Recommendations for Assessment of Blood Donor Suitability, Donor Deferral and Blood Product Management in Response to Ebola Virus; Draft Guidance for Industry; Availability, 75681-75683 [2015-30589]
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Federal Register / Vol. 80, No. 232 / Thursday, December 3, 2015 / Notices
2. CY 2016 Estimates
control number 0938–0685; the CMS–
855S is approved under OMB control
number 0938–1056.
IV. Regulatory Impact Statement
A. Background
We have examined the impact of this
notice as required by Executive Order
12866 on Regulatory Planning and
Review (September 30, 1993), Executive
Order 13563 on Improving Regulation
and Regulatory Review (January 18,
2011), the Regulatory Flexibility Act
(RFA) (September 19, 1980, Pub. L. 96–
354), section 1102(b) of the Social
Security Act, section 202 of the
Unfunded Mandates Reform Act of 1995
(March 22, 1995; Pub. L. 104–4),
Executive Order 13132 on Federalism
(August 4, 1999), and the Congressional
Review Act (5 U.S.C. 804(2)).
Executive Orders 12866 and 13563
direct agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits,
including potential economic,
environmental, public health and safety
effects, distributive impacts, and equity.
A regulatory impact analysis (RIA) must
be prepared for major rules with
economically significant effects ($100
million or more in any 1 year). As
explained in this section of the notice,
we estimate that the total cost of the
increase in the application fee will not
exceed $100 million. Therefore, this
notice does not reach the $100 million
economic threshold and is not
considered a major notice.
B. Costs
The costs associated with this notice
involve the increase in the application
fee amount that certain providers and
suppliers must pay in CY 2016.
Lhorne on DSK5TPTVN1PROD with NOTICES
1. Estimates of Number of Affected
Institutional Providers in December 5,
2014 Fee Notice
In the December 5, 2014 application
fee notice, we estimated that based on
CMS statistics—
• 10,000 newly enrolling Medicare
institutional providers would be subject
to and pay an application fee in CY
2015.
• 35,000 revalidating Medicare
institutional providers would be subject
to and pay an application fee in CY
2015.
• 8,438 newly enrolling Medicaid and
CHIP providers would be subject to and
pay an application fee in CY 2015.
• 19,421 revalidating Medicaid and
CHIP providers would be subject to and
pay an application fee in CY 2015.
VerDate Sep<11>2014
15:11 Dec 02, 2015
Jkt 238001
a. Medicare
Based on CMS data, we estimate that
in CY 2016 approximately—
• 10,000 newly enrolling institutional
providers will be subject to and pay an
application fee; and
• 45,000 revalidating institutional
providers will be subject to and pay an
application fee.
Using a figure of 55,000 (10,000 newly
enrolling + 45,000 revalidating)
institutional providers, we estimate an
increase in the cost of the Medicare
application fee requirement in CY 2016
of $5,585,000 (or (10,000 additional
newly enrolling or revalidating
institutional providers × $554) + (45,000
× $1.00) from our CY 2015 projections
and as previously described.
b. Medicaid and CHIP
Based on CMS and state statistics, we
estimate that approximately 30,000
(9,000 newly enrolling + 21,000
revalidating) Medicaid and CHIP
institutional providers will be subject to
an application fee in CY 2016. Using
this figure, we project an increase in the
cost of the Medicaid and CHIP
application fee requirement in CY 2016
of $1,213,973 (or ((562 additional newly
enrolling institutional providers + 1,579
additional revalidating institutional
providers, or 2,141 total additional
institutional providers) × $554) + 27,859
× $1.00) from our CY 2015 projections
and as previously described.
c. Total
Based on the foregoing, we estimate
the total increase in the cost of the
application fee requirement for
Medicare, Medicaid, and CHIP
providers and suppliers in CY 2016 to
be $6,798,973 ($5,585,000 + $1,213,973)
from our CY 2015 projections.
The RFA requires agencies to analyze
options for regulatory relief of small
businesses. For purposes of the RFA,
small entities include small businesses,
nonprofit organizations, and small
governmental jurisdictions. Most
hospitals and most other providers and
suppliers are small entities, either by
nonprofit status or by having revenues
of less than $7.5 million to $38.5
million in any 1 year. Individuals and
states are not included in the definition
of a small entity. As we stated in the
RIA for the February 2, 2011 final rule
with comment period (76 FR 5952), we
do not believe that the application fee
will have a significant impact on small
entities.
