title: Emerging viral threats to the Australian blood supply.
abstract: OBJECTIVE
  To assess the risk to the Australian blood supply posed by emerging or re-emerging viral infections.
  
  
  METHODS
  A review was undertaken of the English-speaking literature on the potential for emerging viral threats to human health in Australia, the future implications of virus ecology, climate change and population movement and the implications for blood transfusion.
  
  
  RESULTS
  Published data confirm that Australia's blood supply is among the safest in the world for currently screened viral pathogens as a result of rigorous surveillance, donor selection and state-of-the-art processing and laboratory testing. However, Australia has a number of other viral pathogens with the potential to threaten the safety of the blood supply such as the Ross River, Barmah Forrest, Kunjin, Japanese Encephalitis, Murray Valley Encephalitis and dengue viruses. Of these, dengue is currently of most concern to blood safety because; it can cause fatalities, there are regular seasonal outbreaks in Northern Australia and, in contrast to other viruses mentioned above an overseas case of transfusion transmission has already been documented. Notably, despite the lack of a suitable dengue screening test the ARCBS already implements supplementary measures to protect the blood supply during outbreaks.
  
  
  CONCLUSIONS
  Current interventions have proven extremely effective in minimising transfusion transmission in Australia of recognised viral pathogens. The threat posed by emerging viral pathogens to the safety of blood transfusion emphasises the need for global collaboration and consideration of further intervention strategies on a country by country basis including options such as nucleic acid testing and pathogen reduction technologies.
authors.affiliation: School of Biomedical Sciences, the Western Australian Biomedical Research Institute, Curtin University, Perth, WA. r.dunstan@curtin.edu.au
authors.forename: Robert A
authors.initials: RA
authors.lastname: Dunstan
authors.forename: Clive R
authors.initials: CR
authors.lastname: Seed
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Keller
mesh_terms: D001102:Arbovirus Infections / Q000097:blood / Q000635:transmission; D001315:Australia; D001771:Blood Banks / Q000592:standards / Q000639:trends*; D001803:Blood Transfusion; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D012449:Safety; D014777:Virus Diseases / Q000097:blood / Q000635:transmission*
references.citation: Vox Sang. 2003 Jan;84(1):11-9
references.pmid: 12542729
references.citation: Semin Pediatr Infect Dis. 2005 Jan;16(1):60-5
references.pmid: 15685151
references.citation: Vox Sang. 2007 Aug;93(2):179-82
references.pmid: 17683364
references.citation: J Transl Med. 2007 Jun 06;5:25
references.pmid: 17553144
references.citation: Blood Rev. 2000 Jun;14(2):94-110
references.pmid: 11012252
references.citation: Transfusion. 2005 Apr;45(4):460-2
references.pmid: 15819662
references.citation: Emerg Infect Dis. 2007 Mar;13(3):509-10
references.pmid: 17552118
references.citation: Transfus Apher Sci. 2007 Apr;36(2):201-6
references.pmid: 17459776
references.citation: Med J Aust. 2008 Jan 7;188(1):41-3
references.pmid: 18205563
references.citation: Lancet. 2000 Jun 24;355(9222):2210-5
references.pmid: 10881895
references.citation: Baillieres Best Pract Res Clin Haematol. 2000 Dec;13(4):601-14
references.pmid: 11102279
references.citation: N Engl J Med. 2008 Mar 6;358(10):991-8
references.pmid: 18256387
references.citation: Transfus Med Rev. 2002 Oct;16(4):273-82
references.pmid: 12415513
references.citation: Annu Rev Med. 2004;55:191-207
references.pmid: 14746517
references.citation: Commun Dis Intell Q Rep. 2007 Mar;31(1):1-70
references.pmid: 17503645
references.citation: Med J Aust. 2003 Jan 6;178(1):5-6
references.pmid: 12492380
references.citation: Transfusion. 2008 Jan;48(1):55-63
references.pmid: 17894794
references.citation: Arch Pathol Lab Med. 2007 May;131(5):719-33
references.pmid: 17488157
references.citation: Microbes Infect. 2000 Nov;2(14):1693-704
references.pmid: 11137043
references.citation: Transfusion. 2007 Oct;47(10):1783-93
references.pmid: 17880602
references.citation: Clin Med (Lond). 2004 Mar-Apr;4(2):152-60
references.pmid: 15139736
references.citation: ISBT Sci Ser. 2006 Sep;1(1):257-262
references.pmid: 32328160
references.citation: Transfusion. 2007 Jun;47(6):1080-8
references.pmid: 17524100
references.citation: Intern Med J. 2005 Oct;35(10):592-8
references.pmid: 16207258
references.citation: N Engl J Med. 2001 Jun 14;344(24):1807-14
references.pmid: 11407341
references.citation: J Clin Virol. 2006 May;36 Suppl 1:S1-2
references.pmid: 16831686
references.citation: J Infect Dis. 2001 Feb 1;183(3):359-67
references.pmid: 11133366
references.citation: Vox Sang. 2004 Jul;87 Suppl 2:56-61
references.pmid: 15209880
references.citation: Transfusion. 2006 Aug;46(8):1276-8
references.pmid: 16934059
references.citation: Biochem Biophys Res Commun. 1997 Dec 8;241(1):92-7
references.pmid: 9405239
references.citation: Thromb Res. 2002 Oct 31;107 Suppl 1:S39-45
references.pmid: 12379292
references.citation: Emerg Infect Dis. 2006 Mar;12(3):395-402
references.pmid: 16704775
references.citation: Lancet. 1996 Apr 6;347(9006):921-5
references.pmid: 8598754
references.citation: Semin Hematol. 2007 Jan;44(1):32-41
references.pmid: 17198845
references.citation: N Engl J Med. 2007 Feb 22;356(8):769-71
references.pmid: 17314335
references.citation: Transfus Med Rev. 2006 Jul;20(3):181-9
references.pmid: 16787826