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Blood donation from Eastern Ontario man tests positive for West Nile Virus
Canadian Blood Services takes added precautions in Ottawa and Eastern Ontario Public Health regions, donors urged to continue giving blood

Ottawa, July 28, 2005 – A unit of blood donated from a resident of Eastern Ontario has tested positive for West Nile Virus (WNV). The positive WNV unit is the first detected by Canadian Blood Services in 2005.

The unit of blood was donated in Ottawa on July 26, 2005. A sample taken from the donated blood tested positive at Canadian Blood Services' West Nile Virus laboratory in Toronto.

The donor and officials from the Ottawa and Eastern Ontario Public Health Units have been notified of the test results. The unit of donated blood has been withdrawn from inventory and was not shipped to a hospital for transfusion. The blood donor will not be eligible to donate again for 56 days.

Because of the positive test result and based on its 2005 WNV plan, Canadian Blood Services has taken added precautions against West Nile Virus (WNV) in the Ottawa region.

Beginning with collections from July 27, blood donations collected at all donor clinics held in the Ottawa and Eastern Ontario Health Units are subject to single-unit testing (each individual unit is tested), rather than mini-pool testing (six units are pooled prior to testing). Single-unit testing is believed to be able to identify extremely low levels of virus in blood donations from people who have just become infected. Mini-pool testing will continue as usual on every blood donation in all other regions across the country. The decision to move to single-unit testing in the Ottawa and Eastern Ontario Health Units, triggered by a single case of WNV in a blood donor in that region, is a highly precautionary measure. Single-unit testing will cease in the two health units when no new positive donors are reported in the region for a two-week period. These actions are consistent with our 2005 WNV Action Plan.

“The 2005 plan provides us with the flexibility to quickly respond when increased WNV risk is identified in any given community,” said Dr. Graham Sher, Chief Executive Officer of Canadian Blood Services. “Since the implementation of WNV testing on July 1, 2003, which has been complemented by additional safety measures each year, there have been no known cases of WNV transmission through the blood system.”

Canadian Blood Services has carried out WNV testing on every blood donation since July 1, 2003. Between then and July 24 of this year, 1,915, 697 blood donations have been tested for WNV. Of these, 14 donations confirmed during the summer and fall of 2003, were found to contain the virus. The infected donations were withdrawn and the donors were deferred from giving blood again for 56 days. No WNV infected donations were found in 2004. The positive WNV unit announced today, marks the first for 2005. There have been no known cases of transfusion-related WNV in Canada since testing began in July 2003.

WNV continues to be unpredictable and Canadian Blood Services’ 2005 WNV action plan will be continuously re-evaluated as the season progresses, based on blood donor testing and public health surveillance information.

Canadian Blood Services uses an investigational test developed by Roche Diagnostics. The Roche test uses the same technology that is already used to test every unit of blood for HIV and Hep C virus.

Canadian Blood Services is also encouraging Canadians to continue donating blood since the need never stops and is particularly challenging during the summer months.

“We want donors and recipients to continue to feel confident in their blood system. A greater risk than West Nile Virus is that Canadians will not continue to donate and there will be a blood shortage.” said Dr. Sher. “Remember…you cannot become infected with WNV by giving blood and mosquito bites do not disqualify you from donating.”

Call 1-888-2 DONATE to make an appointment.

NOTE: For more information on the Canadian Blood Services 2005 WNV Action Plan please see backgrounder below.

About Canadian Blood Services
Canadian Blood Services is a national, not-for-profit charitable organization that manages the blood supply in all provinces and territories outside of Quebec and oversees the country's Unrelated Bone Marrow Donor Registry. Canadian Blood Services operates 41 permanent collection sites and more than 19,000 donor clinics annually. The Provincial and Territorial Ministers of Health provide operational funding to Canadian Blood Services. The federal government, through Health Canada, is responsible for regulating the blood system. For more information, please visit our Web site at www.bloodservices.ca.

