When people started to sicken and die in the 1980s from HIV/AIDS, guardians of the blood supply in many countries were slow to react. As a result, thousands of unnecessary infections followed transfusion with HIV-tainted blood products.
Today, another group of diseases that affect the blood supply is emerging—transmissible spongiform encephalopathies (TSEs). But public health leaders are flying blind on TSEs since little is known about their transmissibility through blood. The stakes are high. Some caution against do-nothing policies that could someday see thousands facing horrific deaths from these mysterious diseases. Others argue that TSEs represent at most a minuscule risk to the blood supply and that overreaction through banning of certain donors and disposal of possibly infected supplies could lead to blood shortages.
The carcass of a cow infected with bovine spongiform encephalopathy is burned in a field in Dorset, England. So-called mad cow disease first appeared in Great Britain around 1985, apparently as a result of cattle eating processed feed containing sheep parts that transmitted the infectious agent. (Photo credit: Sinclair Stammers/Science Photo Library)
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The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
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