WNV Data Analysis Suggests Mosquito Monitoring and Weather

2013 #26
INSIDE:
Our Space: What on Earth
do Railroads Have to do
with Blood Banking? ..... 2
Phyllis Ericson Retires as
CEO of Nebraska
Community Blood Bank 4 Greg Hart retires as
President and CEO of
The Blood Connection .. 5 The FABC Working for
You – Spotlight on Blood
Donation PSA in Haiti ... 7 Q&A with ABC’s Executive
Services & Accounting
Department ................... 8
RESEARCH IN BRIEF .... 9 BRIEFLY NOTED .......... 11 LEGISLATIVE NEWS ... 13 GLOBAL NEWS ............ 13 INFECTIOUS DISEASE
UPDATES .................. 14 STOPLIGHT®: Status of
the ABC Blood Supply
2012 vs. 2013 ............. 15 MEMBER NEWS ........... 15 COMPANY NEWS ........ 15 July 19, 2013
WNV Data Analysis Suggests Mosquito Monitoring and Weather
Patterns May Help Predict, Prevent Future Outbreaks
Last summer, the US experienced the largest West Nile virus (WNV) outbreak
ever seen in the US, with 5,674 total cases reported to the Centers for Disease
Control and Prevention in 2012. An analysis of the 2012 WNV outbreak in Dallas
County, Texas, which had an especially high number of cases, suggests that monitoring mosquitoes and understanding weather and geographical patterns of past
outbreaks may help to predict and prevent future WNV outbreaks.
A group of researchers, led by Robert W. Haley, MD, director of the Division of
Epidemiology at the University of Texas Southwestern Medical Center, used data
from the 2012 WNV epidemic in Dallas and 11 years of prospective WNV human
and mosquito surveillance to address questions about the causes and the most
effective surveillance and control measures for minimizing future outbreaks.
Their results, published Wednesday in The Journal of the American Medical Association, showed that the two largest WNV outbreaks in Dallas were preceded by
a mild winter followed by an early, warm spring season. Also, areas with higher
property values, greater housing density, and a higher percentage of unoccupied
houses were found to be WNV hot-spots during both outbreaks. Perhaps most
importantly, the researchers suggested that public health authorities closely monitor the mosquito vector index (an estimate of the average number of WNVinfected mosquitoes per trap-night) in real-time, and use a predictive threshold to
determine when mosquito control measures should be implemented to prevent
human WNV infection and future outbreaks.
MEETINGS ................... 16 POSITIONS AVAILABLE
................................... 17 The researchers analyzed public health surveillance data of Dallas County, which
included the number of residents diagnosed with WNV between May 30, 2012
and December 2012, mosquito trap results, weather data, and syndromic surveillance from area emergency departments. They calculated incidence and ageadjusted incidence rates for West Nile neuroinvasive disease (WNND), daily
prevalence of emergency department visits for asthma and skin rash, and Culex
quinquefasciatus mosquito (the primary local West Nile vector) species-specific
vector index.
The investigators identified 173 cases of WNND, 225 cases of West Nile fever,
and 19 deaths due to WNV in Dallas County. The incidence rate for WNND was
7.30 per 100,000 residents in 2012, compared with 2.91 per 100,000 in 2006, the
second-largest WNV Dallas County outbreak. An unusually rapid and early
(continued on page 3)
ABC Newsletter
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July 19, 2013
OUR SPACE
ABC President Dave Green
What on Earth do Railroads Have to do with Blood Banking?
I admit I was a bit skeptical when I learned that ABC’s Meetings Committee had arranged to have Mark Fagan
from Harvard deliver a two hour presentation on how the railroad industry offers us insights into our unprecedented environmental challenges. After all, what do railroads have in common with blood banks? Following
the truly dynamic and interactive session by Mr. Fagan at last March’s ABC Annual Meeting, I (and I believe
other attendees) awakened to the incredible wealth of knowledge other industries could offer in helping us
thrive in difficult times. Based on the immensely positive feedback on this session, the Meetings Committee
planned for the August ABC Interim Meeting in Milwaukee to build on the discussion started in March by
welcoming Mr. Fagan back to help guide us through a discussion on how ABC should deliver value to you –
ABC’s member blood centers.
ABC has a long standing tradition of serving its members. Over the past few months, the ABC board has
championed (and the ABC staff has expertly led) a shift in emphasis aimed at focusing on ABC’s core values:
Advocacy, Education, Data, and Innovation. At the same time, we are searching for a new CEO to lead ABC
into the future. The August Interim Meeting therefore is a great opportunity for members to come together and
engage in thought-provoking, creative, and meaningful discussions designed to chart our course forward; in
essence the board is asking you to join in designing the architecture for the ABC of tomorrow. What matters
most to your centers? How can ABC best leverage the interests and assets of center’s supplying more than half
the nation’s blood supply to enhance the membership’s ability to serve our communities? How do we define,
measure, and deliver value? How do we fund these activities? These are tough questions but we are confident
that tackling them together, will produce the clarity of purpose and collective resolve to continue delivering
the value ABC members want and deserve. Most importantly, however, we need you to bring your ideas to
this discussion.
If you are already scheduled to attend the August session with Mr. Fagan, we look forward to seeing you
there. If you are not yet committed to attending, we ask you to reconsider and join in this important dialogue.
We are eager to chart our roadmap forward together.
[Editor’s Note: Mr. Fagan’s presentation will take place on Monday, Aug. 5 from 11 to 11:45 a.m., and will
continue after lunch from 1 to 3 p.m. ABC members may contact Lori Beaston for registration details at
lbeaston@americasblood.org]
dgreen@mvrbc.org
The ABC Newsletter (ISSN #1092-0412) is published 46 times a
year by America’s Blood Centers® and distributed by e-mail.
Contents and views expressed are not official statements of ABC or
its Board of Directors. Copyright 2013 by America’s Blood
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obtain prior permission if proper credit is given.)