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For more information contact:
Derek Mellon
Media Room Relations Manager
Canadian Blood Services
613 739 2177
derek.mellon@blood.ca

2005 ACTION PLAN TO PROTECT THE BLOOD SYSTEM FROM WEST NILE VIRUS

Over the past two years, Canadian Blood Services implemented extensive plans to reduce the risk of West Nile Virus (WNV) to the blood system. This included WNV testing on every blood donation since July 1, 2003 using an investigational test developed by Roche Diagnostics.

In 2005, Canadian Blood Services Action Plan builds on the success of the past two years and ongoing research into the virus. The Action Plan will allow Canadian Blood Services the flexibility to quickly respond when increased WNV risk is identified in any given community.

This plan differs from that in place in 2004 in that it is based on an assessment of risk rather than a pre-determined timeframe. Single unit testing will begin as soon, or as late as necessary to reflect the current WNV situation in Canada.

WNV continues to be unpredictable and the Action Plan will be continuously re-evaluated as the season progresses and new information comes to light.

MEASURES FOR 2005

Pooled Testing
Canadian Blood Services will continue to test every blood donation for WNV with the investigational Roche test using a testing procedure where six samples are mini-pooled prior to testing. If a mini-pool of blood samples tests positive for WNV, each unit is tested individually to identify the infected unit, which is then discarded. Any units that are found to contain WNV will be withdrawn and donors will be deferred from giving blood again for 56 days.

Single-unit testing
In 2005, single unit testing will commence when 1 positive donation is found through the mini-pool testing program or when recent human cases are identified in the population of a health region at a rate of greater than 1 in 1000 in rural areas or greater than1 in 2500 in urban areas.

Once single unit testing is begun in an identified population, single unit testing may also be initiated in adjacent populations if it is deemed appropriate by medical authorities and if system capacity permits.

Pooled testing will continue on all donations where single unit testing is not being undertaken.

If single unit testing was initiated because a positive donation was found through mini-pool testing, it will cease when no new positive donors are reported in that health region for a two week period. If single unit testing was initiated because of confirmed human cases of WNV in the local health region population, it will cease when new confirmed human cases, likely acquired locally in the population of that health region over the preceding two weeks, falls below the population trigger of 1 in 1,000 in rural areas or 1 in 2,500 in urban areas.

This year’s plan will allow Canadian Blood Services to target its single-unit capacity to areas where a higher level of risk has been identified. The geographic area covered by single-unit testing will be targeted based on actual human cases as determined by surveillance information.

The plan also recognizes that the system’s capacity for single unit testing is limited. If capacity for single unit testing is exceeded, Canadian Blood Service’s efforts will balance the need for both blood safety and availability. In the event of a large or widespread WNV outbreak, the triggers for implementing or discontinuing single unit testing in a health region may have to be modified to ensure that an adequate blood supply is maintained for those who need it. In such a situation, Canadian Blood Services will also consider additional measures, such as suspending collections in areas of intense human activity while increasing collections in areas of no or less activity. Canadian Blood Services is committed to providing Canadians with a safe and secure blood system.

Surveillance
Canadian Blood Services will continue to work closely with The Canadian Public Health Agency and Hema-Quebec, as well as public health units and public health laboratories across the country, to ensure it is immediately aware of the presence of the virus in humans. In addition, Canadian Blood Services is committed to providing public health officials with notification of positive test results from its own donor screening test. Information about mosquitoes, birds and animals is also being tracked, as such information often predicts the presence of the virus in the human population.

Cancelling blood donor clinics in severely affecting areas
In the event that WNV activity is higher than expected, and the capacity for single-unit testing is exceeded, Canadian Blood Services may take the added precaution of stopping the collection of blood in severely affected areas. The decision to cancel any blood donor clinics will be made by reviewing all information available at the time. Public health officials, blood donors and the public will be given as much notice as possible. Clinic cancellations will involve well defined areas and will only occur if there is sufficient blood to meet hospital needs. Canadian Blood Services may ask the public to help it increase donations in areas of the country not experiencing outbreaks of WNV, in an effort to make up for reduced collections in heavily hit areas.

