不良反应分析与提高安全性策略理查德本杰明-广州血液中心.PPT

Need 2008 data * Need Ab, ABO type of 2008 plasma presence * Even with enhanced testing and diversion, the Red Cross continues to get Septic Reaction reports, including fatalities KEY POINTS: As populations grow, change their environments, and move to new areas, new infectious threats will continue to emerge. With plane travel being so quick and convenient, infections can diffuse very rapidly, as was seen during the SARS epidemic. All donations made between 20 Sept and 4 Dec 2005 were tested for the presence of dengue viral nucleic acid. The Epi Curve above has number of cases on the y-axis, and week of symptom onset on the x-axis. Suspected cases are in yellow, and confirmed cases in red. The number of cases began rising in August with a peak in mid-September (422). The study period, highlighted above, began one week after the peak and ended 2 weeks before the end of the year. This study period was intentionally chosen during the high dengue transmission season to increase the yield of dengue +’ve donors. Using this prevalence rate and applying it to the average of 77K donations/year in PR, this implies that there would be… However, this would present the upper bound of this estimate as this prevalence was determined during a period of high dengue transmission * * * 红色代表新出现的疾病；蓝色代表再次出现或发病率再增高的疾病 Adapted from Morens DM. Nature. 2004;430:242–9. 输血安全威胁:感染在世界各地持续出现 西尼罗河病毒 SARS 登革热 Chikungunya 猪流感 美国1999-2007西尼罗河病毒神经侵袭性疾病的发病率 该颜色代表任何WNV的活动性（包括鸟、蚊、马及人） * 2003: 23例有记载的传播 2004-8: 9例 国内传播 0例 在红十字会内 红十字会证实的WNV病例，2003-2007 供者数 总例数（N=1055） * 巴贝斯虫生活周期 * ARC 血液预警项目2005至2007年间输血传播巴贝斯虫感染病例 Tonnetti, L et al, Transfusion 2009, 已发表 病例 年龄 诊断 是否死亡 输血成分 居住地 间隔时间 受血者 明确 疑似 * 巴贝斯虫感染: 突出的问题 3年期间发生18例输血感染巴贝斯虫病例，包括2例追溯性病例 5 例死亡 17 (24%) 例中4位供者曾到流行地区作短暂停留 血液筛查尚无可靠检测方法 生产商对开发针对区域性疾病的检测缺乏热情 登革病毒 黄病毒属成员 由伊蚊传播; 蚊= 人 4种血清型: DEN-1，-2，-3，和-4 超过25亿人生活在登革病毒危险区，而且这种流行病有扩张的趋势。 * 对2005年9月20日至12月4日采集的所有血液进行监测(~16,000) 0 50 100 150 200 250 300 350 400 450 1 4 7 10 13 16 19