America’s Blood Centers
President: Dave Green
Interim Chief Executive Officer: William M. Coenen
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Business Manager: Leslie Norwood
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ABC Newsletter
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July 19, 2013
Dallas WNV Outbreaks (continued from page 2)
escalation of a large number of human cases closely followed increasing infection in mosquitoes. There
was a statistically significant association between increases in the vector index and increases in WNND
cases with symptom onset one to two weeks later. The researchers also found that a vector index threshold of 0.5 in June or July distinguished the two largest epidemics from the remaining nine years, which
had minimal human illness.
The data suggest it may be too late to initiate mosquito control activities when significant numbers of
human cases and deaths are reported to prevent cases already incubating. Rather, a vector index threshold
should trigger vector control measures. “Our findings support incorporating mosquito infection indices
into response plans and closely monitoring the mosquito vector index in real time,” write the authors.
“The goal is to recognize significant increases above historically predictive thresholds of epidemic transmission when augmented mosquito control measure can prevent the most human illness.” While the
precise vector index threshold may vary by region, both this analysis and the CDC identified 0.5. (CDC’s
updated guidelines for WNV prevention, surveillance, and control can be found at
www.cdc.gov/westnile/resources/pdfs/wnvGuidelines.pdf.)
In the geographical analysis, the researchers found that WNND cases clustered in the north half of the
county over the entire 11 years studied, with one particular “hot spot” identified in the north central region characterized by higher property values, greater housing density, and a higher percentage of houses
unoccupied. This may be because these neighborhoods have more neglected swimming pools that amplify
mosquito populations and may also sustain lower bird species diversity associated with greater virus amplification. These findings should encourage more intensive public health prevention measures in similar
areas with a history of WNV outbreaks.
Another common thread among the two Dallas County WNV outbreaks was the weather pattern. The
mild winter may have allowed more infected female mosquitoes to survive the winter, and the early
spring with warm temperatures allowed for a longer period of mosquito-bird transmission with an early
start to human infections. Identifying climate patterns that are conducive to WNV outbreaks can “alert
health departments to seasons requiring particularly heightened preseason control measures and expanded
vector surveillance,” write the authors.
The authors conclude that other areas with wide variations in WNV activity between seasons, like Dallas,
should “consider conducting an analysis of local WNV history to identify predisposing weather patterns
and perennial high-risk geographical areas to efficiently direct pre-season prevention measures and surveillance resources.” The findings also highlight the importance of “continuing investments in robust
mosquito surveillance programs, including sufficient numbers of traps, rapid testing of mosquitoes, timely
collation of information, and establishment of local baseline patterns.”
WNV and Blood Donation. WNV can be transmitted through infected blood donations, and blood centers screen for WNV infection in donors. The authors of the current analysis identified 17 WNV-positive
blood donors in Dallas County during 2012. Carter BloodCare, an ABC member blood center that serves
58 counties in north, central, and east Texas, reacted to the local outbreak last summer by activating individual donor nucleic acid testing (ID NAT) to screen for WNV in the most highly affected regions, Laurie
J. Sutor, MD, MBA, vice president of Medical and Technical Services at Carter BloodCare, told the ABC
Newsletter. (see ABC Newsletter, 8/24/12). The center identified 72 positive donors throughout its entire
service area (58 counties) during 2012.
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July 19, 2013
Dallas WNV Outbreaks (continued from page 3)
Dr. Sutor said this study suggests that “improved predictive models could help blood centers monitor for
onset of the West Nile season. Further, as this article illustrates, working closely with our local health
departments can benefit both donors and patients.”
The JAMA article is available at http://jama.jamanetwork.com/article.aspx?articleid=1713591.
Citation: Chung WM, et al. The 2012 West Nile encephalitis epidemic in Dallas, Texas. JAMA.
2013;310(3):297-307. 
Phyllis Ericson Retires as CEO of Nebraska Community Blood Bank
Nebraska Community Blood Bank (NCBB), a division of Innovative Blood Resources, announced in a
July 1 press release the retirement of Phyllis Ericson, MS, MT(ASCP) a long-time NCBB senior executive. Ms. Ericson had a 24-year career with NCBB and spent nearly 40 years in the healthcare industry.
Don Berglund, CEO of Innovative Blood Resources, said in the release, “Phyllis
has been, and will continue to be, an outstanding leader in the Nebraska community. And she is leaving a rich legacy of exemplary work within the
community of non-profit blood banks around the country, and in our communities as well.”
The press release notes that Ms. Ericson has “demonstrated a deep commitment
to the cause of blood donation, to the safety of volunteer donors and recipients,
and to ensuring that safe and reliable blood is readily available to those who
need it.” Under Ms. Ericson’s leadership, she led NCBB to build and sustain a
“stellar reputation for quality and service excellence” and to become the first
blood center to inventory 100 percent leukoreduced red cells to patients, according to the release.
Over the years, Ms. Ericson has been actively involved with America’s Blood Centers. “The ABC family
will miss Phyllis. She has supported ABC initiatives by serving on the board of directors and many ABC
committees,” said ABC Interim CEO William M. Coenen. “I remember many years ago when the ABC
Financial Ratio survey and report was floundering, Phyllis took charge and single-handedly restored this
valuable tool. We all wish her happiness and good health in her retirement.”
Ms. Ericson plans to pursue her passions for gardening, traveling, and genealogy in her retirement. Ellen
DiSalvo, MBA, MT(ASCP), SBB, vice president of Laboratory Services at Innovative Blood Resources,
will expand her responsibilities to oversee services to the organization’s Nebraska-based hospital partners
and provide leadership for Nebraska operations, including the Nebraska Community Advisory Board. 
ABC Newsletter
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July 19, 2013
Advertisement
Greg Hart retires as President and CEO of The Blood Connection
The Blood Connection, headquartered in Greenville, S.C., announced on Monday that Greg Hart,
MT(ASCP)SBB, will retire as president and CEO of the center in December, after more than 15 years at
the helm of this organization.
“Greg Hart has been a strong leader in the center’s 34-year history and
steadily increased the organization’s ability to collect, process, test, and
distribute blood components to people in need,” said Scott Pietras, chair of
The Blood Connection’s board. “The board is grateful for his innumerable
contributions to the organization and his distinguished tenure has helped
the center become the preeminent, independently managed, non-profit
community blood center in the region.”
