The yield of temporary exclusion of blood donors, exposed to emerging infections abroad

Abstract
Background and Objectives Emerging infections abroad pose a threat to the safety of blood, donated by travelling blood donors. In this study, the yield of donor deferral after travelling was evaluated, by comparing the estimated numbers of infected donors returning from various affected areas. Methods A deterministic model was applied to calculate the number of infected donors, returning from six areas affected by outbreaks: Greece – Macedonia (West Nile fever), Italy – Emilia Romagna (West Nile fever), Thailand (chikungunya), Latvia (hepatitis A), central Turkey (Sicilian sandfly fever) and Italy – Tuscany (Toscana sandfly fever). Results The estimated number of infections among returning blood donors was surprisingly low, ranging from 0·32 West Nile virus-infected donors per year returning from Macedonia (Greece) to approximately 0·005 infected donors per year returning respectively from Tuscany (sandfly fever), Latvia (hepatitis A) and central Turkey (sandfly fever). Conclusion The yield of the temporary exclusion of blood donors travelling to a specific, affected area is low, but the continuous monitoring of emerging infections and the timely assessment of new threats are laborious and imperfect. Safety measures may be instituted after the greatest threat of a new outbreak has passed. A general deferral of travelling donors may be more appropriate than targeted measures. It can be argued that all donors who stayed outside their country or continent of residency should be deferred for 4 weeks.