In addition, section 1102(b) of the Act
requires us to prepare a regulatory
impact analysis if a rule may have a
PO 00000
Frm 00025
Fmt 4703
Sfmt 4703
75681
significant impact on the operations of
a substantial number of small rural
hospitals. This analysis must conform to
the provisions of section 604 of the
RFA. For purposes of section 1102(b) of
the Act, we define a small rural hospital
as a hospital that is located outside of
a Metropolitan Statistical Area for
Medicare payment regulations and has
fewer than 100 beds. We are not
preparing an analysis for section 1102(b)
of the Act because we have determined,
and the Secretary certifies, that this
notice would not have a significant
impact on the operations of a substantial
number of small rural hospitals.
Section 202 of the Unfunded
Mandates Reform Act of 1995 (UMRA)
also requires that agencies assess
anticipated costs and benefits before
issuing any rule whose mandates
require spending in any 1 year of $100
million in 1995 dollars, updated
annually for inflation. In 2015, that
threshold is approximately $144
million. The Agency has determined
that there will be minimal impact from
the costs of this notice, as the threshold
is not met under the UMRA.
Executive Order 13132 establishes
certain requirements that an agency
must meet when it promulgates a
proposed rule (and subsequent final
rule) that imposes substantial direct
requirement costs on state and local
governments, preempts state law, or
otherwise has federalism implications.
Since this notice does not impose
substantial direct costs on state or local
governments, the requirements of
Executive Order 13132 are not
applicable.
In accordance with the provisions of
Executive Order 12866, this notice was
reviewed by the Office of Management
and Budget.
Dated: November 14, 2015.
Andrew M. Slavitt,
Acting Administrator, Centers for Medicare
& Medicaid Services.
[FR Doc. 2015–30686 Filed 12–2–15; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2014–D–2175]
Recommendations for Assessment of
Blood Donor Suitability, Donor Deferral
and Blood Product Management in
Response to Ebola Virus; Draft
Guidance for Industry; Availability
AGENCY:
Food and Drug Administration,
HHS.
E:\FR\FM\03DEN1.SGM
03DEN1
75682
ACTION:
Federal Register / Vol. 80, No. 232 / Thursday, December 3, 2015 / Notices
Notice.
The Food and Drug
Administration (FDA or Agency) is
announcing the availability of a draft
document entitled ‘‘Recommendations
for Assessment of Blood Donor
Suitability, Donor Deferral and Blood
Product Management in Response to
Ebola Virus; Draft Guidance for
Industry.’’ The draft guidance document
provides blood establishments that
collect blood and blood components for
transfusion or further manufacture,
including Source Plasma, with FDA
recommendations for assessing blood
donor suitability, donor deferral, and
blood product management in the event
that an outbreak of Ebola virus disease
(EVD) with widespread transmission is
declared in at least one country. The
draft guidance document applies
primarily to Ebola virus (species Zaire
ebolavirus), but recommendations are
expected to apply to other viruses of the
Ebolavirus genus such as Sudan virus,
¨
Bundibugyo virus, and Taı Forest virus.
The recommendations would apply to
routine collection of blood and blood
components for transfusion or further
manufacture, including Source Plasma.
DATES: Although you can comment on
any guidance at any time (see 21 CFR
10.115(g)(5)), to ensure that the Agency
considers your comment on this draft
guidance before it begins work on the
final version of the guidance, submit
either electronic or written comments
on the draft guidance by March 2, 2016.
ADDRESSES: You may submit comments
as follows:
Lhorne on DSK5TPTVN1PROD with NOTICES
SUMMARY:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
VerDate Sep<11>2014
15:11 Dec 02, 2015
Jkt 238001
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand delivery/Courier (for
written/paper submissions): Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Division of Dockets
Management, FDA will post your
comment, as well as any attachments,
except for information submitted,
marked and identified, as confidential,
if submitted as detailed in
‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA 2014–
D–2175 for ‘‘Recommendations for
Assessment of Blood Donor Suitability,
Donor Deferral and Blood Product
Management in Response to Ebola
Virus; Draft Guidance for Industry.’’
