Chapter 3 Xenotropic Murine Leukemia Virus-Related Virus as a Case Study: Using a Precautionary Risk Management Approach for Emerging Blood-Borne Pathogens in Canada

Abstract

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

murine leukemia virus-related virus (XMRV) (Lombardi et al., 2009). XMRV is a recently

discovered human gammaretrovirus first described in prostate cancers that shares

significant homology with murine leukemia virus (MLV) (Ursiman et al., 2006). It is known

that XMRV can cause leukemias and sarcomas in several rodent, feline, and primate species

but has not been shown to cause disease in humans. XMRV was detectable in the peripheral

blood mononuclear cells (PBMCs) and plasma of individuals diagnosed with CFS

(Lombardi et al., 2009). After this report was published there was a great deal of uncertainty

surrounding this emergent virus and its involvement in the etiology of CFS. The uncertainty

was, in part, due to CFS being a complex, poorly understood multi-system disorder with

different disease criteria used for its diagnosis. CFS, also known as Myalgic

Encephalomyelitis (ME), is a debilitating disease of unknown origin that is estimated to

affect 17 million people worldwide. The initial report connecting XMRV to prostate cancers

and CFS garnered significant media and scientific interest since it provided a potential

Susie ElSaadany2**, Tamer Oraby1

*

Daniel Krewski1, 4 and Peter R. Ganz5

1McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of

Ottawa, Ontario, Canada

2Blood Safety Surveillance and Health Care Acquired Infections Division, Centre for Communicable Diseases and

Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada

3Aspinall and Associates, Cleveland House, High Street, and Earth Sciences, Bristol University, Bristol, United

Kingdom

4Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa,

Ontario, Canada

5Health Canada, Director’s Office, Ottawa, Ontario, Canada

** Corresponding Author

, Marian Laderoute2

, Jun Wu2

, Willy Aspinall3

,

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32 The Continuum of Health Risk Assessments

explanation for the disease but also an avenue for possible therapeutic treatments since

XMRV is known to be susceptible to some anti-retroviral drugs (Cohen, 2011).