[Transfusion and transmission of infectious and parasitic diseases excluding AIDS and viral hepatitis].

Many viruses, bacteria or parasites can survive in stored blood for varying lengths of time. Recipients are therefore exposed to a risk which depends on the prevalence of pathogens in blood donor populations, the clinical and laboratory controls performed in blood transfusion centres and the efficiency of the patient's immune system. Beside the HIV and hepatitis viruses, transfusions may transmit the HTL virus in endemic areas or if the blood donor comes from one of these areas (e.g. the French West Indies), the CMV virus (but only in patients with weak immune defences) and some exotic viruses in specific regions. As regards bacterial agents, syphilis is prevented by blood storage at 4 degrees C for 72 hours and brucellosis remains a minor risk, but the very rare endotoxinic shock is severe and lethal in two-thirds of the cases. Infestation by parasites is common in certain areas, but it may occur in France after transfusion from blood donors coming from these areas; malaria transmitted by blood perfusion is a real problem. Drastic procedures of rejection of blood donors at risk, including examination and laboratory screening, must be applied and are effective in preventing these dangers. These procedures are well-known and are compulsory in France.