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# Appendix 4: Management of post donation illness

This appendix gives guidance on the management of donations taken from donors who report post donation illness with a (probable) infectious cause. The actions are based upon the nature and potential severity of the illness, relevant incubation period and the risk of the illness causing harm to a transfusion recipient.

Recipient notification and look-back/trace-back investigations are outside the scope of this guidance. Please follow local policies and procedures.

## Infections

Infection | Incubation period | Action for donation
--- | --- | ---
Bordetella pertussis (whooping cough) | 7 to 10 days | Discard if within 10 days
Borrelia burgdorferi (Lyme disease) | 3 to 30 days | Acute Lyme disease: discard up to 30 days. Chronic Lyme disease: no action required.
Costochondritis / Coxsackie virus (Bornholm disease) | 1 to 7 days | Discard up to one week
Coxsackie A (hand, foot and mouth disease) Usually Coxsackie A, but can be other enteroviruses | 3 to 7 days | Discard up to 7 days
Epstein-Barr virus (glandular fever) | 30 to 50 days | Discard up to 50 days
Hepatitis A (acute) | 2 to 6 weeks | Discard up to 7 weeks
Hepatitis B (acute) | 6 weeks to 6 months | Discard all in date components. Seek microbiological advice regarding recall of previous donations if the donor's history and/or testing results suggest this is an acute (recent) infection.
Hepatitis C (acute) | Up to 6 months | Discard all in date components. Seek microbiological advice regarding recall of previous donations if the donor's history and/or testing results suggest this is an acute (recent) infection.
Hepatitis E (acute) | 2 to 8 weeks | Discard up to 9 weeks
Herpes simplex (oral and genital) | 2 to 12 days for primary infection. Primary viraemia during incubation period, secondary viraemia at time of symptoms. | For primary infection: discard up to 14 days. For recurrent infection: no action required if recurrent lesion(s) and lesions were absent or healing when donated.
Human immunodeficiency virus (HIV) | n/a | Discard all in-date components at any interval after donation. Seek microbiological advice regarding recall of previous donations if the donor's history and/or testing results suggest this is an acute (recent) infection.
Human T-cell lymphotropic virus (HTLV) | n/a | Discard all in-date components at any interval after donation
Influenza | Influenza A: 1 to 5 days. Adenovirus: 4 to 5 days. | No action unless severe systematic symptoms (defined as fever/myalgia ± cough/cold symptoms). If present, discard up to 5 days.
Legionella (Legionnaires' disease, Pontiac fever) | Up to 3 weeks | Discard up to 3 weeks
Measles | 10 to 21 days | Discard up to 3 weeks
Mpox | 21 days | Discard up to 21 days. Follow local processes for public health notification if the component has been transfused. If the donor has reported contact with mpox in the 21 days before donation, place the donation on hold and seek public health advice to determine the risk.
Mumps | 16 to 18 days. Primary and secondary viraemia. | Discard up to 3 weeks
Mycoplasma (M. pneumoniae) | 1 to 4 weeks. Mostly headache, malaise, fever, 5–10% progress to pneumonia. | Discard up to 3 weeks
Parvovirus B19 (Fifth disease, Slapped cheek syndrome) | 13 to 20 days | Discard up to 3 weeks
Rubella (German measles) | 14 to 21 days | Discard up to 3 weeks
SARS-CoV-2 (COVID-19) | 2 to 14 days | Discard if: A SARS-CoV-2 test has been taken and COVID-19 confirmed, and Symptoms and/or the positive test result occurred in the 48-hour period after donation. If a SARS-CoV-2 test is negative or has not been taken, refer to the relevant advice on this page for the donor's symptoms.
Tuberculosis | n/a | Discard all in-date components at any interval post donation. Look-back to relevant transfused recipients.
Varicella zoster (chickenpox) | 10 to 21 days | Discard if within 3 weeks
West Nile Virus | 3 to 15 days | Discard up to 15 days

## Conditions

Condition | Action for donation
--- | ---
Appendicitis | No action if confirmed appendicitis and asymptomatic at the time of donation
Chest infection | No action unless systemic symptoms; if present discard up to 5 days
Common cold | No action unless symptoms
Conjunctivitis | No action providing well on the day
Diarrhoea and vomitting | Causes may include (incubation period given below): Salmonella (12 to 72 hours) Shigella (1 to 7 days) Campylobacter (1 to 11 days) Rotavirus (24 to 72 hours ) Norovirus (1 to 2 days) Cryptosporidium (2 to 5 days) Yersinia (4 days) With all the above, likely to be significant bacteremia or viraemia. Staphylococcal, clostridium and Bacillus cereus food poisoning is all toxin-induced. Discard up to 14 days. If this is an episode of food poisoning which occurred after the donation, no action required.
Jaundice | Assess whether infective cause possible. Discard all in-date components after any notification if infection is a possible cause: See specific entry if infective cause identified Discard not required if a non-infective cause (e.g. drug reaction) has been identified
Malaria | With any disclosure of illness or risk after donation, follow local policies and procedures.
Shingles (herpes zoster) | Possible viraemia for 48 hours from symptoms and/or rash. Discard if rash or any symptoms develop within 48 hours. Symptoms include tingling of skin, pain or eruption of vesicles.
Skin disease - cellulitis/erysipelas | Caused by Streptococcus pyogenes. Discard up to 1 week.
Skin disease - impetigo | Caused by Group A streptococcus / Staphylococcus aureus. 3 to 5 days incubation period. No action if no systemic symptoms; if present, discard up to 1 week.
Sore throat | May include: Rhinovirus Group A streptococcus (2 to 4 days incubation period) Epstein-Barr virus (0 to 50 days incubation period) If a sore throat is accompanied by simple cold symptoms and no systemic symptoms, no action is required. Systemic symptoms include malaise, myalgia, fever, headache. If systemic symptoms, discard up to 1 week. If glandular fever, discard up to 50 days.
Transmissible spongiform encephalopathy (prion disease) | If informed of a possible or confirmed case of prion associated disease, recall (do not discard) any in date components. Follow local policies and procedures.
Urinary tract infection (UTI) | If symptomatic at donation: discard. If asymptomatic at donation: no action unless systemic symptoms, then discard up to 5 days. Systemic symptoms include malaise, myalgia, fever and headache.

Last updated in WB-DSG Edition 203 Release 63 (31 May 2022)

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