New Hepatitis B and C Infections in Repeat Blood Donors, and Why CDC Wants to Know

Repeat blood donors are people who give blood two or more times within 12 months. An incident infection is a new hepatitis B (HBV) or hepatitis C (HCV) infection within that period. A new infection in a repeat donor is especially worrying because these donors usually lack the common risk factors for viral hepatitis.

Why these cases matter

Blood collection centers screen every donation with laboratory serologic and nucleic acid tests (NAT) and a thorough assessment of behavioral risk factors. Because they are screened so often, repeat donors are considered at low risk of viral hepatitis — but new infections still happen, and sometimes a donor does not disclose a new behavioral risk.

Such an infection matters for the donor's own health, and it can also be a sentinel event for a healthcare-associated infection (HAI). Between 2008 and 2015, public health investigations of these reports uncovered at least six HAI outbreaks or transmissions, each traced from a single donor; four were described by Moorman and colleagues in Transfusion in 2015.

How reporting works

1. Blood collection centers may voluntarily report incident HBV and HCV infections in repeat donors to CDC.
2. CDC passes the information to the relevant state health department to investigate.
3. These cases are likely to be a subset of the laboratory-reported surveillance cases in that state.

Help for health departments

In 2012 CDC, working with state and local health departments, published a guide to investigating suspected healthcare-associated viral hepatitis infections. On request, CDC can also advise health departments and share lessons from many states' past investigations on:

• infection control breaches previously linked to transmission in particular settings;
• what to look for when observing practices;
• wording for notification messages;
• which populations to screen;
• laboratory testing, including molecular genetic investigation.

CDC's Division of Viral Hepatitis offers technical assistance.

Sources

Rewritten from the Centers for Disease Control and Prevention page "Reporting HBV and HCV Infections in Repeat Blood Donors" (public domain), in hubnx's own words. Its stock photograph is not reproduced.