Emerging Infectious Disease Agents and their Potential Threat to Transfusion Safety

UPDATED Influenza A and B Viruses Fact Sheet - Jan 2025
UPDATED Oropouche Virus - Interim Fact Sheet - 11/04/24

• Developed by AABB’s Emerging Infectious Disease Subgroup in response to member questions and concerns. Check back frequently for updates.

AABB's Oropouche Virus Information and Resources - November 5, 2024 (member-protected)
FDA’s Important Information Regarding the Oropouche Virus and Blood Donation
FDA's Important Information for HCT/P Establishments Regarding Oropouche Virus and HCT/P Donation
CDC’s Clinical Overview of Oropouche Virus
CDC ArboNET Current Year Data – Oropouche Virus

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

• Prion Agents (3)
• Viral Agents (48)
• Bacterial Agents (10)
• Other Bacterial Agents (6)
• Protozoan Agents & Nematode Agents (5)
  • Future updates are expected for the Malaria Fact Sheet based on:
    • the release of the first licensed blood donor screening test for malaria,
    • discussions at FDA’s May 9th BPAC Meeting, Proposed strategies to reduce the risk of transfusion-transmitted malaria by testing donations from donors at risk of malaria exposure for the presence of Plasmodia spp. nucleic acid, and
    • new FDA recommendations, once finalized.

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, , 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, but will consider each agent individually based on interest to the membership and public health. 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 regulatory@aabb.org.

Acknowledgments

WHO Scientific framework for epidemic and pandemic preparedness – v3 2024