Recently reported cases of people contracting the West Nile virus through organ transplants have sparked public concern that the virus may be transmitted by blood transfusions.
"We're going to presume there is a risk," said Pamela Clark, medical director for Virginia Blood Services. Medical officials recently discovered that four organ recipients in Mississippi, who all contracted West Nile virus, received their organ from the same donor.
Although no reported cases of West Nile virus have been transmitted through blood, it remains a theoretical possibility, or an estimated two in 10,000 chance, according to the Center for Disease Control.
"As far as testing goes, the only West Nile virus test takes about 10 days," said Laura Cameron, spokeswoman for Virginia Blood Services, which collects blood for medical centers including University and Richmond hospitals. But because platelets expire in five days, "there is currently no test that a blood center like us can do for West Nile virus."
But ongoing research at the University Medical Center may rectify this problem.
For two years, scientists have tested new technologies to deactivate microbes contained in viruses by treating blood with a compound that binds to nucleic acid. The treated product then prevents replication of the microbes after exposure to ultra-violet light.
"This has the potential to make blood free of microbial contamination," said Paul Mintz, director of the Medical Center's clinical lab and blood transfusion services. "It is the next significant advance in blood safety. It is very exciting."
The Medical Center now is involved in two clinical trials for companies that have developed compounds.
Although the experiments were designed before the recent outbreak of West Nile virus, one of the compounds, called Psoralen, appears promising when used to inactivate West Nile virus pathogens.
The fact Psoralen can be found in nature "suggests it's going to be very safe," Mintz said. "It has an enormous kill. Its kill should prevent West Nile transmission."
But although "theoretically it should get every virus," the compounds are only effective in deactivating microbes that contain DNA and RNA, and not in diseases caused by prions, such as Mad Cow Disease.
However, Mintz stressed that there has "never been a case of blood tranfusion transmission of prions disease in humans."
Scientists also are testing a synthetic molecule and a vitamin compound, both of which work through the same process as Psoralen, which has been in development for over 10 years.
"It's really the FDA's [Federal Drug Administration's] call," Clark said. Clark emphasized the time-consuming road to FDA approval of safety and efficacy.
Mintz predicts it will be over two years before the products will be available, because each of the five trials takes anywhere from five months to a few years to reach completion.
In the meantime, the FDA has instructed blood centers across the nation to continue adhering to general screening procedures.
"I don't anticipate that this is going to be a public health problem," Mintz said, pointing out that, unlike HIV carriers, West Nile virus only remains in a carrier's bloodstream for one to two weeks.
Four million Americans receive blood transfusions every year, and in addition to pre-screening donors, the FDA requires that all donated blood be screened for infectious diseases including Hepatitis B and C and HIV.
"If somebody needs a transfusion, it is much more risky not to receive it than to receive it," Mintz added, noting that, "the blood supply is short and Virginia Blood Services can always use student donors who qualify."
Clark shares this view.
"I don't think there's a lot of danger. The thing that scares us is that we don't want West Nile virus to scare people from donating," she said.
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