Global Alert and Response (GAR)

WHO Recommendations on SARS and Blood Safety

15 May 2003

These guidelines are constantly reviewed and updated, as new information becomes available. These are compiled to provide a generic basis on which national health authorities may wish to develop guidelines applicable to their own particular circumstances.

Although no probable SARS case has been ascribed to transmission by labile blood products or blood derivatives, there is a theoretical risk of transmission of the SARS virus through transfusion of labile blood products*, since low viraemia has been detected up to approximately 10 days after the onset of symptoms from probable SARS patients (see Identification of a Novel Coronavirus in Patients with Severe Acute Respiratory Syndrome).

The Department of Blood Safety and Clinical Technology (WHO/BCT), World Health Organization, proposes the following recommendations as precautionary principles to address the theoretical SARS risk through transfusion of labile blood products.

These include:

  • Deferral of blood donations from donors in the categories listed.
  • The blood transfusion services (BTSs) to ask the blood donors who have donated blood, to report if diagnosed as suspect or probable SARS case within 1 month after blood donation and the BTSs to recall the blood products still not transfused.
  • For countries with existing systems and facilities to trace recipients of blood, to follow up the recipients who have received blood/blood products from the donors presenting within one month after donation fulfilling the probable case definition of SARS.

These recommendations may also be the basis of screening criteria for organs, tissues and cells for transplantation, taking into consideration that precautionary measures, in particular for travellers from areas with recent local transmission, need to be balanced with the benefit of transplantation for the patient. The BTSs staff should be aware of the recommendations for health care workers on prevention of SARS.

For a case definition of SARS, consult Case Definitions for Surveillance of Severe Acute Respiratory Syndrome (SARS)

For viral inactivation procedures used in the manufacturing of plasma derived products

For full details about SARS

Geographic Region

Donation of Blood

Areas with recent local transmission**

  • Asymptomatic, no close contact ***
  • Yes
  • Asymptomatic, with close contact
  • Deferral for 3 weeks after the last day of contact
  • Symptomatic, probable case SARS
  • Deferral for 3 months after full recovery and cessation of therapy
  • Symptomatic, suspect case SARS
  • Deferral for 1 month after full recovery and cessation of therapy
  • Symptomatic, SARS excluded ****
  • Follow national/local donor selection guidelines
Areas with no recent local transmission
Travellers from areas with recent local transmission
  • Asymptomatic
  • Deferral for 3 weeks after the last day of return
  • Symptomatic, probable case SARS
  • Deferral for 3 months after full recovery and cessation of therapy
  • Symptomatic, suspect case SARS
  • Deferral for 1 month after full recovery and cessation of therapy
  • Symptomatic, SARS excluded ****
  • Follow national/local donor selection guidelines
Travellers from areas with no recent local transmission
  • Follow national/local donor selection guidelines

* Labile blood products- whole blood, red cell preparations, platelet preparations, granulocyte preparations, fresh frozen plasma and cryo-precipitate.

** A region at the first administrative level where the country is reporting local transmission of SARS.

*** Having cared for, lived with, or had direct contact with respiratory secretions or body fluids of a suspect or probable case of SARS.

****A case should be excluded if an alternative diagnosis, by clinical or laboratory procedures can fully explain their illness. (see SARS: Availability and use of laboratory testing)

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