Received comments will be placed in
the docket and, except for those
submitted as ‘‘Confidential
Submissions,’’ publicly viewable at
https://www.regulations.gov or at the
Division of Dockets Management
between 9 a.m. and 4 p.m., Monday
through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION’’. The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on
https://www.regulations.gov. Submit
both copies to the Division of Dockets
Management. If you do not wish your
name and contact information to be
made publicly available, you can
provide this information on the cover
sheet and not in the body of your
comments and you must identify this
information as ‘‘confidential.’’ Any
information marked as ‘‘confidential’’
will not be disclosed except in
accordance with 21 CFR 10.20 and other
applicable disclosure law. For more
information about FDA’s posting of
comments to public dockets, see 80 FR
PO 00000
Frm 00026
Fmt 4703
Sfmt 4703
56469, September 18, 2015, or access
the information at: https://www.fda.gov/
regulatoryinformation/dockets/
default.htm.
Docket: For access to the docket to
read background documents or the
electronic and written/paper comments
received, go to https://
www.regulations.gov and insert the
docket number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts
and/or go to the Division of Dockets
Management, 5630 Fishers Lane, Rm.
1061, Rockville, MD 20852.
Paul
E. Levine, Jr., Center for Biologics
Evaluation and Research, Food and
Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 7301,
Silver Spring, MD 20993–0002, 240–
402–7911.
FOR FURTHER INFORMATION CONTACT:
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of
a draft document entitled
‘‘Recommendations for Assessment of
Blood Donor Suitability, Donor Deferral
and Blood Product Management in
Response to Ebola Virus; Draft Guidance
for Industry.’’ The draft guidance
document provides blood
establishments that collect blood and
blood components for transfusion or
further manufacture, including Source
Plasma, with FDA recommendations for
assessing blood donor suitability, donor
deferral, and blood product
management in the event that an
outbreak of EVD with widespread
transmission is declared in at least one
country.
Ebola virus is a member of the family
Filoviridae that can cause severe
hemorrhagic fever in humans and nonhuman primates with historically high
morbidity and mortality rates of up to
90 percent. However, in the 2014
outbreak in West Africa, the mortality
rate has been markedly lower. In
humans, EVD is typically characterized
at onset by fever, severe headache,
muscle pain and weakness, followed by
diarrhea, vomiting, abdominal pain, and
sometimes diffuse hemorrhage (bleeding
or bruising). In previous outbreaks of
EVD, symptoms generally appeared
within 21 days and most often within 4–
10 days following infection; however,
based on mathematical models,
symptom onset later than 21 days is
estimated as possible in 0.1 to 12
percent of cases. In addition, there have
been isolated reports of apparently
asymptomatic Ebola virus infection in
E:\FR\FM\03DEN1.SGM
03DEN1
Lhorne on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 80, No. 232 / Thursday, December 3, 2015 / Notices
individuals who had contact with Ebola
patients.
Transmission of Ebola virus from
human to human occurs by direct
contact with body fluids (such as blood,
urine, stool, saliva, semen, vaginal
fluids, or vomit) of symptomatic
infected individuals. Therefore, blood
and blood products from symptomatic
individuals, if they were to donate,
would have the potential of transmitting
Ebola virus to recipients.
Current regulations 21 CFR 640.3(b)
and 21 CFR 640.63(b)(3) require that a
donor be in good health with a normal
temperature at the time of donation.
Standard procedures that are in place to
assure that the donor feels healthy at the
time of donation serve as an effective
safeguard against collecting blood or
blood components from a donor who
seeks to donate after the onset of clinical
symptoms. FDA is providing guidance
to reduce the risks of collecting blood
and blood components from potentially
Ebola virus-infected persons during the
asymptomatic incubation period before
the onset of clinical symptoms, as well
as from individuals with a history of
Ebola virus infection or disease.
The draft guidance permits blood
establishments to update their donor
educational materials to instruct donors
with a history of Ebola virus infection
or disease to not donate blood or blood
components. In the event that one or
more countries is designated as having
widespread transmission of Ebola virus,
the draft guidance includes
recommendations to blood
establishments to update their donor
history questionnaire (DHQ), including
the full-length and abbreviated DHQ
and accompanying materials, to assess
prospective donors for risk of Ebola
virus infection or disease. The draft
guidance also includes
recommendations to blood
establishments to defer indefinitely a
blood donor with a history of Ebola
virus infection or disease, until more
data regarding the persistence of Ebola
virus in survivors becomes available.
For a donor who in the past 8 weeks has
been a resident of or has travelled to a
country with widespread transmission
of Ebola virus disease, FDA
recommends that establishments defer
the donor for 8 weeks from the time of
the donor’s departure from that country.
