Emerging Infectious Disease Agents and their Potential Threat to Transfusion Safety

Infectious disease agents and their potential threat to transfusion safety (an update to the 2009 Transfusion supplement) – Feb 2024

EID Fact Sheets Issued by AABB's Transfusion-Transmitted Diseases (TTD) Committee – Background for the 2024 Update

The August 2009 issue of TRANSFUSION included a Supplement on EID agents and their potential threat to transfusion safety. Members of AABB’s TTD Committee identified 68 infectious agents and described them in detail, including dengue, chikungunya and H1N1 influenza viruses, Plasmodium and Babesia species and the vCJD prion. The Supplement provided a set of tools identifying, describing, and prioritizing EID agents that were identified as having an actual or potential risk of transfusion transmission for which no intervention was in use at the time.

The Supplement’s original fact sheets included background information about each agent, assessments of the agent’s clinical features and characteristics specifically related to transfusion transmission like its presence in blood and potential interventions including the effectiveness of pathogen reduction, amongst others. All fact sheets have now been updated with some archived (as no new information is available suggesting a transmission threat) and several new fact sheets added. The fact sheets do not establish standards or requirements, but instead are intended to inform collection facilities and transfusion services about individual pathogens for which questions may arise as part of routine operations and for consideration of a starting point for policy development or enhancement.

Consensus opinions about prudent approaches (such as donor deferral periods) are included wherever possible based on facts that are currently inferred or known. Additionally, each agent and possible interventions are judged for their anticipated impact upon blood safety using scientific data and data related to the public perception of the agent.

Tables in the original supplement (including summarizing the agents by agent category, priority ratings, those documented to be transfusion-transmitted, and those in which an arthropod vector is the usual mode of transmission) have not been updated. The original tables remain useful.

Since publication of the original supplement, a variety of pathogens have been considered as possible threats to transfusion safety. Chief among these are a large variety of arthropod-borne viruses (arboviruses) including, most prominently, chikungunya and Zika. The breadth of this group of pathogens is very wide and their risks to transfusion recipients largely unstudied. Examples that have been considered by the EID group include Jamestown Canyon (Orthobunyavirus), Bourbon (Thogotovirus), Heartland (Bandavirus) in the US, Oropouche (Orthobunyavirus), Mayaro (Alphavirus) in the Americas and Severe Fever and Thrombocytopenia Syndrome (Phlebovirus) in East Asia. In the absence of credible allegations of transfusion transmission, we have elected not to draft fact sheets. Ongoing horizon scanning will determine our activity in the future for arboviruses as well as other pathogen groups. Readers are encouraged to engage in these discussions.

As with the original Supplement, all the updated and new fact sheets are provided online to TRANSFUSION subscribers and AABB members at www.transfusion.org. Input can be provided by contacting the TTD writing group at eid@aabb.org.