Reporting HBV and HCV Infections in Repeat Blood Donors

Information on reporting incident hepatitis B virus (HBV) and hepatitis C virus (HCV) infections meeting CSTE acute case definition among repeat blood donors from blood collection centers to public health departments

Incident HBV and HCV infections identified during repeat blood donations in which the donor tested first nucleic acid test negative, then subsequently positive for one of these infections within the following 6 months, meet the 2012 CSTE acute HBV and HCV surveillance case definitions for public health reporting across the US. A modification to increase this period to 12 months was adopted for HCV in 2016.

Routine laboratory reporting to public health departments does not include the context of past successful donations suggesting a lack of common risk factors, which raises the possibility of healthcare-associated infection (HAI). We hope to promote awareness among public health personnel about an effort that began in 2015 for reporting of these incident HBV and HCV infections in repeat blood donors by blood collection centers, to alert state or local public health personnel for prioritized investigation. Reporting of incident infections in repeat blood donors is in addition to routine laboratory reporting of HBV and HCV infections, therefore the additional notifications will be a subset of laboratory-reported cases.

Sentinel events for healthcare-associated infection (HAI)

At least six HAI outbreaks or transmissions (four described in Moorman et al, Transfusion 2015external icon) were detected between 2008 and 2015 by public health investigation of such reports, in each instance from a single donor. Investigation of acute infections may yield important information for state and/or local public health departments in order to facilitate public health measures such as contact tracing and enhancement of infection control practices, and may enhance understanding of local hepatitis transmission patterns, regardless of transmission source.

Resources for public health investigation of potential HAI

Toolkits and other resources for investigating HAI are available at: https://www.cdc.gov/hepatitis/outbreaks/Healthcare-associatedOutbreaks.htm

Upon consultation CDC can provide assistance to health departments for investigation and share best practices based on many states’ previous experiences with topics such as infection control breaches previously associated with transmissions in specific settings, practice observation recommendations, guidance for notification messages, populations to screen, and laboratory testing including molecular genetic investigation.