Transfusion-transmissible infections: Viral

Several viruses are transmissible by blood transfusion.

To minimise the risk of potential blood donors transmitting infectious agents to patients, all donations are subjected to stringent screening procedures. The Australian Red Cross Blood Service mandatory testing includes the screening of donations for a number of transfusion-transmissible viruses which include:

  • Human Immunodeficiency Virus (HIV) 1 and 2
  • Hepatitis B Virus (HBV)
  • Hepatitis C Virus (HCV)
  • Human T-cell lymphotropic virus (HTLV) I and II

When required, some red cell and platelet donations also undergo screening for Cytomegalovirus (CMV) antibodies in order to provide a CMV seronegative inventory of cellular components. However, leucodepletion may be equal to CMV seronegativity in the prevention of transfusion transmission of CMV. 

There are also some viruses which may be transmitted by blood transfusions which are not routinely tested in blood donors in Australia, such as Dengue virus (Dengue Fever), West Nile virus, Chikungunya virus and Parvovirus B19 which causes the "Slapped Cheek Syndrome" or Fifth disease.

Blood donors are subjected to a panel of stringent screening procedures, including collection of a comprehensive medical and travel history as part of the donor assessment process.  For example, the risk of transmitting dengue fever, West Nile and Chikungunya viruses are minimised by excluding donors from or have recently travelled to areas where the diseases are endemic.  Similarly, the risk of transmitting HIV, hepatitis B and hepatitis C are reduced by excluding donors who engage in high risk behaviour.

Usual causes?

The primary cause of transfusion-transmissible viral infections is thought to be related to donations made by individuals in the window period, which is the interval between the time of infection and the appearance of clinical symptoms or detectable disease markers, such as specific antibodies or viral nucleic acid sequences.
 

Investigation

Clinically assess patients for manifestations of specific viral infections.
Perform appropriate investigations and specific testing for viral markers.
 

What to do?

Treat the specific diagnosis, if available.

Notify the Blood Service.