Xenotropic Murine Leukemia Virus-Related Virus as a Case Study: Using a Precautionary Risk Management Approach for Emerging Blood-Borne Pathogens in Canada

In October 2009 it was reported that 68 of 101 patients with chronic fatigue syndrome (CFS) in the United States, when tested, were infected with a novel gamma retrovirus, xenotropic \n \nmurine leukemia virus-related virus (XMRV) (Lombardi et al., 2009). XMRV is a recently \n \ndiscovered human gammaretrovirus first described in prostate cancers that shares \n \nsignificant homology with murine leukemia virus (MLV) (Ursiman et al., 2006). It is known \n \nthat XMRV can cause leukemias and sarcomas in several rodent, feline, and primate species \n \nbut has not been shown to cause disease in humans. XMRV was detectable in the peripheral \n \nblood mononuclear cells (PBMCs) and plasma of individuals diagnosed with CFS \n \n(Lombardi et al., 2009). After this report was published there was a great deal of uncertainty \n \nsurrounding this emergent virus and its involvement in the etiology of CFS. The uncertainty \n \nwas, in part, due to CFS being a complex, poorly understood multi-system disorder with \n \ndifferent disease criteria used for its diagnosis. CFS, also known as Myalgic \n \nEncephalomyelitis (ME), is a debilitating disease of unknown origin that is estimated to \n \naffect 17 million people worldwide. The initial report connecting XMRV to prostate cancers \n \nand CFS garnered significant media and scientific interest since it provided a potential \n \n \n \nSusie ElSaadany2**, Tamer Oraby1 \n \n* \n \nDaniel Krewski1, 4 and Peter R. Ganz5 \n \n1McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of \n \nOttawa, Ontario, Canada \n \n2Blood Safety Surveillance and Health Care Acquired Infections Division, Centre for Communicable Diseases and \n \nInfection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada \n \n3Aspinall and Associates, Cleveland House, High Street, and Earth Sciences, Bristol University, Bristol, United \n \nKingdom \n \n4Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, \n \nOntario, Canada \n \n5Health Canada, Director’s Office, Ottawa, Ontario, Canada \n \n** Corresponding Author \n \n, Marian Laderoute2 \n \n, Jun Wu2 \n \n, Willy Aspinall3 \n \n, \n \nwww.intechopen.com \n \n32 The Continuum of Health Risk Assessments \n \nexplanation for the disease but also an avenue for possible therapeutic treatments since \n \nXMRV is known to be susceptible to some anti-retroviral drugs (Cohen, 2011).

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