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6.4 Infection and environment
O6-4.4 Fifteen years of testing the nation: the role of blood donor infection surveillance in informing the safe supply of blood
  1. L Byrne1,2,
  2. C Reynolds1,2,
  3. S Brailsford1,2,
  4. K Davison1,2
  1. 1NHS Blood and Transplant, London, UK
  2. 2Health Protection Agency, London, UK

Abstract

Introduction Surveillance of infections in UK blood donors and recipients commenced in 1995 with the aim of informing donor selection and testing policies and hence minimising the risk of transfusion transmitted infections. The surveillance programme has evolved to include information on new tests, horizon scanning for emerging infections and microbiological screening of antenatal samples.

Methods Applications of surveillance data for the 15-year period were reviewed. The role in informing transfusion and public health policies, epidemiology and natural history of infections are described.

Results Annual estimates of and trends in incidence and prevalence of infection among donors, donor behaviours associated with infections, non-compliance with selection criteria, and estimates of the risk of transfusion-transmitted infection were determined. These data were used to evaluate and inform policy on microbiological testing and donor selection such as the introduction of nucleic acid testing and the associated risks of changes to deferral criteria. The surveillance programme has expanded into other areas: cohort studies of HCV and HTLV infected patients, look-back studies of transfusion recipients, collaborative work on genotyping and sero-surveillance, and assessments of donor health such as heart disease. The unit also contributes to national surveillance programmes through the notification of infections and informs antenatal screening policy with work on rubella.

Conclusion Blood donors are a sentinel population and surveillance provides a regular and valuable source of epidemiological information about a low-risk population providing opportunities for additional work into the nature of infection. Surveillance programmes within blood services are essential to evaluate and optimise blood safety.

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