To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The English National Blood Service (NBS) established a nucleic acid amplification technology (NAT) Steering Group in 1996 to produce a strategy in anticipation of a regulatory requirement for hepatitis C virus (HCV) RNA testing of manufacturing scale plasma fractionation pools. This subject was first raised in 1995 by the Committee for Proprietary Medicinal Products (CPMP) and the requirement was published in CPMP/BWP/390/971 (CPMP, 1998). The ‘start pool’ of plasma for fractionation had to be tested by NAT and shown to be negative for HCV RNA.
The implementation date for HCV NAT was 1 July 1999 for plasma fractionators. (Please refer to Chapter 20.) Hepatitis C virus RNA pre-testing of sub-pools (i.e. testing before pooling of all plasma takes place) was implemented in the National Blood Service to avoid the loss of large-scale plasma pools for fractionation as a result of contamination by HCV RNA. In addition, it was also important to prevent transmission of HCV via any other blood components from donors identified to be HCV RNA positive through testing of plasma pools for fractionation (please refer to Chapters 13 and 14). This inevitably led the blood services to introduce the requirement for real-time NAT to allow timely withdrawal of all labile blood components identified as HCV RNA positive. Nucleic acid testing for all labile components was introduced as soon as practicable and was completed by the NBS in July 2000.
John A. J. Barbara, Emeritus Consultant in Microbiology to NHS Blood and Transplant; Visiting Professor in Transfusion Microbiology, University of the West of England, Bristol, UK,
Roger Eglin, Head, National Transfusion Laboratories, NHS Blood and Transplant Colindale, London, UK
In 1983, a small textbook was published entitled Microbiology in Blood Transfusion (Barbara, 1983).
At the beginning of this book the characteristics of microbial agents that might predispose them to the potential for transmission by transfusion were explored. Some of the characteristics identified included:
Presence of the agent in one or more of the constituent components of blood
Propensity for causing asymptomatic (sub-acute) infections
Protracted incubation period to the development of symptoms
A long-term carrier state of expressed microbial components (e.g. HBsAg in the case of hepatitis B virus)
A long-term latency of the agent via incorporation of the microbial nucleic acid into the white cells of the infected host. The microbial nucleic acid could reactivate to initiate infection in the recipient of a transfusion from an infected donor.
In any table of transfusion-transmissible infections (TTIs) summarizing the situation at that time, the predominant microbial agents featured would typically be persistent rather than acute. More recently, the risk (actual or potential) from acute infections, especially in situations of high incidence and attack rates in a population, has also become a significant issue. The epidemic of West Nile fever virus (WNV, see Chapters 6 and 15) is a very good example of this. A summary of the currently clinically significant TTIs is shown in Table 1. These agents will all be covered in detail throughout the ensuing chapters. Chapter 6 also considers the potential risks from ‘new’ or newly recognized agents.
Email your librarian or administrator to recommend adding this to your organisation's collection.