Should a prospective donor be deferred following exposure to 'SARS'?

A colleague in Saudi Arabia reports that his center has been instructed to begin asking prospective blood donors questions to assess their risk for exposure to SARS. (Editor's NOTE: see the Mar. 31 WHO update on the quarantine instituted in Hong Kong.) The exact question being asked is as follows "Have you travelled through Hong Kong, or in the Guangdon Province of China or Vietnam after February 1, 2003?"

According to the new Saudi Arabian policy, if a prospective donor should answer the aforementioned question in the affirmative, the donor would be deferred for 4 weeks. No policy has yet been set in the event that a donor reports that he/she has recovered from SARS and there have been no cases of SARS as yet in their setting. The inquiring colleague adds that he finds no reason to go into clinical details of SARS with a prospective donor, since a person experiencing the signs and symptoms of SARS would have acute disease which would automatically disqualify them according to AABB Standards. The inquiring colleague wonders if any other centers have given consideration to such a policy.

The following responses were received.

1. A colleague affiliated with America's Blood Centers has reported that given the recent posting from Saudi Arabia on SARS deferrals, they thought the e-network forum would be interested in the following article from Singapore on a similar deferral policy in that country (link no longer avalable).
   
   'Blood Bank takes extra precautions due to SARS' - By Johnson Choo, April 2, 2003

Singaporeans are not just worried about contracting SARS, but the outbreak has also deterred many from donating blood. Over the past two weeks there has been a 30 per cent drop in number of donors.

But since March 18, the Blood Bank has also tightened its screening process to minimise exposure. In past years, this is usually the time that the Red Cross goes to schools to encourge students to donate blood.

This year schools are closed because of the SARS outbreak and people are reluctant to donate blood.

"If you go to that place and those people who are donating blood might be infected, so somehow they might cause you to be infected as well," said one Singaporean. Another added "It's virus right? It's in the air, so you can't tell."

Despite facing a shortfall, the Centre for Blood Transfusion Medicine has become more stringent in screening donors.

They are being asked if they have a flu or fever, if they have returned recently from one of the SARS-affected areas or if they have had close contact with any known SARS patients.

Donors who answer yes to any of these questions, are asked to wait three weeks before they will be considered as blood donors.

Dr Diana Teo, Director, Centre for Transfusion Medicine, said "At this point in time there is no test available for SARS. SARS is a very new disease. So as a precaution, what we're doing now is to make sure that those that may have been exposed to SARS at all, have been asked not to donate blood, so that we are reducing the risk to its minimum."

ADDENDA April 12, 2003

2. Editor's NOTE:  On April 11, the AABB reported that the FDA plans to offer guidance on SARS to protect the blood supply. The Canadian Blood Services has already issued deferral guidelines for donors considered at risk of SARS.

ADDENDA April 18, 2003

3. Editor's NOTE:  On April 17, the FDA announced this Guidance for Industry: Revised Recommendations for the Assessment of Donor Suitability and Blood Product Safety in Cases of Suspected Severe Acute Respiratory Syndrome (SARS) or Exposure to SARS. (Updated August 20, 2004)

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Ira A. Shulman, MD
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W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator

Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator