Blood banks' new summer challenges: Zika, donor iron levels

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The summer has always been tough for blood banks: High schools and colleges, which often hold blood drives, are out of session, and regular donors go on vacation. But this year, a couple of new factors are aggravating the shortage: the Zika outbreak and new donor rules for hemoglobin levels.

In February, the U.S. Food and Drug Administration recommended that people defer giving blood for four weeks after traveling to areas where Zika virus is transmitted. And in May, the FDA increased the minimum acceptable hemoglobin level for male blood and platelet donors.

The travel restriction is intended to protect the U.S. blood supply from Zika virus, according to the FDA. 

The rule has had a "significant" impact on the San Diego Blood Bank, which provides blood to hospitals in Los Angeles, Orange, Imperial and San Diego counties, says CEO David Willis. He estimates the organization has turned away 2 percent of potential donors because of their recent travel to Mexico, the Caribbean or South America.

"There are some months that we'll see 10,000 people and if we have to turn away 2 percent of those, it's hundreds," Willis says.

Others say the Zika guideline has only had a minimal effect.

Children’s Hospital Los Angeles has turned away just a tiny fraction of its potential donors – about five to ten people a month – due to their having recently traveled to regions with active Zika virus transmission, according to Dr. Ajay Perumbeti, the hospital's director of transfusion medicine. Children's sees about 15,000 donors a year, he says.

The American Red Cross reports that nationwide, just one-tenth of 1 percent of donors were deferred due to their travel history between March 14 and May 31, according to spokeswoman April Phillips. She adds that the data don't include potential donors who chose to delay giving blood.

For Cedars-Sinai Medical Center's Blood Donor Services, the new hemoglobin rule has proven to be a bigger issue than the Zika restriction, says supervisor Shawn Wittmier. While Cedars has deferred less than 1 percent of people due to their travel history, it has turned away about an additional 8 percent of potential donors because their hemoglobin levels were too low, he says.

The Houchin Community Blood Bank, which provides blood services in Kern County, is turning away about 10 percent of potential donors due to hemoglobin levels, up from 5 percent before the rule change, says director of community development Carola Enriquez.

The hemoglobin requirement was instituted to protect donors' health, according to the Red Cross. Hemoglobin is a protein in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs. Donating blood removes iron from the body, and iron helps create the red blood cells that contain hemoglobin. 

The travel restriction and the new hemoglobin requirement - on top of the typical challenges that blood banks face during the summer – are "increasing the issues we have and, in fact, decreasing the number of people eligible to donate," says Don Escalante, spokesman for Lifestream Blood Bank, which provides the lion's share of blood supplies in Riverside and San Bernardino counties.

The American Red Cross issued an emergency appeal this week, explaining that demand has outpaced supply and asking eligible blood and platelet donors to give as soon as possible.

Willis, of the San Diego Blood Bank, had his own suggestion: "Come in before you go on vacation."