Protection Against Outbreaks

While current screening tests have reduced the risks from transfusion-transmitted infections (TTI), these tests are reactive, meaning that it is first necessary to identify specific pathogens for which to develop and implement tests.

In contrast, pathogen inactivation is a proactive safety measure. The process can neutralise clinically-relevant pathogens present in platelet concentrates independent of whether they have been identified as specific blood supply risks.

This is critical because there is typically a lag between the emergence of new pathogens, and the recognition that an additional safety intervention may be needed.

The efficacy of the INTERCEPT™ Blood System was demonstrated in 2006 when a chikungunya epidemic occurred on the French island of Réunion, in the Indian Ocean. When approximately one third of the island’s 900,000 inhabitants were infected by the virus and local blood collections were suspended. After implementation of the INTERCEPT Blood System on the island in 2006, no cases of chikungunya transmission via blood components have been reported.1

Similar experiences occurred in Guadeloupe, Martinique, French Polynesia and Puerto Rico, where more recent outbreaks of chikungunya and dengue caused severe problems.

During the Zika outbreak in French Polynesia between October 2013 and April 2014, a large number of Zika infections in asymptomatic blood donors at the time of donation (42 / 10) were detected. A study by Aubry et.al (2) was recently published in the Transfusion journal in which it was shown that the INTERCEPT treatment is able to inactivate Zika virus in plasma. The viral load in the pre-inactivation samples were 6.46 to 6.63 log TCID50 / ml, no viral replication was found in the plasma samples directly after inactivation.

‘In areas with active Zika virus transmission, the FDA recommends that whole blood and blood components for transfusion be obtained from areas of the US without active transmission. Blood establishments may continue collecting and preparing platelets and plasma if an FDA-approved, pathogen-reduction device is used’.

 US Food and Drug Administration (FDA) press release, 16 February 2016

Source:
1.Rasonglès P, et al., Transfusion of platelet components prepared with photochemical pathogen inactivation treatment during a Chikungunya virus epidemic in Ile de La Réunion, Transfusion (2009) 49, 1083-1091
2.Aubry M, et all., Inactivation of Zika virus in plasma with amotosalen and ultraviolet A illumination, Transfusion 2016, Jan;56(1):33-40.DOI:10.1111/trf.13271. Epub 2015 Aug 18.