Mr. Hart, who has had a 40-year career in blood banking and became president and CEO of The Blood Connection in 1998, has led the organization
through steady growth over the years, said the release. Under his leadership, blood collections more than doubled, five new donation centers were
constructed, and a sixth donation center is currently in the works. Also
during Mr. Hart’s tenure, a state-of-the-art headquarters and biologics processing center was constructed
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July 19, 2013
Greg Hart to Retire (continued from page 5)
to more effectively test and manage vital community blood donations. The center’s services grew to include cellular therapy and immunohematology reference lab services.
“When I came to The Blood Connection, it had a great heritage of blood services stewardship and worthy
not-for-profit goals of providing the highest quality blood supplies and services at the lowest possible
cost. While keeping those same goals intact, the past 15 years have been a time of collective challenge
and accomplishment for all of us at The Blood Connection, and it has been with great personal gratification and pride that I have worked with our committed board and staff, supportive sponsor organizations,
and the community donors themselves,” said Mr. Hart. “Without their support, we could not do what we
do.”
Mr. Hart has served as a board member and vice chair of the Foundation for America’s Blood Centers
(FABC) board, and has served on various America’s Blood Centers committees. He is the current board
chair of The Community Blood Centers’ Exchange, Inc. and Attorney in Fact for The Community Blood
Centers’ Exchange Risk Retention Group (BCx), a provider of professional and general liability insurance
and risk management services for blood centers. He has served as chair for BCx’s governance committee
and is the current chair of BCx’s audit committee and its claims committee. He is currently on the Standardization Committee for Blood Centers of America. He served for eight years as a director for Donate
Life South Carolina and two terms as board chair for that organization.
“In addition to growing and leading an extremely successful blood center, The Blood Connection, Greg
Hart has been instrumental in the broader blood banking community, helping to innovate and facilitate
critical solutions to enhance our collective ability to serve our communities. ABC congratulates Greg on
his outstanding career and significant contributions to our mission,” said ABC President Dave Green.
The Blood Connection’s board of trustees has begun a leadership transition that will take place over the
next six months. (Source: The Blood Connection, 7/15/13) 
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ABC Newsletter
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July 19, 2013
The FABC Working for You – Spotlight on Blood Donation PSA in Haiti
The Foundation for America’s Blood Centers (FABC) funds initiatives that improve the availability, quality, and
safety of blood to save, extend, or enhance the lives of patients. The FABC works through funding projects spearheaded by America’s Blood Centers’ members, as well as ABC initiatives that benefit its member blood centers.
While most of America’s Blood Centers’ members are aware of the FABC’s work to support programs
that seek to improve the safety and quality of the blood supply in the US, they may not realize that the
FABC’s efforts also have a global reach. The FABC’s dedication to global leadership has most recently
been demonstrated through a blood donation public service announcement (PSA) created and airing in
Haiti funded by the FABC.
As part of the FABC’s 2013 grant awards, Oklahoma Blood Institute received $4,190, working with
representatives of the National Blood Safety Program in Port-au-Prince, Haiti to provide funding for
production of a TV ad that would increase donor
participation and improve the sufficiency and safety
of the blood supply in Haiti.
“The challenge [in Haiti] is to increase blood donation from 25,000 blood units to 35,000. People have
some taboos related to blood donation by lack of In a Haitian blood donation public service announcement,
information; that’s why it was very important to funded by the FABC, Haitian comedian Tonton Bicha plays a
create this public service announcement,” said Ernst previously skeptical blood donor who becomes a regular
Noel, MD, director of Haiti’s National Blood Safety donor following a positive first donation experience.
Program, who coordinated the PSA production. “The goal is to attract new volunteer blood donors and to
increase repeated volunteer blood donation by giving information about the demands [for donated blood]
and also about some misinformation related to blood donation.”
The TV ad features a famous Haitian comedian, Tonton Bicha, who rushes out of the blood center, enraged that he has been asked to donate blood, when he is met by a blood drop “donation mascot,” who
encourages him to give blood and clears up some misconceptions that the man has regarding blood donation. The blood drop then introduces the man to a woman who needs a blood donation for her child,
which convinces him to make his first blood donation. By the end of the ad, the man has been converted
to a blood donor, asking the nurse how often he can give blood.
The main message of the ad is that “giving blood is safe and helps patients to become healthier,” said Dr.
Noel. He added that advertising is a vital component of the National Blood Safety Program’s promotional
activities. “The funding [from the FABC] permitted us to achieve this objective by assisting with the cost
of the ad’s production.”
“One of the FABC’s main initiatives is global leadership in improving blood safety and availability. We
are proud to have supported the production of a TV ad with the potential to increase voluntary blood donations in Haiti,” said FABC Board Chair Francine Décary, MD, PhD. 
ABC Newsletter
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July 19, 2013
Advertisement
Q&A with ABC’s Executive Services & Accounting Department
America’s Blood Centers’ Staff Answers your Questions
America’s Blood Centers recently conducted its SEQuaLS assessment, a customer service survey that solicits
feedback from member blood centers on ABC’s activities. Through this assessment, members were able to
pose questions to the ABC staff. Each ABC department will respond to these questions through this weekly
Q&A column in the Newsletter.
Q: Does ABC make available financial data from its member centers to compare blood center operations?
A: Yes, every year, ABC conducts a financial ratio survey and publishes a financial ratio report, which
lists key financial indicators. This tool was created more than 30 years ago and provides blood centers
with a powerful resource for managing their blood programs, benchmarking critical operational data with
peers, and identifying best practices. This information can also be a useful tool in communicating with
blood center boards of directors and local constituencies about the blood center’s financial profile. More
than 98 percent of ABC’s member blood centers participate annually in this survey. ABC members must
(continued on page 9)
ABC Newsletter
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July 19, 2013
Q&A with ABC (continued from page 8)
participate in the survey to obtain the survey results. For more information about this survey contact ABC
Interim CEO William M. Coenen at wmcoenen@americasblood.org.