For a donor who has had close contact
with a person confirmed or under
investigation for Ebola virus infection or
disease in whom diagnosis is pending,
FDA recommends that establishments
defer a donor for 8 weeks after the last
close contact that could have resulted in
direct contact with body fluids, or 8
weeks after the last sexual contact with
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15:11 Dec 02, 2015
Jkt 238001
a person known to have recovered from
Ebola virus disease. In addition, FDA
recommends that establishments defer
for a period of 8 weeks after exposure
a donor who has been notified by a
Federal, State, or local public health
authority that he or she may have been
exposed to a person with Ebola virus
disease.
The draft guidance includes FDA
recommendations on retrieval and
quarantine of blood and blood
components from a donor later
determined to have Ebola virus
infection or disease or risk factors for
Ebola virus infection or disease, for
notification of consignees, and for
reporting a biological product deviation
to FDA. The draft guidance also
addresses convalescent plasma intended
for transfusion.
The draft guidance is being issued
consistent with FDA’s good guidance
practices regulation (21 CFR 10.115).
The draft guidance, when finalized, will
represent the current thinking of FDA
on ‘‘Recommendations for Assessment
of Blood Donor Suitability, Donor
Deferral and Blood Product
Management in Response to Ebola
Virus; Draft Guidance for Industry.’’ It
does not establish any rights for any
person and is not binding on FDA or the
public. You can use an alternative
approach if it satisfies the requirements
of the applicable statutes and
regulations.
II. Paperwork Reduction Act of 1995
The draft guidance refers to
previously approved collections of
information found in FDA regulations.
These collections of information are
subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520). The collections
of information in 21 CFR 601.12 have
been approved under OMB control
number 0910–0338; the collections of
information in 21 CFR 606.160(b)(1)(i),
640.3(a) and 640.63(b)(3) have been
approved under OMB control number
0910–0116; the collection of
information in 21 CFR 606.171 has been
approved under OMB control number
0910–0458.
III. Electronic Access
Persons with access to the Internet
may obtain the draft guidance at either
https://www.fda.gov/
BiologicsBloodVaccines/Guidance
ComplianceRegulatoryInformation/
Guidances/default.htm or https://
www.regulations.gov.
PO 00000
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75683
Dated: November 27, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015–30589 Filed 12–2–15; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HOMELAND
SECURITY
U.S. Customs and Border Protection
[1651–0017]
Agency Information Collection
Activities: Protest
U.S. Customs and Border
Protection, Department of Homeland
Security.
ACTION: 60-Day Notice and request for
comments; extension of an existing
collection of information.
AGENCY:
U.S. Customs and Border
Protection (CBP) of the Department of
Homeland Security will be submitting
the following information collection
request to the Office of Management and
Budget (OMB) for review and approval
in accordance with the Paperwork
Reduction Act: Protest. CBP is
proposing that this information
collection be extended with no change
to the burden hours or to the
information collected. This document is
published to obtain comments from the
public and affected agencies.
DATES: Written comments should be
received on or before February 1, 2016
to be assured of consideration.
ADDRESSES: Written comments may be
mailed to U.S. Customs and Border
Protection, Attn: Tracey Denning,
Regulations and Rulings, Office of
International Trade, 90 K Street NE.,
10th Floor, Washington, DC 20229–
1177.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Requests for additional information
should be directed to Tracey Denning,
U.S. Customs and Border Protection,
Regulations and Rulings, Office of
International Trade, 90 K Street NE.,
10th Floor, Washington, DC 20229–
1177, at 202–325–0265.
SUPPLEMENTARY INFORMATION: CBP
invites the general public and other
Federal agencies to comment on
proposed and/or continuing information
collections pursuant to the Paperwork
Reduction Act of 1995 (Pub. L. 104–13).
The comments should address: (a)
Whether the collection of information is
necessary for the proper performance of
the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
E:\FR\FM\03DEN1.SGM
03DEN1
Agencies
[Federal Register Volume 80, Number 232 (Thursday, December 3, 2015)]
[Notices]
[Pages 75681-75683]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-30589]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2014-D-2175]
Recommendations for Assessment of Blood Donor Suitability, Donor
Deferral and Blood Product Management in Response to Ebola Virus; Draft
Guidance for Industry; Availability
AGENCY: Food and Drug Administration, HHS.
[[Page 75682]]
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing
the availability of a draft document entitled ``Recommendations for
Assessment of Blood Donor Suitability, Donor Deferral and Blood Product
Management in Response to Ebola Virus; Draft Guidance for Industry.''
