Blood safety policy: should cautionary policies be adopted with caution?

Abstract

Preview
In this issue of Blood Transfusion, nationwide studies on the prevalence of the hepatitis E virus (HEV) infection in Italian blood donors1 and the residual risk of transfusion-transmitted hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections after the implementation of nucleic acid testing in Italy2 show that the risk of transmitting infections via blood transfusion is currently very low. However, regarding the challenges the blood system faces, the risk of new and emerging pathogens (i.e. prions or viruses such as Dengue, Chikungunya, West Nile and Zika)3-5 entering the blood supply remains. In Italy, plans for the surveillance of human vector-borne diseases were implemented after the Chikungunya outbreak in 20076, along with preventive measures for reducing the risk of transmission of West Nile virus through donated blood7, tissues and organs. As far as HEV is concerned8, before considering the introduction of universal or selective HEV RNA screening of blood donations in Italy, in addition to carrying out a cost-effectiveness analysis, Spada and co-authors1 correctly state that it would be essential to establish the true incidence of HEV infection and the related risk factors in a large representative sample of Italian blood donors. [ … ]