[Editor’s Note: The ABC staff has nearly completed answering the questions asked by members through the
SEQuaLS assessment and will be winding down these columns. If you have additional questions that you
would like answered by an ABC staff member, please send them to newsletter@americasblood.org. ABC
thanks its members who took the time to complete the SEQuaLS survey, and hopes that these Q&A columns
have been informative.] 
RESEARCH IN BRIEF
American Red Cross (ARC) data published in the July issue of Transfusion shows that the risk of
TRALI has been significantly reduced among blood groups A, B, and O, but not for AB, likely due
to continued reliance on group AB plasma from female donors. This data was also presented by the
study’s lead author Anne F. Eder, MD, PhD, at last week’s AABB workshop on TRALI risk-reduction
(see ABC Newsletter, 7/12/13). ARC began preferentially distributing plasma from male donors in 2007
and subsequently observed an 80 percent decrease in TRALI after plasma transfusion. While 99 percent
of plasma distributed for groups A, B, and O are collected for males, only 60 percent for group AB are
from males, due to the growing demand for AB plasma. ARC compared the rate of suspected TRALI per
distributed plasma components before 2006 and after (2008-2011) implementing predominantly maledonor plasma strategy. As described during last week’s workshop, the risk of TRALI from the general
inventory of distributed plasma decreased significantly from 18.6 cases per million units in 2006 to 4.2
cases per million units in 2009 to 2011. However, the risk from AB plasma did not change and was significantly greater than group A, B, and O plasma in 2008 to 2011. The researchers conclude that these
data reflect continued reliance on group AB plasma from female donors to meet increasing demand, suggesting that the residual risk of TRALI is primarily due to transfusion of AB plasma from human
leukocyte antigen (HLA) or human neutrophil antigen (HNA) antibody-positive female donors.
Citation: Eder AF, et al. The residual risk of transfusion-related acute lung injury at the American Red
Cross (2008-2011): limitations of predominantly male-donor plasma mitigation strategy. Transfusion
2013. July;53(7):1442-9.
An review recently published in The Cochrane Database of Systematic Reviews suggests that delayed
umbilical cord clamping improves iron stores and hemoglobin levels in infants without increasing
risk for the mother. In most deliveries, doctors clamp and sever the umbilical cord less than a minute
after the infant’s birth, but studies have suggested benefits to the infant from delaying the umbilical cord
clamping. Cutting the umbilical cord immediately is generally done to reduce the risk of maternal hemorrhaging, but the new review found that delaying clamping for at least a minute after birth significantly
improves iron stores and hemoglobin levels in newborns and does not increase risk to mothers. The researchers, led by Susan J. McDonald of the Midwifery Professorial Unit at La Trobe University and
Mercy Hospital for Women in Australia, searched for randomized controlled trials comparing early and
late cord clamping, and assessed trial quality for eligibility in the review. They included 15 trials involving 3,911 women and infant pairs. There were no significant differences between the early vs. late cord
clamping groups in severe postpartum hemorrhage and no significant differences in mean blood loss or
maternal hemoglobin values. Newborns with later clamping had higher hemoglobin levels 24 to 48 hours
postpartum and were less likely to be iron-deficient three to six months after birth,
(continued to page 10)
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RESEARCH IN BRIEF (continued from page 9)
compared with term babies who had early cord clamping. While some experts find the data persuasive, an
American College of Obstetricians and Gynecologists committee examined many of the same studies in
December 2012 and found the evidence “insufficient to confirm or refute the potential for benefits from
delayed umbilical cord clamping in infants, especially in settings with rich resources,” according to The
New York Times. The committee cited the risks of jaundice and the relative infrequency of iron deficiency
in the US as reasons for not changing the practice of immediate cord clamping and cutting. Although not
mentioned in the review, delayed umbilical cord clamping may have an adverse impact on cord blood
collections.
Citation: McDonald SJ, et al. Effect of timing of umbilical cord clamping in term infants on maternal
and neonatal outcomes. Cochrane Database Sys Rev. 2013 July 11. [Epub ahead of print]
A study published on July 3 in the American Journal of Sports Medicine suggests that leukocyteenriched platelet-rich plasma (PRP) therapy may have modestly improved “tennis elbow” symptoms. PRP therapy has been publicized in recent years through the media as a successful treatment for
various injuries of high-profile athletes. A PRP treatment involves drawing a small amount of blood and
separating out the platelets, which are then injected into the injured area to stimulate tissue repair. While
studies have shown that PRP might augment healing and repair, there is a lack of high quality clinical
evidence supporting its efficacy, which was highlighted in a December 2011 issue of Blood Bulletin
(available to ABC members at http://members.americasblood.org/go.cfm?do=FileCenter.Get&fid=3499).
Led by Allan K. Mishra, MD, of the orthopedic surgery department of the Menlo Medical Clinic at Stanford University Medical Center, a group of researchers conducted a randomized control trial of 230
patients with chronic lateral tennis elbow, treated over five years at 12 centers. The patients, who were
symptomatic for at least three months and unresponsive to conventional therapy, were divided into two
groups: PRP recipients or active controls. Patients and investigators were blinded throughout the study;
patients were treated with or without PRP after receiving local anesthetic, and were followed up for 24
weeks. At 12 weeks, the PRP-treated patients reported an improvement of 55.1 percent in their pain
scores, compared with 47.4 percent in the active control group (P = 0.94). At 24 weeks, the PRP-treated
patients reported an improvement of 71.5 percent in their pain scores compared with 65.1 percent in the
control group. The percentage of patients reporting significant elbow tenderness at 12 weeks was 37.4
percent in the PRP group vs. 48.4 percent in the control group. At 24 weeks, 29.1 percent of the PRPtreated patients reported significant elbow tenderness vs. 54 percent in the control group. The success
rates for patients with 24 weeks of follow-up were 83.9 percent in the PRP group, compared with 68.3
percent in the control group. Although this difference was statistically significant, the success rate in the
control group was non-negligible. It is important to note that the pain score improved only moderately in
the PRP group when compared to the controls, and that there were no significant differences in function
between the two groups based upon response to the Patient-Rated Tennis Elbow Evaluation. Although
there were no severe side effects to the therapy, the number of patients treated is too small to exclude
significant reactions occurring at low rates. There are some limitations to the study, including that the
results are specific to tennis elbow and may not be applicable to other sites. Also, conventional therapy
had failed for three months in these patients, which means that the findings may not apply to the majority
of cases of tennis elbow. The study was unable to accrue the patient cohorts required by power calculations and there was no statistical adjustment for the multiple outcome comparisons made. Experts note
that before embracing this therapy as a standard-of-care, additional confirmatory trials are needed, and a
standardized protocol for the preparation of PRP needs to be established.
