Back to the West Nile Virus listserv archive.

Date: June 10, 2003
Posted by: Lois Levitan (lcl3@cornell.edu)

[1] Index of WestNileVirus-L Postings re: WNV Transmission via Blood 
and Organ Donations
[2] NYTimes June 10 2003: Blood Supply to be Tested for West Nile. 
By Donald G. McNeil Jr.


[1] INDEX OF WESTNILEVIRUS-L POSTINGS RE: WNV TRANSMISSION VIA BLOOD 
& ORGAN DONATIONS

This topic has been addressed in several previous WestNileVirus-L 
postings, including:
Sept 2, 2002:
    Subject: re Organ donation/Blood transmission risk, WNV
Sept 3, 2002:
    Subject: West Nile Virus & Organ Transplants
Sept 4, 2002:
    Subject: West Nile Virus & Organ Transplants #2
Sept 5, 2002:
    Subject: WNV & Organ Transplants, Blood Transfusions #3
Sept 6, 2002:
    Subject: Critique of NYTimes Opinion Piece on WNV Risk from Blood 
Transfusions
Sept 19, 2002.
    Subject: WNV & Organ Transplant/Blood Transfusion #4: CDC Update
Oct 28, 2002.
    Subject: FDA Guidance to Blood Industry re: WNV & Workshop Announcement
Oct 29, 2002.
    Subject: CDC Dispatch re: WNV & Blood Transfusions (Oct 28, 2002)
Dec 20, 2002.
    (1) Subject: Intrauterine Transmission - CDC Press Briefing Dec 
19, 2002  & NYTimes Article
    (2) Subject:  several postings re: Transplacental Transmission of WNV
March 20, 2003.
    Subject: WNV—Blood Banks in Race Against Mosquitoes (Science Mar 21 03)

These and all other postings are archived on the Environmental Risk 
Analysis Program's "What's Going on with the West Nile Virus" 
webpages:  From ERAP's WNV homepage 
(http://environmentalrisk.cornell.edu/WNV/) click on "WestNileVirus-L 
Archive" in the Navigation Bar.

For a summary of this topic, from the Navigation Bar listing of 
Frequently Asked Questions, click on "Human-to-Human Transmission."



[2]
  NEW YORK TIMES June 10, 2003: BLOOD SUPPLY TO BE TESTED FOR WEST NILE
By DONALD G. McNEIL Jr.

By midsummer, nearly all of the country's blood supply will be 
undergoing tests for West Nile virus, companies that make blood tests 
and the American Red Cross said yesterday.

The tests are experimental and even if successful will not eliminate 
the threat of the virus, which is spread mostly by mosquito bites. 
Last year, more than 4,100 people became seriously ill with West 
Nile, and 284 of them died. Only about 30 of the infections are 
thought to have come from transfusions or transplants.

Because mosquitoes thrive in warm, wet summer weather, the season for 
West Nile is just beginning.

No human cases have been detected this year in the nation, but the 
virus has already been found in 17 states, said Dr. Stephen M. 
Ostroff, deputy director of the national center for infectious 
diseases at the Centers for Disease Control and Prevention.

The virus was found in birds in 13 states, in horses in 5 and in 
mosquitoes in 2. In the past, it has also been found in cats and 
other domestic animals. The disease arrived in New York in 1999, and 
by last year had spread to 39 states.
[LCL NOTE: In 2002 the virus was detected in 44 states in the US and 
5 Canadian provinces.  It very rarely affects domestic animals and 
pets.]

"It's too early to tell how bad this year's outbreak will be," Dr. 
Ostroff said yesterday. Health officials advise draining water where 
mosquitoes breed and using insect repellent.

About 80 percent of those infected have no symptoms, but in about 1 
person in 150 the disease causes dangerous brain inflammation. About 
1 infected person in 1,000 dies, mostly the elderly and people with 
weak immune systems.

Because the new blood tests are experimental, it is not clear how 
much virus must be present before West Nile can be detected, so the 
tests "may not be 100 percent effective in keeping infected blood out 
of the system," said Dr. Jesse Goodman, director of the Food and Drug 
Administration's Center of Biologics Evaluation and Research. But he 
called their existence "a fairly remarkable success story," saying, 
"We've come a long way in a few months."

Last year, when it became clear that the virus could be spread by 
blood and transplanted organs, the drug agency asked the blood bank 
industry and diagnostics companies to come up with a test and the 
National Heart, Lung and Blood Institute offered grants to start the 
research.

Two companies responded: Gen-Probe of San Diego and Roche, the 
multinational pharmaceutical company with headquarters in Basel, 
Switzerland, both of which make tests for the viruses that cause AIDS 
and hepatitis.

Gen-Probe, whose tests are used on about 80 percent of the country's 
blood, invented one that will run on its existing blood-laboratory 
instruments. Roche's test requires a new machine; it began installing 
them in April in blood banks in Houston, Orlando, Fla., and South 
Bend, Ind.

The Gen-Probe test can detect as little as 10 copies of the virus in 
a milliliter of blood, a company scientist said. That is 10 times as 
sensitive as it needs to be, he said, and comparable with its 
approved AIDS and hepatitis tests.

Dr. Susan Stramer, chief scientific officer for the American Red 
Cross, which collects about 45 percent of the nation's blood supply, 
said "pretty close to 100 percent" of the nation's blood would be 
tested with one of the two tests, excluding perhaps only some 
hospitals that collected their own blood and some small blood banks 
that did not ship across state lines.

An official at Gen-Probe said it made no sense to test in only one 
area of the country because blood could be shipped anywhere, and 
vacationers might catch the disease in one state and donate blood in 
another.

Both companies, using slightly different technology, extract RNA from 
the virus, and multiply it billions of times. Because the test is for 
the virus itself, it can detect an infection much sooner after the 
mosquito bite, perhaps in as little as two weeks. Tests for 
antibodies, an immune response to the virus, may not be accurate for 
50 days or more.

At the moment, with no test, blood banks turn away any donors who 
have symptoms of illness and ask them to report any illnesses they 
develop within two weeks.

Most infected people develop antibodies within two weeks that clear 
the virus from the blood, the drug agency has said. People who have 
recovered are considered safe donors, which is not true for those who 
test positive for the hepatitis or the virus that causes AIDS.

For now, the new test will add $4.40 to the cost of a unit of blood, 
Dr. Stramer said. But because the tests are experimental to collect 
data, the companies are allowed to charge only their costs.

If approved, "the price will go up so we can make a profit," said 
Hank Nordhoff, Gen-Probe's president. His company received $1 million 
in federal grants to develop the test and has been promised $2.5 
million more.

Asked if that would cover his costs, he said "there's a risk we could 
lose money," if the virus dies out.

"But," he added, "$3.5 million is better than a poke in the eye with 
a sharp stick."

-- 
Lois Levitan, PhD       Program Leader
Environmental Risk Analysis Program
Department of Communication
Center for the Environment
213 Rice Hall, Cornell University
Ithaca, New York USA 14853-5601

Phone:   (607) 255-4765     Fax: (607) 255-0238
Email:	LCL3@cornell.edu

Program Email: envrisk@cornell.edu
Web:http://environmentalrisk.cornell.edu

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