Volume: 28S3 • September 2002

Blue Ribbon Committee on Bloodborne Parasitic Diseases

Health Canada
Centre for Infectious Disease Prevention and Control
Bureau of Infectious Diseases
Blood-borne Pathogens Division*

* Now the Health Care Acquired Infections Division, Blood-borne Pathogens Section.

Blue Ribbon Committee on Bloodborne Parasitic Diseases
29 Pages - 275 KB in PDF Format

Table of Contents | Introduction | Background

Table of Contents

Introduction

Background

Bloodborne Parasitic Pathogens in Canada

Arthropod-borne parasitic diseases
Malaria
Trypanosoma cruzi infection

Surveillance for Bloodborne Parasitic Pathogens in the U.S.

Systems of surveillance for emerging infectious diseases
Emerging Infections Program (EIP)
Provider-based networks
Surveillance and the blood supply

Donors
Recipients: persons with hemophilia
Repositories
T. cruzi
Transfusion-transmitted malaria

Laboratory Services Environment

Potential Offshore Threats to Canada's Blood Supply

Parasites found in Central and South America
Surveillance of the blood supply in Central and South America

Conclusions

References

Meeting of the Blue Ribbon Committee: 5 and 6 March, 2001

Introduction

Welcome and Purpose of the Meeting

Key Issues and Concerns

Key Themes

Cross-cutting Issues

Mandate
Definition of bloodborne parasites

Identified Needs and Recommendations Related to Themes

Theme - technical
Theme - laboratory research and development
Theme - epidemiology and demography
Theme - sociologic aspects and public education
Theme - professional education
Theme - policies (in place)
Theme - resources
Theme - policy development

Summary

Appendix: Meeting Participants

Introduction

Several parasitic diseases have emerged recently in Canada, mainly as the result of cases detected in Canadian travelers, immigrants, or refugees. Some of these diseases cause prolonged parasitemia and could pose a risk to the blood transfusion system of the country. Malaria, babesiosis, and Chagas' disease are three clear examples. However, the actual prevalence of these infections in Canadians as well as in populations living in certain high-risk areas of the world remains largely unknown.

Health Canada's Blood-borne Pathogens Division of the Bureau of Infectious Diseases, Centre for Infectious Disease Prevention and Control (CIDPC), Public Health Agency of Canada, is responsible for the evaluation of risks of parasitic diseases and has successfully conducted surveillance studies on viruses and prions. In order to improve the investigative, surveillance, and risk assessment aspects related to bloodborne pathogens, the Division hosted a meeting of the Blue Ribbon Committee on 5 and 6 March, 2001, in Ottawa. Participants included international experts currently involved in research and laboratory diagnosis of bloodborne parasites and parasitic diseases; their expertise and extensive experience provided important insights.

This report first provides background information on bloodborne parasites and the surveillance systems in place both in Canada and internationally, and then goes on to outline the processes and outcomes of the March meeting.

Background

Bloodborne Parasitic Pathogens in Canada

Interest in bloodborne pathogens has been high since the release of the Final Report of the Commission of Inquiry on the Blood System in Canada (Krever commission)⁽¹⁾. The recommendations in this report, specifically concerning the need for greater vigilance to protect the safety of the blood supply, have led to an increase in the resources available to achieve that end. Although Canada's blood supply is now as safe as it can be at this point in time, there is a clear need to examine old, new, and renewed threats to Canada's blood collection/donation system.

Parasitic diseases have always been an important consideration for blood safety, and the threat is growing, given increased travel and changing immigration patterns. The broad spectrum of new immigrants arriving in Canada together with other factors, such as global warming and the potential expansion of parasite-endemic areas, dictate a continued high degree of vigilance against the possibility of parasitic infection within the blood supply.

The role of CIDPC is clear: to identify risk, assess that risk, and advise on policy options to maintain the safety of the blood supply. However, fulfilling this role depends on well-defined scientific requirements to serve as the basis for surveillance activities. Identifying and defining these scientific requirements and recommendations were underlying goals of the conference.

Although risk among blood donors is obviously a major concern, consideration of the risks posed by parasitic diseases should not focus solely on this aspect. Discussion of the impact of bloodborne parasitic pathogens on the population at large is also important, specifically concerning the following: infections imported with population movement; infections that occur with returning travelers; and infections that are endemic to Canada. Discussion of these issues must also take into account that in some cases the risk of transmission of secondary infection will be rather restricted or even unique.

Blue Ribbon Committee on Bloodborne Parasitic Diseases
29 Pages - 275 KB in PDF Format