Citation: Mishra AK, et al. Platelet-Rich Plasma Significantly Improves Clinical Outcomes in Patients
with Chronic Tennis Elbow: A Double-Blind, Prospective, Multicenter, Controlled Trial of 230 Patients.
Am J Sports Med. 2013 July 3. [Epub ahead of print] 
ABC Newsletter
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July 19, 2013
BRIEFLY NOTED
The first of a four-part series on the costs of transfusion was published in the July issue of Transfusion. “Healthcare costs in the US are increasingly overwhelming individuals, communities, and
governments,” write authors Seema Kacker, Kevin D. Frick, and Aaron A.R. Tobian. Healthcare spending
is increasing faster than overall gross domestic product, and the field of transfusion medicine has not been
isolated from these changes. Blood transfusion costs have increased dramatically over the past two decades, due in-part to increased demand, increased utilization of risk-reduction methods, and the
development and implantation of new technologies for donation and transfusion, write the authors. One
approach to cost containment has been a growing use of economic evaluation. In a series of four review
articles published in Transfusion, the authors will introduce and discuss the concepts and motivation behind conducting and interpreting economic analyses relevant to transfusion medicine. The first article
provides an overview of costing methods in the context of transfusion medicine and discusses the purpose
behind conducting economic evaluations. This article is available to subscribers or for purchase at
http://onlinelibrary.wiley.com/doi/10.1111/trf.12188/abstract.
Citation: Tobian AA, et al. The costs of transfusion: economic evaluations in transfusion medicine, Part
1. Transfusion. 2013 July;53(7):1383-5.
BRIEFLY NOTED (continued on page 12)
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BRIEFLY NOTED (continued from page 11)
Through its summer blood donation campaign, the Armed Services Blood Program (ASBP) is asking donors to roll up their sleeves and “join the ASBP ‘arms’ race” by donating blood. “Every arm is
needed this summer, and we take all types,” said the ASBP in a July 1 press release. “Our summer campaign this year is a service-specific campaign,” said Julie Oliveri, ASBP Communications and Marketing
director. “In this way we hope to ensure our military family is ‘armed’ with the blood products needed for
those who are ill or injured.” Starting July 1 and ending Sept. 30, the campaign will be deployed at 23
ASBP blood donor centers worldwide. “A single whole blood donation to the military blood program has
the potential to save up to three lives,” said Air Force Col. Richard H. McBride, ASBP director. “That can
make a huge difference, especially since donations tend to decrease during the summer.” Col. McBride
added that donations sometimes slow down this time of year because the military blood program’s eligible donors are on vacation. Although donors get their well-deserved summer time off, the need for blood
donations is ongoing. Rose Lori Briggs has become an avid blood donor at the Robertson Blood Center at
Fort Hood, Texas, after years of watching her father donate blood when she was a child. “(My father)
donated every eight weeks despite the busy summer season or vacations, and I try to do the same,” said
Ms. Briggs. “Luckily, the ASBP makes it easy to fit donating into my schedule with walk-in appointments.” All of the blood collected by ASBP directly support ill or injured service members, veterans, and
their families worldwide. More information about the ASBP’s summer donation campaign can be found
at http://1.usa.gov/11VieVw. (Source: ASBP press release, 7/1/13) 
ASBPO will not Attend this Year’s AABB Annual Meeting
The Armed Services Blood Program Office (ASBPO) announced in a statement from the director, Col. Richard
H. McBride, that ASBPO will not be able to attend or host the military blood program workshop at this year’s
AABB Annual Meeting & CTTXPO to be held Oct. 12-15 in Denver, Colo. The decision was made under the
direction of the Assistant Secretary of Defense for Health Affairs due to financial restrictions caused by ongoing
federal budget issues requiring the military departments and the Office of the Secretary of Defense to reduce
overall spending. ASBPO hopes to attend next year’s conference pending that the budget issues are resolved. A
full statement is available at http://1.usa.gov/18mZxve.
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July 19, 2013
LEGISLATIVE NEWS
Stephen J. Ubl, president and CEO of the Advanced Medical Technology Association (AdvaMed),
released a statement on July 8 supporting a proposed comprehensive tax reform repeal of the medical device tax. “AdvaMed commends the efforts of the Ways and Means Committee Chairman Dave
Camp (R-MI) and Senate Finance Committee Chairman Max Baucus (D-MT) to advocate comprehensive
US tax reform to improve America’s Competitiveness and rebuild our nation’s economic future. We look
forward to working with them as they develop their legislation,” said Mr. Ubl. The tax, authorized as part
of the Patient Protection and Affordable Care Act, is levied on medical device manufacturers, suppliers,
and importers, and like other excise taxes is considered an indirect cost on consumers. Under the 2.3 percent tax, device manufacturers are required to pay an estimated average of 194 million per month in
medical device tax payments. “This tax threatens a medical device industry that helps employ 2 million
nationwide, generates approximately $25 billion in payroll, pays out salaries that are 40 percent higher
than the national average and invests nearly $10 billion in research and development annually,” said
AdvaMed. The organization argues that the tax will stifle innovation and slow the speed with which new
products become available to patients. As of Monday, medical device manufacturers had paid an estimated $1 billion to the Internal Revenue Service for the medical device tax. “In reaching this threshold, the
device tax has denied manufacturers the resources that would have otherwise been available to invest in
R&D, capital investments, and to support jobs across the US, said the Medical Imaging & Technology
Alliance, AdvaMed, and the Medical Device Manufacturers Association in a July 15 press release. Last
year, America’s Blood Centers lobbied for, and succeeded in receiving, an exemption from the IRS for
blood test and blood grouping reagents sold to blood centers (see ABC Newsletter, 12/7/12). The exemption saved independent blood centers about $8.9 million annually (assuming that the tax would have been
passed directly to consumers) or about $17.7 million for the entire blood industry. AdvaMed’s recent
statements regarding the medical device tax can be viewed at http://bit.ly/1dHDCQ2 and
http://bit.ly/13BMYXp. (Sources: AdvaMed press releases, 7/8/13; 7/14/13) 
GLOBAL NEWS
As of July 1, blood services in the Netherlands will no longer screen all blood donors for Human Tlymphotropic virus (HTLV), but will test only first-time donors, according to the EBA Newsletter.
