Lessons from the response to the threat of transfusion-transmitted vCJD in Ireland
Original article
Lessons from the response to the threat of transfusion-transmitted vCJD in
Ireland
Leçons tirées de la gestion du risque de transmission-tranfusionnelle du
vMCJ en Irelande W.G. Murphya, b, Corresponding author contact
information
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Abstract
By the time vCJD was first described in 1996, it was already far too late
to offset further disaster from transmission of the disease by blood
transfusion: almost all the humans who would be infected and infectious were
already diseased. Nothing done by the blood transfusion services around that
time, with the exception of excluding transfusion recipients as blood donors,
would have made any useful contribution to containing the extent of the
epidemic. The ability to spread emerging diseases before the problem is manifest
or understood is a fixed and unavoidable feature of blood transfusion as it is
practiced today. A second fixed property of blood transfusion is that the root
cause of disaster is not within the control of the blood transfusion universe.
Strategies that have emerged to cope with similar threat in other enterprises
that also contain these properties comprise the components of robust design:
surveillance, preparedness for action, engagement, herding together, evasion or
avoidance, early adoption of potentially useful measures, engineered resilience,
defence in depth, damage limitation including modularity and removal of feedback
loops, and contingency, redundancy and failure management, and ultimately,
individual escape. Early adoption of leucodepletion based on the possibility
that it might work rather than any hard evidence was a good example of threat
management. Exclusion of previously transfused donors is a robust mechanism for
containing any future infection; optimal blood use structures that provide a
national transfusion rate as low as possible also constitute an effective threat
management strategy.
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Résumé Lorsque la maladie fut décrite pour la première fois en 1996, il
était déjà trop tard pour mettre en place des actions préventives contre ce
nouveau désastre potentiel de transmission transfusionnelle de la maladie : en
effet, tous les sujets contaminés et probablement infectieux étaient déjà
décédés. Aucune des mesures déjà mises en place à cette époque, à l’exception de
l’exclusion des donneurs ayant été transfusés, auraient permis de lutter
efficacement contre l’épidémie. La capacité qu’ont les maladies émergentes de se
propager avant même que le problème soit identifié et compris est un
caractéristique classique et courante en transfusion sanguine dans sa pratique
actuelle. Une seconde caractéristique est que la racine du mal n’est pas sous
contrôle en la transfusion sanguine. Les stratégies préventives vis-à-vis de
risques émergents similaires rencontrés dans d’autres entreprises forment un
plan d’actions robustes comprenant : la veille, la préparation à l’action,
l’engagement, l’esprit d’équipe, l’évitement, la mise en place de mesures
préventives précoces, la gestion de l’urgence, etc. La mise en place anticipée
de la déleucocytation fondée sur le pari que cela pourrait avoir une action
bénéfique est un bon exemple de gestion de risque. L’utilisation des produits
sanguins à bon escient constitue également une stratégie de management efficace
pour diminuer le risque potentiel de transmission par transfusion.
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Keywords Prion; vCJD; Blood transfusion; Risk management Mots clés Prion;
vMCJ; Transfusion sanguine; Gestion du risque
Sunday, July 21, 2013
Welsh Government and Food Standards Agency Wales Joint Public Consultation
on the Proposed Transmissible Spongiform Encephalopathies (Wales) Regulations
2013 Singeltary Submission WG18417
Sunday, August 25, 2013
Prion2013 Chronic Wasting Disease CWD risk factors, humans, domestic cats,
blood, and mother to offspring transmission
Friday, August 16, 2013
*** Creutzfeldt-Jakob disease (CJD) biannual update August 2013 U.K. and
Contaminated blood products induce a highly atypical prion disease devoid of
PrPres in primates
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Sunday, September 1, 2013
Evaluation of the Zoonotic Potential of Transmissible Mink Encephalopathy
We previously described the biochemical similarities between PrPres derived
from L-BSE infected macaque and cortical MM2 sporadic CJD: those observations
suggest a link between these two uncommon prion phenotypes in a primate model
(it is to note that such a link has not been observed in other models less
relevant from the human situation as hamsters or transgenic mice overexpressing
ovine PrP [28]). We speculate that a group of related animal prion strains
(L-BSE, c-BSE and TME) would have a zoonotic potential and lead to prion
diseases in humans with a type 2 PrPres molecular signature (and more
specifically type 2B for vCJD)
snip...
Together with previous experiments performed in ovinized and bovinized
transgenic mice and hamsters [8,9] indicating similarities between TME and
L-BSE, the data support the hypothesis that L-BSE could be the origin of the TME
outbreaks in North America and Europe during the mid-1900s.
Sunday, August 11, 2013
Creutzfeldt-Jakob Disease CJD cases rising North America updated report
August 2013
*** Creutzfeldt-Jakob Disease CJD cases rising North America with Canada
seeing an extreme increase of 48% between 2008 and 2010
TSS
posted by Terry S. Singeltary Sr. | 10:03 AM
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