Sun | Dec 4, 2016

Bloody Mess

Published:Sunday | October 26, 2014 | 12:00 AM

Crisis looms as despite shortage, Blood Bank bars donors who had chik-V for a month;
Doctors differ on length of ban necessary

Erica Virtue, Senior Gleaner Writer

The chikungunya virus (chik-V) outbreak affecting the island could pose a major challenge to the Blood Bank at a time of the year when blood is usually in high demand.

Lack of detailed research and data about the chik-V has left medical professionals with differing views as to when persons infected by the virus can donate blood, but all agree that there has to be a ban of between two weeks and several months.

However, the National Blood Transfusion Service (Blood Bank) has decided that chik-V victims must be out of the disease for at least a month before they can give blood.

"Even after one month, you may be unable to give blood if you present with other symptoms. However, the Blood Bank will carry out an assessment of the patient to determine if he or she is able to give blood," said Sandra Brown-Thomas, public relations officer at the Blood Bank.

Brown-Thomas admitted that the ban could make an already dicey situation even more of a problem.

"Once we are not able to collect blood, it is going to worsen the shortage. And the fact is even if you are outside of the chik-V period and you present with any other virus, you are screened out," noted Brown-Thomas.

She said the Blood Bank will rely on the honesty of prospective donors to give correct information, but it will also depend on the experience and skill of its nurses to determine those eligible, while appealing to persons who have not contracted chik-V to give blood.

ONE-MONTH BAN UNNECESSARY

But Dr Doreen Brady-West, consultant haematologist at the University Hospital of the West Indies, believes that unless there is some other concern, there is no reason for the Blood Bank to ban chik-V victims for one month.

"Chik-V presents with fever, bad feelings, pains and skin rash within one to seven days. After that, the patients start feeling better. However, there is not a lot of detailed research on the disease, but within seven days to two weeks, the virus would have left your body," Brady-West told The Sunday Gleaner through microbiologist Dr Alison Nicholson.

Brady-West noted that with or without chik-V, prospective donors presenting with chronic symptoms of the disease - including fever, diarrhoea and skin rashes - are not ordinarily considered for donation.

However, Dr Winston Dawes, former president of the Sports Medicine Association of Jamaica, believes the ban on giving blood should be even longer than the one month imposed by the Blood Bank.

"Not enough research has been done, so individuals cannot speak definitively on the matter. To be on the safe side, I would say two months, and that is if you don't have any symptoms from the disease. By that time, you would have developed antibodies to it.

"The problem is that there is not a lot of research on it and, to some extent, there is a lot of guesswork going on. From the research in Italy, in a few cases, individuals have showed symptoms for as long as two years. As to whether the virus has caused inflammation in the area, or the virus has remained dormant and is still causing the problem, we don't really know," said Dawes.

"The fact is that even if it's resilient in the tissues, the viral count would be low … . The way it is going in Jamaica, everyone will get it. So if you have it, and they infuse the virus into you, it would not make a difference," added Dawes.

Nicholson, whose works include the study of organisms that cause infections, noted that chik-V presents itself in two phases - a subacute phase and a chronic phase. About 13 per cent of victims will develop the chronic phase.

"The thing with chik-V is that we don't have any experience with it, as you know, and there is not a tremendous amount of literature on it - I guess because it's not really a Western disease. We need to document what we are finding to add to the research and add to the body of literature out there," said Nicholson.

"Individuals suffering symptoms for more than three months will become chronic sufferers of the disease," added Nicholson, noting that the quicker symptoms are resolved, the less likely one will be to becoming a chronic sufferer.

"If you get rid of the symptoms within a short period, then that's your story. But I don't know if it's the ones with the chronic symptoms who will be barred. There is so much lack of information, doctors are just taking precaution," noted Nicholson.

erica.virtue@gleanerjm.com