Blood Donation Precautions to Prevent Zika Virus Transmission
The risk posed by Zika virus to the blood supply is unclear, but current evidence suggests that infection could be transmitted by transfusion. Almost 3% of blood donors tested positive for Zika virus RNA during the French Polynesian outbreak. The maximum duration of viremia is estimated to be less than 28 days. Frequent travel between the United States and endemic regions in the Caribbean and Central or South America will place many US travelers at risk for Zika virus infection.
The Food and Drug Administration has published new recommendations for blood collection pertaining to Zika virus. The guidance includes two sets of recommendations: one for areas with active transmission of Zika virus and one for areas without active transmission.
For areas with active transmission of Zika virus infection, FDA recommends that whole blood and blood components be obtained from areas of the United States without active transmission of Zika virus. Two exceptions are permissible. Blood components can be collected within a zone of active Zika virus transmission if donors are tested for Zika virus using an FDA-approved test. However, at present, the FDA has not licensed a blood donor-screening test for Zika, chikungunya or dengue virus. Platelets or plasma can be collected in an endemic area if an FDA-approved pathogen reduction technology is utilized. Pathogen reduction technology has been shown to be effective for reducing arboviral loads and infectivity in platelets and plasma.
For areas without active transmission of Zika virus, FDA recommends that blood collection centers should update their Donor History Questionnaire to include deferral for four weeks if any of the following criteria are met:
- A history of Zika virus infection
- Signs and symptoms suggestive of Zika virus infection within 2 weeks of returning from an endemic area
- A history of sexual contact with a man who either has been diagnosed with Zika virus infection, or with a man who has traveled to an area of active Zika virus transmission in the previous 3 months
- A history of travel to or residency in an area with active Zika virus transmission
Household contact with a person with confirmed Zika virus infection is not a reason for deferral, unless there was sexual contact.
References
Recommendations for Donor Screening, Deferral, and Product Management to Reduce the Risk of Transfusion –Transmission of Zika Virus: Guidance for the Industry. US Department of Health and Human Services, FDA, CBER, February 2016. Available at: http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guida nces/default.htm.
Aubry M, Richard V, Green J, et al. Inactivation of Zika virus in plasma with amotosalen and ultraviolet A illumination. Transfusion 2016;56:33-40.
