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Swine Influenza and Blood Banking


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On our website we have posted links to the CDC and our state lab. They can find the latest info as well as testing requirements, treatment guidelines, etc. We have increased the amount of naso pharyngeal swabs we have on hand.

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A "new" strain of virus, relatively uncommon passed from human to human - until now - capable of morphing. Blood bankers are wondering aloud "Should we be screening the blood supply for this new virus, can it be transmitted through the blood supply from asymptomatic, infected donors?" Does this sound like circa 1980 to anyone else?

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The difference is that there is a much shorter incubation time in the human host, the symptoms are clear-cut with a rapid onset and are easily recognizable by the infected person, as opposed to HIV and hepatitis with a long incubation period where the individual is asymptomatic, and symptoms usually appear gradually. Donors are instructed to call and let us know if they experience any illness within 72 hours after donation...and they do call us.

We don't test for other flu viruses during regular flu seasons. Even though this strain has new characteristics to which the population's immune system has never been exposed (which allows it to spread), it is still an influenza virus.

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Our website has daily updates, linkes to CDC and NYSDOH. Also, the website has bulletins regarding proper hygiene and hand washing.

We do not collect blood products, so we have to watch for AABB and FDA guidelines with regards to future blood screening measures (if any) to be implemented.

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Influenza-like illness in the United States and Mexico

24 April 2009 -- The United States Government has reported seven confirmed human cases of Swine Influenza A/H1N1 in the USA (five in California and two in Texas) and nine suspect cases. All seven confirmed cases had mild Influenza-Like Illness (ILI), with only one requiring brief hospitalization. No deaths have been reported.

The Government of Mexico has reported three separate events. In the Federal District of Mexico, surveillance began picking up cases of ILI starting 18 March. The number of cases has risen steadily through April and as of 23 April there are now more than 854 cases of pneumonia from the capital. Of those, 59 have died. In San Luis Potosi, in central Mexico, 24 cases of ILI, with three deaths, have been reported. And from Mexicali, near the border with the United States, four cases of ILI, with no deaths, have been reported.

Of the Mexican cases, 18 have been laboratory confirmed in Canada as Swine Influenza A/H1N1, while 12 of those are genetically identical to the Swine Influenza A/H1N1 viruses from California.

The majority of these cases have occurred in otherwise healthy young adults. Influenza normally affects the very young and the very old, but these age groups have not been heavily affected in Mexico.

Because there are human cases associated with an animal influenza virus, and because of the geographical spread of multiple community outbreaks, plus the somewhat unusual age groups affected, these events are of high concern.

The Swine Influenza A/H1N1 viruses characterized in this outbreak have not been previously detected in pigs or humans. The viruses so far characterized have been sensitive to oseltamivir, but resistant to both amantadine and rimantadine.

From what I'm reading, this is not the usual "Swine Flu". This virus, according to WHO, that they are describing as causing Influenza Like Illness, or ILI, has not previously been detected in pigs or humans. This lends at least some credibility that the virus may have been manipulated, or genetically engineered in some way (based on some of the things I have read). Just a thought. I think it's not outside the reaml of reason to at least consider that a biological weapon may have gotten out.

Edited by Hi-Freq
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Please review the below information from the FDA regarding swine influenza and the safety of blood products. This strain of influenza-A has never been detected before because the virus has undergone an explainable change that has happened many times in the human history. When a host becomes infected with multiple types of influenza viruses, then there is an opportunity for the genetic material of the viruses to recombine in such a way that it produces a new strain that the population has no previous immunity toward. This is how all pandemics have begun.

Information about Newly Emerging 2009 H1N1 Influenza Virus and Blood Safety

I. Background

The ongoing outbreak of new emerging 2009 H1N1 Influenza Virus (H1N1 flu) infections in the United States has raised questions about whether this virus can be transmitted through blood transfusion. No case of transfusion transmitted seasonal influenza has ever been reported in the United States or elsewhere, and, to date, no cases of transfusion transmitted H1N1 flu have been reported. FDA is continuing to work with the Centers for Disease Control and Prevention (CDC) and is in close contact with the AABB Interorganizational Task Force on Pandemic Influenza and the Blood Supply to monitor this outbreak and its impact on blood safety and availability.

At this time, it is important to remember that, when clinically indicated, the benefits of a transfusion far outweigh the risks, including any theoretical risk of H1N1 flu transmission through blood or blood products.

II. Blood Safety Provisions

Donor Deferral

Under FDA regulations, individuals who are not in good health are not suitable to donate blood and blood establishments must defer these potential donors. (See FDA regulations at 21 CFR 640.3.) Blood donor screening procedures currently in place at blood establishments should identify persons with symptoms of H1N1 flu infection. The symptoms of H1N1 flu in people are similar to the symptoms of regular human influenza and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with H1N1 flu. Severe illness and deaths have been reported among infected individuals in Mexico and in the U.S.