The draft guidance document provides blood establishments that collect
blood and blood components for transfusion or further manufacture,
including Source Plasma, with FDA recommendations for assessing blood
donor suitability, donor deferral, and blood product management in the
event that an outbreak of Ebola virus disease (EVD) with widespread
transmission is declared in at least one country. The draft guidance
document applies primarily to Ebola virus (species Zaire ebolavirus),
but recommendations are expected to apply to other viruses of the
Ebolavirus genus such as Sudan virus, Bundibugyo virus, and Ta[iuml]
Forest virus. The recommendations would apply to routine collection of
blood and blood components for transfusion or further manufacture,
including Source Plasma.
DATES: Although you can comment on any guidance at any time (see 21 CFR
10.115(g)(5)), to ensure that the Agency considers your comment on this
draft guidance before it begins work on the final version of the
guidance, submit either electronic or written comments on the draft
guidance by March 2, 2016.
ADDRESSES: You may submit comments as follows:
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments. Comments submitted
electronically, including attachments, to https://www.regulations.gov
will be posted to the docket unchanged. Because your comment will be
made public, you are solely responsible for ensuring that your comment
does not include any confidential information that you or a third party
may not wish to be posted, such as medical information, your or anyone
else's Social Security number, or confidential business information,
such as a manufacturing process. Please note that if you include your
name, contact information, or other information that identifies you in
the body of your comments, that information will be posted on https://www.regulations.gov.
If you want to submit a comment with confidential
information that you do not wish to be made available to the public,
submit the comment as a written/paper submission and in the manner
detailed (see ``Written/Paper Submissions'' and ``Instructions'').
Written/Paper Submissions
Submit written/paper submissions as follows:
Mail/Hand delivery/Courier (for written/paper
submissions): Division of Dockets Management (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
For written/paper comments submitted to the Division of
Dockets Management, FDA will post your comment, as well as any
attachments, except for information submitted, marked and identified,
as confidential, if submitted as detailed in ``Instructions.''
Instructions: All submissions received must include the Docket No.
FDA 2014-D-2175 for ``Recommendations for Assessment of Blood Donor
Suitability, Donor Deferral and Blood Product Management in Response to
Ebola Virus; Draft Guidance for Industry.'' Received comments will be
placed in the docket and, except for those submitted as ``Confidential
Submissions,'' publicly viewable at https://www.regulations.gov or at
the Division of Dockets Management between 9 a.m. and 4 p.m., Monday
through Friday.
Confidential Submissions--To submit a comment with
confidential information that you do not wish to be made publicly
available, submit your comments only as a written/paper submission. You
should submit two copies total. One copy will include the information
you claim to be confidential with a heading or cover note that states
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION''. The Agency will
review this copy, including the claimed confidential information, in
its consideration of comments. The second copy, which will have the
claimed confidential information redacted/blacked out, will be
available for public viewing and posted on https://www.regulations.gov.
Submit both copies to the Division of Dockets Management. If you do not
wish your name and contact information to be made publicly available,
you can provide this information on the cover sheet and not in the body
of your comments and you must identify this information as
``confidential.'' Any information marked as ``confidential'' will not
be disclosed except in accordance with 21 CFR 10.20 and other
applicable disclosure law. For more information about FDA's posting of
comments to public dockets, see 80 FR 56469, September 18, 2015, or
access the information at: https://www.fda.gov/regulatoryinformation/dockets/default.htm.
Docket: For access to the docket to read background documents or
the electronic and written/paper comments received, go to https://www.regulations.gov and insert the docket number, found in brackets in
the heading of this document, into the ``Search'' box and follow the
prompts and/or go to the Division of Dockets Management, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: Paul E. Levine, Jr., Center for
Biologics Evaluation and Research, Food and Drug Administration, 10903
New Hampshire Ave., Bldg. 71, Rm. 7301, Silver Spring, MD 20993-0002,
240-402-7911.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of a draft document entitled
``Recommendations for Assessment of Blood Donor Suitability, Donor
Deferral and Blood Product Management in Response to Ebola Virus; Draft
Guidance for Industry.'' The draft guidance document provides blood
establishments that collect blood and blood components for transfusion
or further manufacture, including Source Plasma, with FDA
recommendations for assessing blood donor suitability, donor deferral,
and blood product management in the event that an outbreak of EVD with
widespread transmission is declared in at least one country.
Ebola virus is a member of the family Filoviridae that can cause
severe hemorrhagic fever in humans and non-human primates with
historically high morbidity and mortality rates of up to 90 percent.
