Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components; Guidance for Industry; Availability, 60005-60007 [2016-20914]
Download as PDF
Federal Register / Vol. 81, No. 169 / Wednesday, August 31, 2016 / Notices
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.
Submit written requests for single
copies of this guidance to the Center for
Tobacco Products, Food and Drug
Administration, Document Control
Center, Bldg. 71, Rm. G335, 10903 New
Hampshire Ave., Silver Spring, MD
20993–0002. Send one self-addressed
adhesive label to assist that office in
processing your request or include a fax
number to which the guidance
document may be sent. See the
SUPPLEMENTARY INFORMATION section for
information on electronic access to the
guidance.
FOR FURTHER INFORMATION CONTACT:
Deirdre Jurand, Center for Tobacco
Products, Food and Drug
Administration, 10903 New Hampshire
Ave., Document Control Center, Bldg.
71, Rm. G335, 10903 New Hampshire
Ave., Silver Spring, MD 20993–0002, 1–
877–287–1373, AskCTP@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
mstockstill on DSK3G9T082PROD with NOTICES
I. Background
FDA is announcing the availability of
a draft guidance for industry entitled
‘‘Submission of Warning Plans for
Cigars.’’
On June 22, 2009, the President
signed the Family Smoking Prevention
and Tobacco Control Act (Tobacco
Control Act) (Pub. L. 111–31) into law.
The Tobacco Control Act granted FDA
important new authority to regulate the
manufacture, marketing, and
distribution of cigarettes, cigarette
tobacco, roll-your-own tobacco (RYO),
and smokeless tobacco products to
protect the public health and to reduce
tobacco use by minors.
The Tobacco Control Act also gave
FDA the authority to issue a regulation
deeming all other products that meet the
statutory definition of a tobacco product
as subject to FDA regulatory authority
(‘‘deeming’’) (section 901(b) of the FD&C
Act (21 U.S.C. 387a)). On May 10, 2016,
FDA issued that rule, extending FDA’s
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tobacco product authority to cigars,
among other products (81 FR 28973).
Among the requirements that now apply
to cigars are health warning statements
prescribed under section 906(d) of the
FD&C Act (21 U.S.C. 387f(d)), which
permits restrictions on the sale and
distribution of tobacco products that are
‘‘appropriate for the protection of public
health.’’ The regulation specifies the
health warning statements to be
displayed and also requires the
submission of warning plans that
provide for the random, equal display
and random distribution of the
statements on cigar packaging and
advertising.
The draft guidance discusses the
regulatory requirements to submit
warning plans, who submits a warning
plan, the scope of a warning plan, when
to submit a warning plan, what
information should be submitted in a
warning plan, where to submit a
warning plan, and what approval of a
warning plan means.
II. Significance of Draft Guidance
FDA is issuing this draft guidance
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 cigar warning plans. 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.
III. Paperwork Reduction Act of 1995
This draft guidance also refers to
previously approved collections of
information found in FDA regulations.
The collections of information in 21
CFR part 1143 have been approved
under OMB control number 0910–0768.
IV. Electronic Access
Persons with access to the Internet
may obtain an electronic version of the
guidance at either https://
www.regulations.gov or https://
www.fda.gov/TobaccoProducts/
Labeling/RulesRegulationsGuidance/
default.htm.
Dated: August 25, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016–20913 Filed 8–30–16; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2016–D–0545]
Revised Recommendations for
Reducing the Risk of Zika Virus
Transmission by Blood and Blood
Components; Guidance for Industry;
Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice of availability.
The Food and Drug
Administration (FDA or Agency) is
announcing the availability of a
document entitled ‘‘Revised
Recommendations for Reducing the Risk
of Zika Virus Transmission by Blood
and Blood Components; Guidance for
Industry.’’ The guidance document is
notifying blood establishments that
collect Whole Blood and blood
components, that FDA has determined
Zika virus (ZIKV) to be a relevant
transfusion-transmitted infection (RTTI)
and provides FDA’s assessment. The
guidance also provides
recommendations to reduce the risk of
transmission of ZIKV by Whole Blood
and blood components. The guidance
applies to the collection of Whole Blood
and blood components. The guidance
does not apply to the collection of
Source Plasma. The guidance
supersedes the February 2016 document
entitled, ‘‘Recommendations for Donor
Screening, Deferral, and Product
Management to Reduce the Risk of
Transfusion-Transmission of Zika Virus:
Guidance for Industry’’ (February 2016
guidance), and the March 2016
document entitled, ‘‘Questions and
Answers Regarding ‘Recommendations
for Donor Screening, Deferral, and
Product Management to Reduce the Risk
of Transfusion-Transmission of Zika
Virus: Guidance for Industry’ ’’ no later
than 12 weeks after the date of the
issuance of this guidance.
