TY - JOUR AU - Harvala, Heli AU - Reynolds, Claire AU - Brailsford, Su AU - Davison, Katy T1 - Fulminant Transfusion-Associated Hepatitis E Virus Infection Despite Screening, England, 2016–2020 T2 - Emerging Infectious Disease journal PY - 2022 VL - 28 IS - 9 SP - 1805 SN - 1080-6059 AB - In England, all blood donations are screened in pools of 24 by nucleic acid test (NAT) for hepatitis E virus (HEV) RNA. During 2016–2020, this screening successfully identified and intercepted 1,727 RNA-positive donations. However, review of previous donations from infected platelet donors identified 9 donations in which HEV RNA detection was missed, of which 2 resulted in confirmed transmission: 1 infection resolved with ribavirin treatment, and 1 proceeded to fatal multiorgan failure within a month from infection. Residual risk calculations predict that over the 5-year study period, HEV RNA detection was missed by minipool NAT in 12–23 platelet and 177–354 whole-blood donations, but transmission risk remains undetermined. Although screening has been able to largely eliminate infectious HEV from the blood supply in England, missed detection of low levels of HEV RNA in donated blood can lead to a severe, even fulminant, infection in recipients and could be prevented by more sensitive screening. KW - hepatitis E virus KW - blood donor KW - platelets KW - hepatitis KW - transmission KW - viruses KW - England KW - HEV KW - enteric infections DO - 10.3201/eid2809.220487 UR - https://wwwnc.cdc.gov/eid/article/28/9/22-0487_article ER - End of Reference