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Risk assessment for transmission of variant C reutzfeldt‐ J akob disease by transfusion of red blood cells in the U nited S tates
Author(s) -
Yang Hong,
Gregori Luisa,
Asher David M.,
Epstein Jay S.,
Anderson Steven A.
Publication year - 2014
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.12637
Subject(s) - residual risk , medicine , transmission (telecommunications) , blood transfusion , engineering , electrical engineering
Background Variant C reutzfeldt‐ J akob disease ( vCJD ) is transmitted by blood transfusion. To mitigate the risk of transfusion‐transmitted vCJD ( TTvCJD ), the US F ood and D rug A dministration has recommended deferral of potential at‐risk blood donors, but some risk remains. We describe a quantitative risk assessment to estimate residual, postdeferral TTvCJD risk in the U nited S tates. Study Design and Methods We assumed that certain US donors may have acquired vCJD infection through dietary exposure to the agent of bovine spongiform encephalopathy during time spent in the U nited K ingdom, F rance, and other countries in Europe. Because of uncertainties regarding the prevalence of vCJD in the U nited K ingdom, we used both low and high UK prevalence estimates as model inputs. The model estimated the risk of infection from a transfusion in year 2011 and the cumulative risk from 1980 through 2011. The model was validated by comparing the model predictions with reported cases of vCJD . Results Using the low UK prevalence estimate, the model predicted a mean risk of 1 in 134 million transfusions, zero TTvCJD infections acquired in the year 2011, and zero cumulative clinical TTvCJD cases for the period spanning 1980 to 2011. With the high UK prevalence estimate, the model predicted a mean risk of 1 in 480,000 transfusions, six infections for 2011, and nine cumulative clinical cases from 1980 to 2011. Conclusions Model validation exercises indicated that predictions based on the low prevalence estimate are more consistent with clinical cases actually observed to date, implying that the risk, while highly uncertain, is likely very small.