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Ideas and Opinions5 July 2016Emerging Infections and Blood Safety in the 21st CenturyEvan M. Bloch, MD, MS, Matthew S. Simon, MD, MS, and Beth H. Shaz, MDEvan M. Bloch, MD, MSFrom Johns Hopkins University, Baltimore, Maryland; Blood Systems Research Institute, San Francisco, California; and Weill Cornell Medical College and New York Blood Center, New York, New York.Search for more papers by this author, Matthew S. Simon, MD, MSFrom Johns Hopkins University, Baltimore, Maryland; Blood Systems Research Institute, San Francisco, California; and Weill Cornell Medical College and New York Blood Center, New York, New York.Search for more papers by this author, and Beth H. Shaz, MDFrom Johns Hopkins University, Baltimore, Maryland; Blood Systems Research Institute, San Francisco, California; and Weill Cornell Medical College and New York Blood Center, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1329 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail An unprecedented level of blood safety has been achieved in the United States in the 30 years since HIV testing was implemented. The tragedy of transfusion-transmitted HIV coupled with the public perception of inaction spurred a massive overhaul of federal regulation of the blood industry, which resulted in zero tolerance for infectious risk in the blood supply. Current blood screening has expanded to antibody and nucleic acid testing (NAT) for HIV, hepatitis B virus, hepatitis C virus, human T-lymphotropic virus, syphilis, Chagas disease, and West Nile virus (WNV) and has virtually eliminated these infections from the blood supply. Nonetheless, ongoing ...References1. Pealer LN, Marfin AA, Petersen LR, Lanciotti RS, Page PL, Stramer SL, et al; West Nile Virus Transmission Investigation Team. Transmission of West Nile virus through blood transfusion in the United States in 2002. N Engl J Med. 2003;349:1236-45. [PMID: 14500806] CrossrefMedlineGoogle Scholar2. Herwaldt BL, Linden JV, Bosserman E, Young C, Olkowska D, Wilson M. Transfusion-associated babesiosis in the United States: a description of cases. Ann Intern Med. 2011;155:509-19. [PMID: 21893613]. doi:10.7326/0003-4819-155-8-201110180-00362 LinkGoogle Scholar3. Snyder EL, Stramer SL, Benjamin RJ. The safety of the blood supply—time to raise the bar. N Engl J Med. 2015;372:1882-5. [PMID: 25902384] doi:10.1056/NEJMp1500154 CrossrefMedlineGoogle Scholar4. Katz LM, Sayers M. Screening for babesiosis: where is the policy? [Editorial]. Transfusion. 2014;54:2154-6. [PMID: 25212423] doi:10.1111/trf.12807 CrossrefMedlineGoogle Scholar5. Wald ML. Blood Industry Shrinks as Transfusions Decline. New York Times. 22 August 2014. Accessed at www.nytimes.com/2014/08/23/business/blood-industry-hurt-by-surplus.html?_r=0 on 10 February 2016. Google Scholar6. Gallian P, de Lamballerie X, Salez N, Piorkowski G, Richard P, Paturel L, et al. Prospective detection of chikungunya virus in blood donors, Caribbean 2014 [Letter]. Blood. 2014;123:3679-81. [PMID: 24904107] doi:10.1182/blood-2014-03-564880 CrossrefMedlineGoogle Scholar7. Musso D, Nhan T, Robin E, Roche C, Bierlaire D, Zisou K, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill. 2014;19. [PMID: 24739982] CrossrefMedlineGoogle Scholar8. Allain JP, Bianco C, Blajchman MA, Brecher ME, Busch M, Leiby D, et al. Protecting the blood supply from emerging pathogens: the role of pathogen inactivation. Transfus Med Rev. 2005;19:110-26. [PMID: 15852240] CrossrefMedlineGoogle Scholar9. Custer B, Hoch JS. Cost-effectiveness analysis: what it really means for transfusion medicine decision making. Transfus Med Rev. 2009;23:1-12. [PMID: 19056030] doi:10.1016/j.tmrv.2008.09.001 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University, Baltimore, Maryland; Blood Systems Research Institute, San Francisco, California; and Weill Cornell Medical College and New York Blood Center, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1329.Corresponding Author: Evan M. Bloch, MD, MS, Department of Pathology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Carnegie 446 D1, Baltimore, MD 21287; e-mail, [email protected]edu.Current Author Addresses: Dr. Bloch: Department of Pathology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Carnegie 446 D1, Baltimore, MD 21287.Dr. Simon: Weill Cornell Medical College, 525 East 68th Street, Box 130, New York, NY 10065.Dr. Shaz: New York Blood Center, 310 East 67th Street, New York, NY 10065.Author Contributions: Conception and design: E.M. Bloch, M.S. Simon, B.H. Shaz.Analysis and interpretation of the data: E.M. Bloch, M.S. Simon.Drafting of the article: E.M. Bloch, M.S. Simon, B.H. Shaz.Critical revision for important intellectual content: E.M. Bloch, M.S. Simon, B.H. Shaz.Final approval of the article: E.M. Bloch, M.S. Simon, B.H. Shaz.Administrative, technical, or logistic support: E.M. Bloch.Collection and assembly of data: E.M. Bloch, M.S. Simon.This article was published at www.annals.org on 15 March 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDengue Virus Surveillance and Blood Safety: A One Health PerspectiveThe Mirasol Evaluation of Reduction in Infections Trial (MERIT): study protocol for a randomized controlled clinical trialBlood Product (Donor) Noninfectious and Infectious Testing and ModificationA risk‐based decision‐making framework for blood safety: what's the case for Zika?Alternative Facts Have No Place in ScienceChristine Laine, MD, MPH and Darren B. Taichman, MD, PhDBlood Transfusion TherapyZika Virus and the Blood Supply: What Do We Know? 5 July 2016Volume 165, Issue 1Page: 57-58KeywordsBloodBlood banksDecision makingHIVHealth careHematologic testsInfectious hepatitisPathogensSafetyZika virus ePublished: 15 March 2016 Issue Published: 5 July 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. 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