New donors will only be permitted to give blood if they are negative for HTLV. Until recently, all blood
donations in the Netherlands were screened for the presence of antibodies to HTLV. However, research
suggests that leukoreduction, which is conducted on all blood products in the Netherlands, effectively
prevents possible transfusion-transmission of HTLV. Changing from universal HTLV screening to only
screening first-time donors is not predicted to cause any negative impact on donors, and will lead to costsavings. (Source: EBA Newsletter, 7/15/13)
Global Healing launched last week the International Blood Safety Alliance Directory, which lists
blood services and other organizations that are working on blood safety projects around the world.
The directory comes following recommendations made at the March International Blood Safety Forum,
that blood centers, non-profit groups, and stakeholders in developing countries must find ways to collaborate with one another in order to avoid duplication of programs/projects and to make sustainable, longlasting change (see ABC Newsletter, 3/29/13). The directory makes it simple to identify the organizations
working on blood safety, where they have projects, and their areas of focus. It can be accessed at
http://globalhealing.org/IBSA/. Global Healing also works with America’s Blood Centers to operate an
International Blood Safety Alliance Listserv where blood centers can coordinate with one another, share
best practices, and ask questions regarding their international blood safety initiatives. Those interested in
being added to the directory or Listserv may contact contact@globalhealing.org. 
ABC Newsletter
-14-
July 19, 2013
INFECTIOUS DISEASE UPDATES
MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS
The Centers for Disease Control and Prevention published an update in its July 12 Morbidity and Mortality Weekly Report regarding its recommendations for Middle East Respiratory Syndrome Coronavirus
(MERS-CoV). To date, no MERS-CoV cases have been reported in the US, although cases have been
reported in eight other countries. Recent published reports have described healthcare transmission of
MERS-CoV, including cases among healthcare personnel in international settings. “These reports highlight the need for rapid detection of infectious patients and adherence to correct infection prevention
measures to prevent transmission of the virus among patients, healthcare personnel, and visitors,” said
CDC. To aid healthcare providers and facilities, CDC has developed checklists that identify key actions
that can be taken now to enhance preparedness for treating persons with MERS-CoV infection and compiled
a
list
of
preparedness
resources,
which
are
available
at
www.cdc.gov/coronavirus/mers/preparedness/. Guidance on case definitions, infection control, case investigation, and specimen collection and testing, is available at the CDC MERS website:
www.cdc.gov/coronavirus/mers/index.html. The Food and Drug Administration announced in the Federal
Register on Wednesday that it has authorized the emergency use of in vitro diagnostics for detection of
MERS-CoV. More information is available at www.gpo.gov/fdsys/pkg/FR-2013-07-17/html/201317103.htm . (Source: CDC MMWR, 7/12/13; Federal Register, 7/17/13))
MALARIA
The Centers for Disease Control and Prevention announced on Monday that it no longer recommends the
use of exchange transfusion as an adjunct to anti-malarial drugs for the treatment of severe malaria. Exchange transfusion, in which a portion of the blood from the infected patient is removed and replaced
with uninfected blood, has been used in countries like the US to complement anti-malarial drugs in severe
malaria. However, there is limited evidence supporting this therapy. CDC examined the efficacy of exchange transfusion as an adjunct treatment for severe malaria by analyzing data from the US National
Malaria Surveillance System and reviewed the entirety of the published literature to update recommendations. When comparing patients with severe malaria who were treated with exchange transfusion to those
who were not, there was no significant association between exchange transfusion and survival outcome.
The literature review found that the available evidence was limited but overall showed no differences in
outcome when exchange transfusion was used. Adverse events due to exchange transfusion were rarely
reported but included acute respiratory distress syndrome, ventricular fibrillation, and hypotension. To
date, this is the largest and most comprehensive study of exchange transfusion for treatment of severe
malaria, said CDC. “Based on this evidence, adjunct exchange transfusion cannot be recommended for
the treatment of severe malaria,” said CDC. (Source: CDC malaria website, 7/15/13)
H7N9 INFLUENZA A VIRUS
Research published July 10 in Nature showed that the new bird flu strain that has killed 43 people in China shows characteristics that may make it prone to spark a pandemic. The researchers, led by Yoshihiro
Kawaoka, of the University of Wisconsin-Madison, conducted experiments in animals to study two early
human A(H7N9) samples. They found that H7N9 can infect monkeys and ferrets, and replicate in both
animals. In monkeys, the virus infected cells in the upper airway, as do most human-adapted flu strains,
but also the lower respiratory tract – a cause for concern. Also, one of the H7N9 samples was spread
through the air among ferrets, whose response to the flu mimics that of humans. Most bird flu viruses do
not spread that way. Another complicating factor is that H7N9 does not kill poultry, making it
(continued on page 15)
ABC Newsletter
-15-
July 19, 2013
INFECTIOUS DISEASE UPDATES (continued from page 14)
difficult to track among birds. However, the H7N9 strains were somewhat sensitive to drugs used for
seasonal flu. Currently no H7N9 cases have been reported outside of China.
Citation: Kawaoka Y, et al. Characterization of H7N9 influenza a viruses isolated from humans. Nature.
