Risk of introducing Zika virus in the Canadian cord blood supply: A risk analysis.

IF 2.5 3区医学 Q2 HEMATOLOGY Transfusion Pub Date : 2024-11-04 DOI:10.1111/trf.18056

Antoine Lewin, Sheila F O'Brien, Matthew Seftel, Catherine Latour, David Allan, Marie-Claude Chouinard, Diane Fournier, Christian Renaud

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Abstract

Background: In Canada, as many as 24% of mothers are deferred from cord blood (CB) donation due to risk factors for Zika virus (ZIKV). However, the ZIKV epidemic has waned considerably since 2016, and there has not been any report of ZIKV transmission by CB transplantation, which questions this policy. Thus, we performed an analysis of the risk of introducing ZIKV in the CB supply maintained by Héma-Québec (HQ) and Canadian Blood Services (CBS).

Study design and methods: This simulation considered the following parameters: the risk of travel exposure in a high-risk ZIKV country, the duration of travel, the daily risk of acquiring ZIKV in a high-risk country, the probability of materno-fetal ZIKV transmission, the probability of asymptomatic fetal viremia, and the probability of sexual transmission. A hundred million Monte Carlo simulations were run.

Results: In the most-likely scenario (probability of traveling to a high-risk ZIKV country while pregnant = 0.178), the risk was estimated at 0.9 ZIKV-positive donations per million donations (95% confidence interval [CI] = 0.4-1.6)-or one every 868 years at HQ and one every 453 years at CBS. In the pessimistic model (probability of traveling to a high-risk ZIKV country while pregnant = 0.240), the risk was estimated at 1.2 ZIKV-positive donations per million donations (95% CI = 0.6-2.1)-or one every 644 years at HQ and one every 340 years at CBS.

Discussion: We conclude that the risk of introducing ZIKV in the Canadian CB supply is too small to justify maintaining the current policy.

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加拿大脐带血供应中引入寨卡病毒的风险：风险分析。

背景：在加拿大，由于寨卡病毒（ZIKV）的风险因素，多达 24% 的母亲被推迟捐献脐带血（CB）。然而，自2016年以来，寨卡病毒疫情已大大减弱，而且还没有任何关于脐带血移植传播寨卡病毒的报道，这就对这一政策提出了质疑。因此，我们对魁北克省血液中心（Héma-Québec，HQ）和加拿大血液服务公司（Canadian Blood Services，CBS）维护的 CB 供应中引入 ZIKV 的风险进行了分析：该模拟考虑了以下参数：在 ZIKV 高风险国家旅行暴露的风险、旅行持续时间、在高风险国家感染 ZIKV 的日风险、ZIKV 母婴传播的概率、无症状胎儿病毒血症的概率以及性传播的概率。结果：在最有可能的情况下（怀孕期间前往 ZIKV 高风险国家的概率 = 0.178），风险估计为每百万例捐赠中有 0.9 例 ZIKV 阳性捐赠（95% 置信区间 [CI] = 0.4-1.6），即在总部每 868 年有一例，在 CBS 每 453 年有一例。在悲观模型中（怀孕期间前往 ZIKV 高风险国家的概率 = 0.240），风险估计为每百万例捐赠中有 1.2 例 ZIKV 阳性捐赠（95% 置信区间 [CI] = 0.6-2.1），即在总部每 644 年有一例，在 CBS 每 340 年有一例：我们的结论是，加拿大 CB 供应中引入 ZIKV 的风险太小，不足以证明维持现行政策是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion 医学-血液学

CiteScore

4.70

自引率

20.70%

发文量

426

审稿时长

1 months

期刊介绍： TRANSFUSION is the foremost publication in the world for new information regarding transfusion medicine. Written by and for members of AABB and other health-care workers, TRANSFUSION reports on the latest technical advances, discusses opposing viewpoints regarding controversial issues, and presents key conference proceedings. In addition to blood banking and transfusion medicine topics, TRANSFUSION presents submissions concerning patient blood management, tissue transplantation and hematopoietic, cellular, and gene therapies.