The donor screening procedures in place today are important measures in reducing the theoretical risk of transfusion transmitted H1N1 flu, particularly in areas where human cases are occurring. In addition, the continued standard practice of blood establishments in maintaining good hygiene and infection control practices will help to minimize possible spread of H1N1 flu in blood establishments. Staff member hand washing between contacts with different donors is especially important.

Additional information on illness with H1N1 flu and general control strategies can be obtained at the Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/swineflu/index.htm.

Potential Component Quarantine and Retrieval

Consistent with FDA’s October 2006 Guidance on Biologic Product Deviation Reporting for Blood and Plasma Establishments (see http://www.fda.gov/cber/gdlns/devbld.htm) Medical Directors of blood establishments should consider whether a post donation report of a flu-like illness in a donor indicates that the previously collected products are unsuitable and that the donor’s suitability for future donations should be assessed (e.g. deferral until well.) In addition to routine reporting of identified cases of H1N1 flu to state and local health departments, medical directors with any case raising concerns regarding potential transfusion transmission of influenza, may contact us at the Therapeutics and Blood Safety Branch of the CBER Office of Biostatistics and Epidemiology at 301-827-3974, as well as the CDC via state and local health departments, as appropriate.

Safety of Plasma Derivatives

The newly emerging 2009 H1N1 Influenza Virus is a large lipid-enveloped virus. Validation studies performed by the product manufacturers have shown that viruses with similar characteristics to this agent are effectively inactivated and/or removed by the manufacturing processes in place for these products.

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We had one person test positive for HINI SO-IV in our area. Today it was announced that 3 local schools are closed for the week in our city because an 11 year old has symptoms, and has a relative who is confirmed positive. Cleaning teams are going in to disinfect the schools, desks, surfaces, etc. This seems a bit extreme to me if this is "only a flu-like illness". We don't even close schools for a week for extreme weather conditions. I recall that HAZMAT teams went in and cleaned/sanitized buildings after the Antrax scares a few years back, when suspicious packages were mailed. Local daycares are also beginning to close. We are currently unsure how this is going to impact our company since many of our employees have either small children or school-age children.

Does this not strike anyone else as a bit odd, that 3 schools would close for a week, cleaning teams would go in to disinfect/sanitize, just because one child "has symptoms" and is a relative of someone who has the flu? Why would such measures be taken?

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How about 'overkill' or decision making by people who are not well informed/incorrectly informed/past good sense or who are looking at what happened in Mexico and don't want to be sued if a death or deaths should occur here. The deaths in Mexico loom large when decisions are made here. According to the interviews with experts from the CDC, infectious disease specialists, etc, there are a number of decisions being made that are extreme, including some school closings. Keeping kids away from one another for several days is a good, time tested way to stop a flu breakout in schools in it's tracks when dealing with the 'normal' flu. I don't know if anyone knows whether or not this would be helpful with this bug.

At times like this, I wonder about the children's fable about the boy who called wolf too many times. We react so very cautiously, things turn out to be not so bad after all (thank heavens!), then people are lulled into complacency and will not respond when they need too. Time will tell which kind of event this is - wolf or not.

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Also, if the actions taken actually work--reduce the spread--the public concludes there was not much risk to begin with when maybe it is just that the actions worked. I am not saying some didn't overreact this time, although early word of it's mortality made it seem justified at first. Mostly I am making an observation of human nature that if the case didn't stay dramatic, they think it must not have been real, rather than the knowledge of scientists actually helped us recognize or avert a crisis.

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I agree with Ann and Mabel. There was not enough data early to conclude if this virus was like "normal flu" where 50,000 will die, or "pandemic flu" where 50,000,000 will die (i.e. 1918). When in doubt, most people are going to err on the side of extreme caution, especially when the lives of children are at stake. Once the CDC revised their recommendations, many schools in our area re-opened a full week earlier than they had originally planned.

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Also, if the actions taken actually work--reduce the spread--the public concludes there was not much risk to begin with when maybe it is just that the actions worked. I am not saying some didn't overreact this time, although early word of it's mortality made it seem justified at first. Mostly I am making an observation of human nature that if the case didn't stay dramatic, they think it must not have been real, rather than the knowledge of scientists actually helped us recognize or avert a crisis.

I agree, I think the possibility of a real crisis might have been avoided this time. Our schools also opened early than originally planned. I don't think there was anything "normal" about this flu at all.

Just curious - how many of you are going to take the H1N1 Vaccine when it becomes available? Isn't Tamiflu marketing that vaccine?

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  • 4 weeks later...

I read recently where H1N1 is expected to become more virulent as it makes it's 3rd cycle through humans, estimated to be sometime this winter. Donald Rumsfeld's connection with Tamiflu leaves me wondering...........:confused: Not necessarily being an alarmist, but I'd rather think through all the possibilities rather than simply discount them because the "authorities" say so.

So, will any of you take the vaccine, or not? I'm personally leaning towards not taking it.

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