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Transfusion-acquired hepatitis A
1Department of Pediatrics, University of Oklahoma College of Medicine-Tulsa 74136.
Southern Medical Journal
|November 1, 1989
Summary
Hepatitis A outbreak linked to blood transfusion in a neonatal unit. Despite screening, infected blood products transmitted the virus, causing illness in some recipients and their contacts.
Area of Science:
- Hepatology
- Infectious Diseases
- Transfusion Medicine
Background:
- Hepatitis A virus (HAV) is a significant cause of acute liver inflammation.
- Blood transfusion is a potential route for pathogen transmission, necessitating rigorous screening protocols.
- Recent implementation of alanine aminotransferase (ALT) testing aims to mitigate transfusion-transmitted infections.
Observation:
- An outbreak of hepatitis A occurred in a neonatal intensive care unit (NICU).
- The outbreak was linked to a single unit of packed red blood cells and platelets from an infected donor.
- Several infants in the NICU received components from the implicated blood unit.
Findings:
- Four infants exposed via transfusion showed serologic evidence of recent hepatitis A infection, though remained asymptomatic.
- Symptomatic hepatitis A developed in several staff and family members exposed to the infants.
- An adult recipient of platelets from the same unit developed elevated liver enzymes, and his wife also showed serologic evidence of infection.
Implications:
- This case highlights the risk of transfusion-transmitted hepatitis A, even with current screening measures like ALT testing.
- It underscores the importance of donor vigilance and potential for occult hepatitis A transmission.
- Further strategies may be needed to enhance the safety of blood products against hepatitis A.