West Nile risk spreads to blood and organ donations

With transmission by organ transplant confirmed and transmission by blood transfusion likely, experts balance the possibility of infection versus the potential impact on supply.

By Victoria Stagg Elliott, AMNews staff. Oct. 7, 2002.

When the possibility of West Nile virus transmission by blood transfusion first came to light in early September, Louis Katz, MD, medical director of the Mississippi Valley Regional Blood Center conducted an unscientific survey.

He went to the lobby of the Davenport, Iowa, blood bank and asked people waiting to donate if they had been bitten by a mosquito lately, and, therefore, could possibly be carriers of the infectious agent. Nineteen out of 20 answered yes, proving how widespread possible exposure could be.

Though Dr. Katz' survey was simple, it underscores what has become an increasing challenge: Figuring out a way to minimize the risks that could result from donated blood or organs that could have been infected with West Nile virus.

Specifically, efforts by the Centers for Disease Control and Prevention and the Food and Drug Administration have taken on a new imperative since experts confirmed that the infection can be transmitted by organ transplantation. The investigation into transmission by blood transfusion was still ongoing at press time. However, the possibility is considered likely enough that any remaining blood linked to the patients who came down with the virus after transfusion has been taken off the shelves.

"We believe there's sufficient evidence, when you put it all together, to say that there is likely a risk, that it is likely that at least some of the reported cases may be related to transmission by blood and, certainly in the one case, transmission through organ transplantation," said Jesse Goodman, MD, MPH, deputy director, FDA's Center for Biologics Evaluation and Research. [...]