El ICHH explica que donar sangre tras realizar un viaje es una práctica segura

La doctora Silvia Fumero, responsable de Hemovigilancia y Área de Extracción del ICHH, explica cuáles son las regiones del mundo a las que hay que prestar especial atención si se quiere donar tras haberlas visitado.

El completo procedimiento seguido por el ICHH incluye un cuestionario previo, análisis durante y después de la donación, y pruebas adicionales si fueran necesarias.

En los meses de verano muchos canarios aprovechan para viajar al extranjero durante sus días de descanso estival. De regreso a su rutina en las islas, a algunos de estos viajeros les surgen dudas a la hora de donar sangre, sobre todo si han estado recientemente en determinadas zonas de Europa o fuera de ella. ¿Es recomendable donar si se ha estado en África? ¿Cuánto tiempo hay que esperar para volver a donar? ¿Hay algún riesgo? La hematóloga Silvia Fumero Guersi, responsable de Hemovigilancia y Área de Extracción del Instituto Canario de Hemodonación y Hemoterapia (ICHH) resuelve estas y otras dudas, al tiempo que subraya que el proceso de donación, incluyendo el cuestionario previo, está diseñado para garantizar por encima de todo la seguridad del receptor de la donación.

Doctora Silvia Fumero Guersi.

Para la doctora Fumero no hay duda de que la donación es un procedimiento seguro, y que lo es porque “ya antes de la donación se empiezan a tener en cuenta numerosos criterios para intentar garantizar que la persona que va a donar esté sana y sin patologías potencialmente transmisibles a través de una transfusión sanguínea”, explica.

Además, “con cada donación de sangre se realizan pruebas de serología y biología molecular para descartar las principales infecciones transmisibles por transfusión conocidas”, añade. Pero además, tal y como indica la doctora, “durante el procesamiento de la sangre también se llevan a cabo técnicas de inactivación de patógenos”, lo que supone un nivel más de seguridad.

De forma general, destaca la doctora Fumero, se puede donar sangre si se ha estado en Europa, aunque señala varias excepciones, como Turquía y Madeira, “que tienen una exclusión de un mes”, así como Georgia y ciertas regiones de Grecia, “cuya exclusión incrementa a cuatro meses”. La doctora afirma que existen en el continente algunas zonas donde se da el virus del Nilo Occidental, y que por eso quien haya visitado esos lugares deberá esperar un mes antes de donar. “En el resto de los destinos fuera de Europa siempre hay que esperar un mes para la donación y cuatro meses si se viaja a zonas endémicas de ciertas infecciones como chagas o malaria”, añade. Las zonas endémicas, aclara, son aquellas donde “se mantiene un proceso patológico de forma estacionaria en una población o zona geográfica durante períodos de tiempo prolongados”.

La doctora explica que el tiempo de espera para poder donar si se ha viajado recientemente a alguno de los países o regiones donde existe riesgo endémico de ciertas enfermedades infecciosas dependerá del período de incubación o de la infección en cuestión, así como del llamado “período ventana”, en el caso de que se disponga de pruebas para detectar la posible infección.

Patologías más comunes y períodos de exclusión

En algunas regiones existe riesgo endémico de contraer ciertas patologías infecciosas, entre las que destacan:

– Malaria o paludismo: se transmite al ser humano por la picadura de mosquitos hembra infectados del género Anopheles. Los primeros síntomas pueden ser leves (fiebre, dolor de cabeza, escalofríos y vómitos). El paludismo por P. falciparum puede agravarse y desenlazar en la muerte si no se trata en las primeras 24 horas.

– Chagas: se trata de una patología potencialmente mortal causada por el parásito Trypanosoma cruzi. Se calcula que hay entre seis y siete millones de personas infectadas en el mundo, la mayoría en América Latina. La infección se puede curar si el tratamiento se administra al poco tiempo de producirse la infección.

Si se viaja a regiones con riesgo de contraer Malaria o Chagas (afecta a hay países de América, África, Asia y Oceanía) que hay que esperar 4 meses tras el regreso para donar sangre.

– Virus del Nilo occidental: se portador es el mosquito del género Cules y sus principales huéspedes los pájaros salvajes. Los humanos y otros animales, como por ejemplo los caballos, son infectados a través de la picadura del mosquito y se les considera huéspedes incidentales al no desarrollar una viremia suficiente para mantener los ciclos de transmisión. Suele encontrarse en África, Europa, Oriente Medio, América del Norte y Asia occidental.

El 80% de las infecciones son asintomáticas y el otro 20% desarrolla síntomas leves indistinguibles de otras infecciones virales (fiebre, dolor de cabeza, malestar general). En un pequeño porcentaje (1 de cada 150 casos) se producen infecciones graves.

– Zika: entre un 60% y un 80% de las infecciones son asintomáticas y cuando aparecen síntomas suelen ser leves y autolimitados (fiebre no muy intensa de 4 a 7 días de duración, generalmente acompañada de erupción cutánea). El virus Zika es un flavivirus.

– Dengue: es una infección vírica transmitida por la picadura de las hembras infectadas de mosquitos del género Aedes. Se presenta en los climas tropicales y subtropicales y los síntomas aparecen entre tres y 14 días después de la picadura. Es una enfermedad similar a la gripe, aunque en algunos casos puede presentar complicaciones (dificultad respiratoria, hemorragias graves o fallo orgánico). Se ha detectado en más de 60 países de Asia, África, Europa y América.

Regiones sensibles

Los lugares a los que hay que prestar especial atención si se viaja a ellos y se quiere donar al regreso son los siguientes. De América, Argentina, Bahamas, Bolivia, Brasil, Colombia, Costa Rica, República Dominicana, El Salvador, Ecuador, Guayana, Guayana Francesa, Guatemala, Haití, Honduras, México, Nicaragua, Panamá, Paraguay, Perú, Surinam y Venezuela. De África, todos excepto Lesotho, Libia, Marruecos, Mauricio, Isla Reunión, Santa Helena, Islas Seychelles y Túnez. De Asia,  todos excepto Bahréin, Brunei Darussalam, Emiratos Árabes Unidos, Israel, Japón, Jordania, Kazakstán, Kuwait, Líbano, Macao, Islas Maldivas, Mongolia, Palestina, Qatar, Singapur, Taiwán y Turkmenistán. Y por último, de Oceanía, Papúa Nueva Guinea, Islas Salomón y Vanuatu.

Un proceso seguro

Muchas de las enfermedades infecciosas descritas presentan brotes que cambian de localización en poco tiempo. De ahí la enorme importancia que tiene responder verazmente al cuestionario previo a la donación e incluso comentar con el médico los viajes realizados. Así, el facultativo podrá establecer, si fuera necesario, cuál será el periodo de exclusión, e incluso realizar pruebas específicas para determinar si existe infección o no. Esta medida de prevención adicional evita el contagio por transfusión de enfermedades infecciosas emergentes o re-emergentes no presentes ya en Canarias.

El hecho de haber viajado al extranjero, incluso a lugares con ciertos riesgos sanitarios, no debe disuadir a los canarios de acudir a donar sangre, una necesidad diaria en los hospitales de las islas, ya que todo el proceso de donación (el período de exclusión, el cuestionario y las pruebas que se realizan durante y después de la donación) garantiza la seguridad del receptor y la calidad de la sangre.

 

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