dear José,
Thanks a lot for your answer.
Your concern regarding neurological complications is well founded; I think, there are not so many thoughts in this field.
A lot of interesting things to do!
Best,
Markus
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