Surveillance for Bloodborne Infections

Abstract

IntroductionSince blood is a biological product, it is a natural vehicle for transmission of infectious agents, and until an artificial blood substitute is developed, the risk of transfusion-transmitted infections will probably not be eliminated. Three agencies of the Department of Health and Human Services–the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and National Institutes of Health (NIH)–have collaborated with partners in local and state public health departments, academia, industry, and consumers to develop prevention strategies addressing emerging infectious disease threats to public health, including the safety of the U.S. blood supply. Four critical components of these prevention strategies are as follows: surveillance and response capabilities; integration of laboratory science and epidemiology (i.e., “applied research”) to optimize public health practice; prevention and control activities to enhance communication of public health information; and a strengthening of local, state, and federal infrastructures to support these activities.1 As highlighted by the Institute of Medicine, in its series of reports about the ongoing threat to health posed by emerging infectious diseases, surveillance is the critical lynchpin for the public health response to both known and unrecognized pathogenic threats.2 Surveillance data can be used to monitor and track temporal and demographic trends of disease, alert us to outbreaks or unexpected alterations in disease frequency or affected populations, serve as a basis for subsequent epidemiologic and laboratory investigations to describe the natural history of a disease or identify risk factors for its occurrence, and evaluate intervention strategies.2,3 This paper will review programs of surveillance in the U.S. to detect established and emerging infectious risks, with an emphasis on those that address blood safety. In addition, recent examples or case studies that illustrate the responsiveness of U.S. surveillance systems to blood safety issues will be presented.