2013 July 10. [Epub ahead of print] 
STOPLIGHT®: Status of the ABC Blood Supply 2012 vs. 2013
3%
14%
8%
23%
24%
31%
20%
Percent of Supply
5%
5%
10%
8%
23%
6%
33%
65%
55%
11%
68%
57%
7%
6/ 20/12 6/ 19/13
No Response
5%
65%
60%
5%
10%
6/ 27/12 6/ 26/13
Green: 3 or More Days
7/ 4/12
12%
16%
52%
5%
8%
25%
21%
56%
55%
15%
15%
55%
20%
7/ 3/13
7%
19%
7/ 11/12 7/ 10/13
7/ 18/12 7/ 17/13
Yellow: 2 Days
Red: 1 Day or Less
The order of the bars is (from top to bottom), red, yellow, green, and no response
MEMBER NEWS
Puget Sound Blood Center and Carter BloodCare are currently conducting a survey to present the
results at a session scheduled to take place on Oct. 14 at the AABB Annual Meeting in Denver,
Colo. The session is titled “Methods of Selection of Platelet Products for Alloimmune Refractory Patients.” To better understand the current practices in blood centers and other institutions across the US
with regard to this topic, Puget Sound Blood Center and Carter BloodCare are requesting that blood centers complete a survey on this subject. ABC members can access the survey can in MCN 13-097 at
http://members.americasblood.org/go.cfm?do=FileCenter.View&fid=4427. The survey must be submitted
by Aug. 5. All responses will remain anonymous. Puget Sound Blood Center and Carter BloodCare thank
all of those who take the time to complete the survey.
COMPANY NEWS
Terumo BCT recently announced the Terumo BCT recipient of the 2013 Blood Safety Innovation
Award, as well as news of the company breaking ground on its new Vietnam manufacturing facility. Terumo BCT named Donald E. Brooks, PhD of the University of British Columbia, Canada, the
recipient of the inaugural 2013 Blood Safety Innovation Award. The award is part of a program that supports one or more grants up to $100,000 to fund innovative science and research that will generate novel
blood safety practices. Dr. Brooks is investigating the prevention of bacterial growth and the shelf-life
extension of platelets for transfusion through the modification of the surface of platelet storage bags.
More information about Dr. Brooks is available at http://bloodsafetygrant.com/latest-updates.html. Terumo BCT announced on Monday that it has broken ground on its new state-of-the-art manufacturing
facility in
(continued on page 16)
ABC Newsletter
-16-
July 19, 2013
COMPANY NEWS (continued from page 15)
Vietnam. The new manufacturing facility, when open in 2015, will support growth and demand for blood
and cellular therapy products globally, said the press release. More information about the new facility can
be found at www.terumo.com/about/pressrelease/2013/20130715.html. (Sources: Terumo BCT press
releases, 7/1/3, 1/15/13) 
MEETINGS
Sept. 18
32nd Annual Symposium: Immunohematology & Blood Transfusion
The National Institutes of Health Clinical Center, Department of Transfusion Medicine
and the American Red Cross will host the 32nd Annual Symposium on Immunohematology & Blood Transfusion on Sept. 18 from 8 a.m. to 2:30 p.m. It will take place in
Building 10 at the NIH Clinical Center. There is no registration fee. Advanced registration is required before Sept. 1. More information and a link to registration can be found at
www.cc.nih.gov/dtm/research/symposium.html. 
ABC Newsletter
-17-
July 19, 2013
CLASSIFIED ADVERTISING
Classified advertisements, including notices of positions available and wanted, are published free of charge for a maximum
of three weeks per position per calendar year for ABC institutional members. There are charges for non-members: $139
per placement for ABC Newsletter subscribers and $279 for non-subscribers. Notices ordinarily are limited to 150 words.
To place an ad, contact Leslie Norwood at the ABC office. Phone: (202) 654-2917; fax: (202) 393-5527; e-mail:
mnorwood@americasblood.org.
POSITIONS AVAILABLE:
Blood Services Account Executive AD003. Responsible for developing and managing critical relationships
between South Texas Blood Center and its Hospital
customers. Responsible for working with all stakeholders, both internal and external, to ensure the entire blood
services supply chain is complete and efficient. Provide
strategic planning, direction and leadership. Demonstrates skill in organizing, leading and inspiring
individuals toward pursuit of customer satisfaction in a
rapidly changing environment. Bachelor's in marketing
or healthcare sciences or related field required Masters
Degree preferred. To apply, please e-mail resume to
hr_dept@bloodntissue.org and include job code AD003.
Requirements include: MT(ASCP) certification. SBB
and/or CQA(ASQ) preferred; Bachelor’s degree preferred; five plus years progressive working experience
in clinical laboratory operations (preferably blood banking) in quality and compliance activities; knowledge of
AABB Standards and regulatory requirements (FDA,
CMS) preferred; experience presenting QC data findings, root cause analysis, and recommended solutions to
staff, QA, and Sr. Management; ability to travel 70
percent across the US. For more information to apply,
please visit our website at: www.fenwalinc.com and
click on the Careers tab and search for job: LZR00004.
Fenwal is an Equal Opportunity Employer.
Project Administrator. Gulf Coast Regional Blood
Center is currently seeking two Project Administrators.
Reporting to the Project Manager, the Project Administrator provides administrative support to coordinate
project teams and perform system administration functions for software often associated with projects. In
addition to possessing two years’ experience in Computer Support/Training preferably in a blood or tissue
center or blood bank, the successful candidate will also
possess a bachelor’s degree from an accredited college
or university; experience in systems administration,
software validation, risk analyses and table configuration; and the skills necessary to successfully coordinate
project team activities from initiation to closing. Gulf
Coast Regional Blood Center is a non-profit 501(c)(3)
organization and is accredited, licensed and inspected by
the Food and Drug Administration (FDA), AABB as
well as local and state authorities. The Blood Center is a
proud member of AABB, America's Blood Centers,
Blood Centers of America, South Central Association of
Blood Banks, and the Texas Medical Center. Please visit
our website for more information about our organization
and to apply online: www.giveblood.org. Lori Pireu –
Recruiter
–
Phone:
(419)
517-9918
–
lpireu@giveblood.org.
