Blood donation

A blood donation occurs when a person voluntarily has blood drawn and used for transfusions and/or made into biopharmaceutical medications by a process called fractionation. Donation may be of whole blood, or of specific components directly. Blood banks often participate in the collection process as well as the procedures that follow it.

Transmission of ME/CFS on blood
Although there have been many outbreaks of people developing myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS), or its many earlier names such as Icelandic disease, Tapanui Flu, and Royal Free disease, a singular infectious trigger has not been found, but one has also not been ruled out. ME/CFS patients are known to have higher rates of infections including enterovirus infections than the general population, adding extra risk to recipients.

From 2009 to 2011, some XMRV research showed the virus was found in chronic fatigue syndrome patients and was a likely cause of CFS, which led to restrictions being brought in on blood donation, but the research proved to be wrong and the original paper was retracted as the virus was found to be the result of laboratory contamination, and other studies did not find the same results. After this, many blood donation restrictions remained, with various reasons being given including the higher rates of infectious diseases found in ME/CFS patients (which could be transmitted by blood), concern for the effects of blood donation on the health of ME/CFS donors, and lack of knowledge about how ME/CFS develops making it impossible to be sure that donated blood was safe.

Blood donation from ME/CFS patients
In the United States the American Association of Blood Banks advises to either accept or defer donors based on "clinical judgment of the donor's health status".

In the United Kingdom (UK) people who develop ME/CFS are banned from giving blood, even if recovered, according to the NHS Blood and Transplant 'Give Blood' website and the Joint United Kingdom Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee (JPAC).

At one time this was also true of United States (US) although these recommendations are no longer found on the the US American Red Cross site. Australia and New Zealand still have bans on blood products being donated by ME/CFS patients.

There is a lack of evidence that ME/CFS patients are contagious. Initial infectious trigger(s) have led to outbreaks over the years and 72% of ME/CFS patients report an onset of a viral or bacterial infection. Families, partners, and friends do not report contracting ME/CFS from someone with the disease ME/CFS or passing it on to others. Because ME/CFS can run in families, a genetic link is a recommended line of research by the Centers for Disease Control and Prevention (CDC).

Prohibition
Blood donation by ME/CFS patients is banned or advised against in some countries:

United Kingdom
Since October 7, 2010, ME/CFS sufferers have been permanently prohibited from giving blood. The NHS Blood and Transplant ‘Give Blood’ website in the UK carries a comprehensive list of different conditions that might prevent you from giving blood. Under "CFS : Post-viral Syndrome" it states:
 * "I am sorry but unfortunately, we cannot accept a donation if you have this condition or if you have previously had the condition even if you are now recovered."

Similarly, the UK's blood transfusion service website confirms that:
 * "people who currently have OR have had ME/CFS at any point in the past may not donate blood in the UK."

In addition, the UK National Health Service Blood and Transplant (NHSBT) advises that blood donors are assessed on the following criteria
 * 1) Whether the donor is safe to give blood because of a medical condition which may be worsened by the act of giving blood. M.E. patients may not be able to compensate for the rapid removal of 15% of their blood volume, including iron, from their circulatory system. Healthy individuals are not normally affected by giving blood.
 * 2) Whether the blood donated is safe for transfusion for the recipient.
 * 3) Whether components such as haemoglobin and clotting factors in the donor's blood are of a suitable quality for the blood product. A phone call to the information NHSTB information line had stated "The reason people with M.E. can't give blood is for the first reason, that it may affect our M.E. in that it could cause a worsening of our health if we are currently unwell, or a relapse if our health has improved. This is also given as the reason in Dr Barnes’ article in Blood and Transplant Matters (Barnes S. Myalgic Encephalomyelitis and Donor Exclusion. Blood and Transplant Matters"). The NHSBT page can no longer be found and a search on the site does not provide results.

United States
When XMRV was believed to be the infectious agent causing CFS, the US Red Cross announced a halt of blood donations from patients. After it was found that XMRV was not involved in CFS, the Red Cross removed its announcement and recommendation pages prohibiting blood donations from CFS patients.

Canada
Canadian Blood Services does not allow ME/CFS patients or Fibromyalgia patients to donate blood, but Hema Quebec has no restrictions on CFS patients.

Australia
The Australian Red Cross has posted: "Because we don't know the cause of this serious, debilitating disease, we can’t rule out that it is caused by a transmissible infection that medical science hasn’t discovered yet. We also don’t know the potential health effects of long-term blood donation on people who have suffered chronic fatigue syndrome."

New Zealand
New Zealand bans blood donation from anyone with chronic fatigue syndrome. NZ Blood states:
 * "People with a diagnosis of Chronic Fatigue Syndrome are permanently ineligible from donating blood in New Zealand."

Patient concerns

 * In 1992, Joan Irvine wrote to the Centers for Disease Control and Prevention (CDC) expressing concern as she believed that she had contracted Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) (also known as chronic fatigue syndrome (CFS) and now ME/CFS) after a blood transfusion in 1987 (she committed suicide in 1996). The CDC replied to her stating "However since ongoing research indicates an infectious agent may be involved in some cases of CFS it would seem prudent to refrain from donating blood until this issue is resolved".


 * In 2009, Margaret Williams has written about this subject, stating that here could be risk of spreading infection if a subset of ME/CFS patients were found to have an infectious disease cause.