However, in the 2014 outbreak in West Africa, the mortality rate has
been markedly lower. In humans, EVD is typically characterized at onset
by fever, severe headache, muscle pain and weakness, followed by
diarrhea, vomiting, abdominal pain, and sometimes diffuse hemorrhage
(bleeding or bruising). In previous outbreaks of EVD, symptoms
generally appeared within 21 days and most often within 4-10 days
following infection; however, based on mathematical models, symptom
onset later than 21 days is estimated as possible in 0.1 to 12 percent
of cases. In addition, there have been isolated reports of apparently
asymptomatic Ebola virus infection in
[[Page 75683]]
individuals who had contact with Ebola patients.
Transmission of Ebola virus from human to human occurs by direct
contact with body fluids (such as blood, urine, stool, saliva, semen,
vaginal fluids, or vomit) of symptomatic infected individuals.
Therefore, blood and blood products from symptomatic individuals, if
they were to donate, would have the potential of transmitting Ebola
virus to recipients.
Current regulations 21 CFR 640.3(b) and 21 CFR 640.63(b)(3) require
that a donor be in good health with a normal temperature at the time of
donation. Standard procedures that are in place to assure that the
donor feels healthy at the time of donation serve as an effective
safeguard against collecting blood or blood components from a donor who
seeks to donate after the onset of clinical symptoms. FDA is providing
guidance to reduce the risks of collecting blood and blood components
from potentially Ebola virus-infected persons during the asymptomatic
incubation period before the onset of clinical symptoms, as well as
from individuals with a history of Ebola virus infection or disease.
The draft guidance permits blood establishments to update their
donor educational materials to instruct donors with a history of Ebola
virus infection or disease to not donate blood or blood components. In
the event that one or more countries is designated as having widespread
transmission of Ebola virus, the draft guidance includes
recommendations to blood establishments to update their donor history
questionnaire (DHQ), including the full-length and abbreviated DHQ and
accompanying materials, to assess prospective donors for risk of Ebola
virus infection or disease. The draft guidance also includes
recommendations to blood establishments to defer indefinitely a blood
donor with a history of Ebola virus infection or disease, until more
data regarding the persistence of Ebola virus in survivors becomes
available. For a donor who in the past 8 weeks has been a resident of
or has travelled to a country with widespread transmission of Ebola
virus disease, FDA recommends that establishments defer the donor for 8
weeks from the time of the donor's departure from that country. For a
donor who has had close contact with a person confirmed or under
investigation for Ebola virus infection or disease in whom diagnosis is
pending, FDA recommends that establishments defer a donor for 8 weeks
after the last close contact that could have resulted in direct contact
with body fluids, or 8 weeks after the last sexual contact with a
person known to have recovered from Ebola virus disease. In addition,
FDA recommends that establishments defer for a period of 8 weeks after
exposure a donor who has been notified by a Federal, State, or local
public health authority that he or she may have been exposed to a
person with Ebola virus disease.
The draft guidance includes FDA recommendations on retrieval and
quarantine of blood and blood components from a donor later determined
to have Ebola virus infection or disease or risk factors for Ebola
virus infection or disease, for notification of consignees, and for
reporting a biological product deviation to FDA. The draft guidance
also addresses convalescent plasma intended for transfusion.
The draft guidance is being issued consistent with FDA's good
guidance practices regulation (21 CFR 10.115). The draft guidance, when
finalized, will represent the current thinking of FDA on
``Recommendations for Assessment of Blood Donor Suitability, Donor
Deferral and Blood Product Management in Response to Ebola Virus; Draft
Guidance for Industry.'' It does not establish any rights for any
person and is not binding on FDA or the public. You can use an
alternative approach if it satisfies the requirements of the applicable
statutes and regulations.
II. Paperwork Reduction Act of 1995
The draft guidance refers to previously approved collections of
information found in FDA regulations. These collections of information
are subject to review by the Office of Management and Budget (OMB)
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). The
collections of information in 21 CFR 601.12 have been approved under
OMB control number 0910-0338; the collections of information in 21 CFR
606.160(b)(1)(i), 640.3(a) and 640.63(b)(3) have been approved under
OMB control number 0910-0116; the collection of information in 21 CFR
606.171 has been approved under OMB control number 0910-0458.
III. Electronic Access
Persons with access to the Internet may obtain the draft guidance
at either https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/default.htm or https://www.regulations.gov.
Dated: November 27, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015-30589 Filed 12-2-15; 8:45 am]
BILLING CODE 4164-01-P