Laboratory Technologist. The Main Lab at the Rhode
Island Blood Center has a part time Laboratory Technologist position available on 2nd shift with rotating
weekends and holidays. Responsibilities include: Routine testing of donor blood samples with proper
technique and documentation, labeling of blood components, performing and documenting quality control
procedures, and generating client reports for donor
testing. Lab Tech I: MLT (ASCP) certification. Lab
Tech II: BB(ASCP), MT, OR SBB (ASCP) certification.
RI license as a Clinical Laboratory Scientist or Technician is required and can be obtained within six months
of hire. Please apply online at www.ribc.org. Only applicants who are selected for interviews will be
contacted directly. JOIN THE TEAM THAT GIVES
THE GIFT OF LIFE!!! As a blood center employee,
you’ll truly make a difference in the lives of Rhode
Island residents. We are an Equal Opportunity Employer
and participate in E-Verify to confirm work authorization.
Clinical Education Consultant (LZR00004). Fenwal,
Inc., a Fresenius Kabi company, is a global blood technology company dedicated to supporting transfusion
medicine and cell therapies. We currently have an opportunity for a Clinical Education Consultant based out
of Dallas, Chicago or St. Louis to work collaboratively
with the customers and the sales teams providing clinical support for Fenwal product’s supporting the US.
Associate Director of Validation/Equipment. The
Rhode Island Blood Center is seeking an Associate
Director of Validation/Equipment for the QA dept.
Responsibilities include: Ensure all regulated areas
achieve and maintain compliance with the FDA, AABB
and any other accrediting agency that inspects/audits
Rhode Island Blood Center. Lead company-wide validations and maintenance activities of critical equipment.
POSITIONS (continued on page 18)
ABC Newsletter
POSITIONS (continued from page 17)
Mentor staff in achieving quality outcomes in everyday
activities and during audit/inspections. Bachelor’s degree required and MT (ASCP), BB(ASCP), or
SBB(ASCP) certification required. Significant experience in a related field lieu of educational and
certification requirements will be taken into consideration. Please apply online at www.ribc.org. Only
applicants who are selected for interviews will be contacted directly. JOIN THE TEAM THAT GIVES THE
GIFT OF LIFE!!! As a blood center employee, you’ll
truly make a difference in the lives of Rhode Island
residents. We are an Equal Opportunity Employer and
participate in E-Verify to confirm work authorization.
IRL Clinical Lab Manager. Blood Systems Laboratories is searching for a Clinical Lab Manager to assist its
busy Immunohematology Reference laboratory (IRL) in
Phoenix, AZ! The successful candidate must be highly
organized, able to multi-task in a busy office environment, as well as work successfully in a team
environment. Responsibilities will include managing the
overall activities and providing skilled technical oversight in the laboratory. This position will work with
other team members to ensure timely, quality, test results. Education/Knowledge: Bachelor’s degree
required. Master’s degree preferred. Must satisfy CLIA
requirements for High Complexity Testing required.
Licenses/Certifications: SBB or CHS certification required. Experience: Seven years clinical laboratory
experience required. To include: three years supervisory experience. Previous experience in molecular
techniques, immunohematology techniques, automated
testing and computerization preferred. For consideration, please submit resume via e-mail by 08/02/2013 to:
jobs@bloodsystems.org ATTN: HR/2013/82. We offer
a competitive benefits package as well as matched
401(k), education assistance, relocation and much more!
Pre-employment drug testing is required. Visit our website at: www.bloodsystems.org. EOE M/F/D/V
Medical Technologist – Immunohematology. The
Community Blood Center (Kansas City) provides blood
for the majority of the hospitals in the region and is
home to one of 56 AABB certified Immunohematology
Reference Labs worldwide. The staff provides consultation to area hospitals, resolution of complex serological
problems and supplies antigen-negative blood or other
special units for transfusion recipients. The lab performs
a variety of serologic procedures, and molecular
-18-
July 19, 2013
phenotyping. Our career ladder allows individuals to
continue to grow in their knowledge base and contribution to our lab. The Community Blood Center employs
seven (7) SBB’s who teach and mentor our new employees. Requirements: BS degree in medical
technology or related field; registered MT (ASCP),
CLS, or BB(ASCP); SBB preferred. Education assistance and tuition reimbursement is available to obtain
SBB certification; and two to five years laboratory
experience; blood bank experience preferred. Skills and
Knowledge: Advance problem-solving, good oral and
written communication, detail oriented, excellent customer service and time management. Hours during
training are Monday-Friday 8:30-5:00 with periodic
weekends (training is approximately six (6) months). 2
Position Openings: (1) 2nd Shift and (1) 3rd Shift with
some weekends required. Must apply online at:
www.savealifenow.org. EOE M/F/D/V
Training Supervisor. LifeShare Community Blood
Services is located 40 miles west of Cleveland, Ohio and
is seeking a Training Supervisor for our Lab. This position trains all lab employees and ensures that
competencies are maintained. Coordinates the activities
for all new laboratory personnel and provide practical
training to include steps involved in accessioning, component production, the labeling function, testing,
distribution, QC tech, data entry, etc. Additionally, the
training supervisor will ensure all regulatory guidelines
and compliance issues are communicated and enforced
throughout all departments. This position is responsible
for maintaining accurate records relating to the training
process and other duties and projects assigned. This
position requires a bachelor’s degree in a chemical,
physical or biological science or medical technology
from an accredited institution with a minimum of two
years laboratory experience. The successful candidate
will have a thorough knowledge of FDA, cGMP,
AABB, CLEA, and OSHA standards and regulations.
Must have demonstrated presentation, organization,
verbal, and written communication skills. Prior experience in training or adult education is desirable. The
schedule may include evenings, weekends, holidays and
overtime as needed. Background check and drug test
required. Please submit resume and cover letter to:
shyster@lifeshare.cc. EOE 