Evaluating the impact of public health notification of suspected transfusion-transmissible hepatitis C virus infection and effectiveness of lookback and traceback investigations by Canadian Blood Services in British Columbia, Canada, August 2002 through February 2005.
BACKGROUND
Suspected transfusion-transmissible infections (TTIs) have been reported to public health (PH) in British Columbia (BC) since August 2002. The impact of PH notification of suspected transfusion-transmissible hepatitis C virus (TT-HCV) infection over the first 2.5 years and the effectiveness of HCV lookback (LB) and traceback (TB) investigations conducted by Canadian Blood Services (CBS) in BC were evaluated.


METHODS
Suspected TT-HCV cases reported to CBS in BC between August 28, 2002, and February 28, 2005, were analyzed. The incremental yield of plausible TTIs from PH-reported suspected TTIs was calculated. The effectiveness of LB and TB investigations was assessed with respect to the impact of improved anti-HCV donor screening, the number of newly recognized HCV infections, and the timeliness of initiating investigations.


RESULTS
Nine of 553 (1.6%) investigations were initiated after PH reporting, yielding an additional 2 of 237 (i.e., 0.8%) plausible TTIs. Ninety-two percent of investigations with transfused units involved transfusions before implementing second-generation anti-HCV enzyme immunoassay (EIA) donor screening. Almost one-third of HCV-infected persons in linked investigations (i.e., LB triggered by a TB and vice versa) were newly identified. Recently tested, PH-reported cases incurred a mean delay exceeding 6 months until initiating a LB or TB investigation.


CONCLUSIONS
PH reporting of TTIs and investigating transfusions after second-generation anti-HCV EIA donor screening identified few plausible TT-HCV infections. Many HCV-infected recipients or lapsed donors first became aware of their infection status as a result of CBS investigations. The current process of reporting suspected TTIs incurs significant time delay.
Whitlock
Mandy
M
British Columbia Center for Disease Control, Canadian Blood Services, BC & Yukon Center, 4750 Oak Street, Vancouver, British Columbia, Canada.
Lord
Sandra
S
Buxton
Jane A
JA
Doyle
Patrick
P
Bigham
Mark
M
D001782:Blood Donors; D002170:Canada; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D011634:Public Health; D013997:Time Factors; D065227:Transfusion Reaction
D018937:Hepatitis C Antibodies