Surveillance for Bloodborne Infections

Introduction Since blood is a biological product, it is a natural vehicle for transmission of infectious agents, and until an artificial blood substitute is developed, the risk of transfusion-transmitted infections will probably not be eliminated. Three agencies of the Department of Health and Human Services–the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and National Institutes of Health (NIH)–have collaborated with partners in local and state public health departments, academia, industry, and consumers to develop prevention strategies addressing emerging infectious disease threats to public health, including the safety of the U.S. blood supply. Four critical components of these prevention strategies are as follows: surveillance and response capabilities; integration of laboratory science and epidemiology (i.e., “applied research”) to optimize public health practice; prevention and control activities to enhance communication of public health information; and a strengthening of local, state, and federal infrastructures to support these activities.1 As highlighted by the Institute of Medicine, in its series of reports about the ongoing threat to health posed by emerging infectious diseases, surveillance is the critical lynchpin for the public health response to both known and unrecognized pathogenic threats.2 Surveillance data can be used to monitor and track temporal and demographic trends of disease, alert us to outbreaks or unexpected alterations in disease frequency or affected populations, serve as a basis for subsequent epidemiologic and laboratory investigations to describe the natural history of a disease or identify risk factors for its occurrence, and evaluate intervention strategies.2,3 This paper will review programs of surveillance in the U.S. to detect established and emerging infectious risks, with an emphasis on those that address blood safety. In addition, recent examples or case studies that illustrate the responsiveness of U.S. surveillance systems to blood safety issues will be presented.

[1]  R. Khabbaz,et al.  Oversight and Monitoring of Blood Safety in the United States , 1999, Vox Sanguinis.

[2]  J. Stoker,et al.  The Department of Health and Human Services. , 1999, Home healthcare nurse.

[3]  R. Will.  New variant Creutzfeldt-Jakob disease. , 1999, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[4]  B. Evatt,et al.  Occurrence of hemophilia in the United States , 1998 .

[5]  A. Levitt,et al.  Preventing Emerging Infectious Diseases: A Strategy for the 21st Century. Overview of the Updated CDC plan. , 1998, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[6]  B. Bell,et al.  Hepatitis A virus infections associated with clotting factor concentrate in the United States , 1998, Transfusion.

[7]  L. Schonberger.  New-Variant Creutzfeldt-Jakob Disease and Bovine Spongiform Encephalopathy: the Strengthening Etiologic Link between Two Emerging Diseases , 1998 .

[8]  B. Herwaldt,et al.  Transfusion-transmitted babesiosis in Washington State: first reported case caused by a WA1-type parasite. , 1997, The Journal of infectious diseases.

[9]  R. Holman,et al.  Creutzfeldt-Jakob disease in the United States, 1979-1994: using national mortality data to assess the possible occurrence of variant cases. , 1996, Emerging infectious diseases.

[10]  S. Kleinman,et al.  The Risk of Transfusion-Transmitted Viral Infections , 1996 .

[11]  A. Hofman,et al.  A new variant of Creutzfeldt-Jakob disease in the UK , 1996, The Lancet.

[12]  M. Bardsley.  Surveillance for Creutzfeldt-Jakob disease--United States. , 1996, MMWR. Morbidity and mortality weekly report.

[13]  G. Satten,et al.  Estimated risk of transmission of the human immunodeficiency virus by screened blood in the United States. , 1995, The New England journal of medicine.

[14]  C. Nass,et al.  The Retrovirus Epidemiology Donor Study (REDS): rationale and methods , 1995, Transfusion.

[15]  M. Kedda,et al.  An outbreak of hepatitis A among south african patients with hemophilia: Evidence implicating contaminated factor VIII concentrate as the source , 1995, Hepatology.

[16]  H. Klein,et al.  Safety of the blood supply. , 1995, JAMA.

[17]  S. Lemon.  The Natural History of Hepatitis A: The Potential for Transmission by Transfusion of Blood or Blood Products , 1994, Vox sanguinis.

[18]  E. Shapiro,et al.  The risk of acquiring Lyme disease or babesiosis from a blood transfusion. , 1994, The Journal of infectious diseases.

[19]  S. Emerson,et al.  Transmission of Hepatitis A to Patients with Hemophilia by Factor VIII Concentrates Treated with Organic Solvent and Detergent To Inactivate Viruses , 1994, Annals of Internal Medicine.

[20]  Chief,et al.  Addressing emerging infectious disease threats: a prevention strategy for the United States. Executive summary. , 1994, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[21]  D. Lawrence,et al.  Human immunodeficiency virus infection due to clotting factor concentrates: results of the Seroconversion Surveillance Project , 1992, Transfusion.

[22]  Joshua Lederberg,et al.  Emerging Infections: Microbial Threats to Health in the United States , 1992 .

[23]  J. Ward,et al.  Human immunodeficiency virus type 1 ‐infected blood donors:behavioral characteristics and reasons for donation , 1991, Transfusion.

[24]  J. Hadler,et al.  Transfusion‐transmitted babesiosis: a case report from a new endemic area , 1991, Transfusion.

[25]  H. Margolis,et al.  The Changing Epidemiology of Hepatitis B in the United States: Need for Alternative Vaccination Strategies , 1990 .

[26]  L. Petersen,et al.  Methodologic approaches to surveillance of HIV infection among blood donors. , 1990, Public health reports.

[27]  S B Thacker,et al.  Public health surveillance in the United States. , 1988, Epidemiologic reviews.

[28]  G. M. Wells,et al.  Rocky mountain spotted fever caused by blood transfusion. , 1978, JAMA.