Deferring ill donors
People who indicate that they feel ill on the day of donation are deferred from donating. Donors who begin to feel ill after they donate are asked to contact Canadian Blood Services so their blood can be removed from the inventory. If any blood from these donors has been delivered to hospitals, the hospitals will be directed to discard it. If any of the affected blood has been transfused, the hospitals will be advised to notify the recipients’ physicians.

WNV in recent blood donors
When public health authorities advise Canadian Blood Services of probable or confirmed cases of West Nile infection, we will check our records to determine if anyone made a recent blood donation. If this is the case, the units will be destroyed. If any of the blood from such a donation is already transfused, the recipients’ physicians will be informed so the appropriate follow-up work can be conducted. It is possible to have multiple recipients of a donor’s blood because the various blood components are separated and used in different ways for different people.

WNV in recent blood recipients
If it is revealed that a recipient who has been diagnosed as having a probable or confirmed case of West Nile infection received blood shortly before developing symptoms, all of the people who donated blood components received by the recipient, will be temporarily deferred. As well, other blood components remaining in the system that were donated by the donors will be withdrawn and discarded. It is common for blood recipients to receive multiple units of blood and each unit would be from a different donor. If any other blood components from the donors have been transfused into other recipients, the recipients’ physicians will be advised.

Informing stakeholders and the public
Canadian Blood Services will also continue to collaborate with patient groups, hospitals, the health care community and other stakeholders to ensure that the country is kept apprised of this year’s risks and the measures being taken to reduce them.

ONGOING NEED FOR DONATIONS
The best way for people to help is to donate blood generously over the summer to ensure patient needs are met and WNV safety measures can be implemented. Donors do not become infected with WNV by giving blood. Most mosquitoes do not carry WNV. Mosquito bites do not disqualify people from giving blood and every blood donation is tested for WNV. Canadian Blood Services assures Canadians that it is safe to donate blood. The greatest risk to the blood system will be if Canadians stop donating and there is a blood shortage.

ADVICE TO PHYSICIANS AND PATIENTS
The benefits of blood transfusions outweigh the risk of WNV in life-saving situations. However, as the human population is affected by the virus, physicians and patients should discuss the use of blood in non-emergency cases, such as elective surgeries. They may want to consider delaying the surgeries or using alternatives to blood transfusions, if applicable. Since each case is unique, this decision can only be made by an individual in consultation with his or her doctor.

At all times, Canadian Blood Services urges hospitals to use as little blood as is possible in each situation that they face. Since blood can never be 100 per cent safe, no person should ever be given a blood transfusion that is not considered necessary. All recipients of blood, who are capable of doing so, should be given the opportunity of providing informed consent before receiving blood or blood products. Canadian Blood Services is committed to providing the information Canadians need in order to make the best possible decisions.

CONSULTATION WITH STAKEHOLDERS

Canadian Blood Services consults with many individuals and groups in order to formulate its action plan for West Nile Virus, including:

  • Canadian Blood Services’ Scientific and Research Advisory Committee (an independent group of international experts),
  • Canadian Blood Services’ Medical Directors located across the country (medical physicians associated with each Canadian Blood Services location),
  • Canadian Blood Services’ Transfusion Medicine Advisory Group (a group of independent Canadian medical experts),
  • Canadian Blood Services’ National Liaison Committee (a broad group of representatives from the Canadian hospital and medical communities, as well as donor and patient groups. The committee reports to the Canadian Blood Services Board of Directors),
  • Canadian Blood Services’ Safety, Science and Ethics Committee (a group of members of the Canadian Blood Services Board of Directors with expertise in medicine and ethics),
  • and the Provincial and Territorial Blood Contacts.

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For more information contact:
Derek Mellon
Media Room Relations Manager
Canadian Blood Services
613 739 2177
derek.mellon@blood.ca

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