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CDC official unveils two-question rapid alert and plans to modernize hemovigilance to detect transfusion-transmitted infections
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Summary
CDC epidemiologist Isabelle Griffin announced a streamlined NHSN Hemovigilance workflow and a two-question TTI Rapid Alert form designed to speed detection of transfusion-transmitted infections amid low voluntary reporting and limited national enrollment.
Isabelle Griffin, an epidemiologist with the Centers for Disease Control and Prevention's Office of Blood, Organ, and Other Tissue Safety, said CDC will modernize its NHSN Hemovigilance Module and introduce a two-question Transfusion-Transmitted Infection (TTI) Rapid Alert form to improve detection and investigation of infections linked to blood, organ and tissue products.
Griffin told attendees that “the problem is that TTI surveillance in The United States is inadequate,” noting that reporting to CDC is voluntary and transfusing hospitals are not required to report transfusion-related adverse events. She cited past failures in U.S. blood safety — including early HIV cases among people with hemophilia — to illustrate the public-health stakes and to frame the 1995 Institute of Medicine recommendations that called for stronger CDC surveillance and an organized system for recipient hemovigilance.
Under the planned workflow, CDC will publish a pathogens-of-interest list that facilities can use to flag laboratory results. A hospital epidemiologist or infection-control practitioner (ICP) will assess whether the flagged patient received a transfusion in the prior 30 days; if so, the facility will submit the new NHSN TTI Rapid Alert form to notify CDC and the state health department and to initiate a shared investigation. Griffin said the form is “straightforward and simple” and that CDC staff will review such reports daily and follow up when a public-health response is needed, such as when an implicated product reached more than one recipient.
Griffin described enhancements to the investigation form to help traceback and ruling-out exposures: expanded laboratory-test fields, epidemiologic risk questions to distinguish non-transfusion exposures, and a more detailed transfusion-component table (including ISBT codes and test results). The form will continue to use CDC’s standardized case definitions, imputability and severity criteria, and will add sections for facility and CDC investigation notes to improve partner communication. She also said states that make TTI reporting mandatory can opt to have their surveillance system transmit the investigation form to CDC electronically in real time.
On capacity, Griffin said enrollment is limited: as of March 2025 about 380 U.S. facilities were enrolled in the NHSN hemovigilance module, of which 75 are in Massachusetts (where reporting is mandated). She said only 61 enrolled facilities — roughly 16% — submitted the annual facility survey that was due in June, and just three TTIs have been reported to CDC so far this calendar year. Griffin said CDC estimates roughly 4,000 additional transfusing facilities are eligible for enrollment and urged hospitals and health departments to help expand coverage.
Griffin closed by urging clinicians to ask about recent transfusion history in patients without obvious exposure risks and asked NHSN facility administrators to consider adding the biovigilance component to aid reporting. For facilities interested in enrolling, she said to contact the NHSN help desk with “hemovigilance” in the subject line.
The presentation did not include a formal vote or policy change; Griffin framed the measures as operational changes to CDC’s surveillance and reporting tools and a call for broader facility participation.
