Overseas Travel
Our priority is always to provide the safest possible blood to all patients in need. Overseas travel to an area with a risk of insect-borne or animal-borne infections can result in infections that may be transmitted through blood transfusion by asymptomatic donors.
Our areas of concern related to infection risks with overseas travel are:
- Chikungunya fever
- Malaria
- Variant Creutzfeldt-Jakob Disease [vCJD or Mad Cow disease]
- West Nile Virus
The overseas travel deferral measures that we have adopted are in line with international guidelines and best practices in bloodbanking. We will continue to closely monitor scientific developments in blood screening that may enable us to review these precautionary measures from time to time.
• Chikungunya fever
Chikungunya (CHIKV) fever is caused by Chikungunya virus (of the family Togaviridae) transmitted by Aedes mosquitos. The symptoms of CHIKV infection are similar to dengue fever, with an acute fever lasting 2 to 5 days, associated with prolonged muscle and joint pains.
Click here to learn more about CHIKV
Theoretically, the virus can spread through transfusion, tissue or organ transplant although to date, there has been no report of CHIKV infection from blood transfusion. The incubation period (from infection to first symptoms appearing) is usually 3 to 7 days but it can range from 2 to 12 days. There is currently no suitable blood donor screening test available for CHIKV infection.
To ensure our blood supply is free of CHIKV, donors who have travelled to CHIKV endemic regions within the last 2 weeks and have had fever or flu symptoms including joint pain, must not donate for at least 3 weeks upon return.
Click here for the latest list of CHIKV endemic areas
• Malaria
To ensure our blood supply is free of malaria, we test the blood of donors who may have been infected or exposed to malaria when they resided in or travelled to a malaria endemic area.
First-time donors with a history of malaria will be deferred indefinitely. Persons who have had malaria may still carry a low level of parasites in their body although they have recovered and display no symptoms.
Donors' blood donations will be tested if they have:
- Visited a malaria endemic area in the last 12 months.
- Lived in a malaria endemic area for more than 6 months continuously.
• Variant Creutzfeldt-Jakob Disease [vCJD or Mad Cow disease]
Variant Creutzfeldt-Jakob disease (vCJD) is a rare but fatal human neurodegenerative condition. As with the Creutzfeldt-Jakob disease, vCJD is classified as a Transmissible Spongiform Encephalopathy (TSE) because of the characteristic spongy degeneration of the brain and its ability to be transmitted.
In contrast to the traditional forms of CJD, vCJD has affected younger patients (average age of 29 years, as opposed to 65 years), and has a relatively longer duration of illness (median of 14 months as opposed to 4.5 months). vCJD is strongly linked to exposure, probably through food, to a TSE of cattle called Bovine Spongiform Encephalopathy (BSE).
Click here to learn more about vCJD
HSA has adopted the policy of excluding donors from the United Kingdom (UK) and most European countries due to the incidence of endogenous human clinical vCJD (“Mad Cow Disease”) infections and outbreaks of vCJD in their cattle industry.
Donors will not be eligible to donate blood if they have:
- Visited or lived in the United Kingdom (England, Northern Ireland, Scotland, Wales, the Isle of Man or the Channel Island) between 1980 and 1996 for a cumulative period of 3 months or longer.
- Visited or lived in France since 1980 for a cumulative period of 5 years or longer.
- Received a transfusion of blood or blood components in France or the United Kingdom (England, Northern Ireland, Scotland, the Isle of Man or the Channel Island) since 1980.
Donors who have lived in other European countries (excluding France and UK) for 5 years or more are advised to donate only plasma via apheresis procedure.
These precautionary deferral measures have been adopted by Singapore as well as many other countries such as the USA, Australia, New Zealand, Japan and Hong Kong. There is currently no reliable screening test for vCJD in the blood. As vCJD has been reported to be transmitted through blood transfusion in at least 3 cases in the UK, we have decided to adopt these stringent precautions in the interests of blood safety for our patients.
• West Nile Virus
West Nile Virus (WNV) is an arthropod-borne virus of the family Flaviviridae. It mainly infects birds, but humans can be infected through the bite of an infected Culex mosquito. The incubation period is about 3 to 14 days. Most of the infected patients are asymptomatic. Some may present as mild fever with flu-like symptoms. Rarely, it may present as meningitis or encephalitis.
Click here to learn more about WNV
Persons considered to be at risk of WNV infection are those who have travelled to areas with risk of WNV transmission, including Greece, the USA and Canada, in the past 28 days. Hence, donors who have travelled to these countries in the last 4 weeks and have had fever should not donate blood for at least 3 weeks upon return.
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