Implementation of the guidance will be
immediate for blood establishments that
collect Whole Blood and blood
components in States and territories
with local transmission of ZIKV by
mosquitos, and will be phased in over
4 to 12 weeks in other States and
territories using a tiered, risk-based
approach. Blood establishments should
follow the recommendations in the
February 2016 guidance until the
recommendations in the guidance
document have been fully implemented.
DATES: The Agency is soliciting public
comment, but is implementing this
guidance immediately because the
SUMMARY:
E:\FR\FM\31AUN1.SGM
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60006
Federal Register / Vol. 81, No. 169 / Wednesday, August 31, 2016 / Notices
Agency has determined that prior public
participation is not feasible or
appropriate. Submit either electronic or
written comments on Agency guidances
at any time.
ADDRESSES: You may submit comments
as follows:
mstockstill on DSK3G9T082PROD with NOTICES
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–
2016–D–0545 for ‘‘Revised
Recommendations for Reducing the Risk
of Zika Virus; 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.
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21:59 Aug 30, 2016
Jkt 238001
• 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.
Submit written requests for single
copies of the guidance to the Office of
Communication, Outreach and
Development, Center for Biologics
Evaluation and Research (CBER), Food
and Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 3128,
Silver Spring, MD 20993–0002. Send
one self-addressed adhesive label to
assist the office in processing your
requests. The guidance may also be
obtained by mail by calling CBER at 1–
800–835–4709 or 240–402–8010. See
the SUPPLEMENTARY INFORMATION section
for electronic access to the guidance
document.
FOR FURTHER INFORMATION CONTACT:
Jonathan McKnight, Center for Biologics
Evaluation and Research, Food and
Drug Administration, 10903 New
PO 00000
Frm 00031
Fmt 4703
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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 guidance entitled ‘‘Revised
Recommendations for Reducing the Risk
of Zika Virus Transmission by Blood
and Blood Components; Guidance for
Industry.’’ The guidance is notifying
blood establishments that collect Whole
Blood and blood components that FDA
has determined ZIKV to be an RTTI
under 21 CFR 630.3(h)(2) and provides
FDA’s assessment. The guidance
provides recommendations to reduce
the risk of transmission of ZIKV by
Whole Blood and blood components.
The guidance does not apply to the
collection of Source Plasma, which is
used for further manufacture of plasmaderived products. If, based upon the
available scientific evidence, the risk of
ZIKV transmission by blood and blood
components significantly changes, FDA
may update the recommendations as
warranted. In making this
determination, FDA will consider
available epidemiologic and other
scientific evidence.
The guidance supersedes the February
2016 guidance entitled,
‘‘Recommendations for Donor
Screening, Deferral, and Product
Management to Reduce the Risk of
Transfusion-Transmission of Zika Virus;
Guidance for Industry’’ and the March
2016 guidance entitled, ‘‘Questions and
Answers Regarding ‘Recommendations
for Donor Screening, Deferral, and
Product Management to Reduce the Risk
of Transfusion-Transmission of Zika
Virus: Guidance for Industry’ ’’ no later
than 12 weeks after the date of the
issuance of this guidance.
Implementation of the guidance will be
immediate for blood establishments that
collect Whole Blood and blood
components in States and territories
with local transmission of ZIKV by
mosquitos, and will be phased in over
4 to 12 weeks in other States and
territories using a tiered, risk-based
approach. Blood establishments should
follow the recommendations in the
February 2016 guidance until they fully
implement the recommendations in the
guidance document currently being
issued.
ZIKV is an arbovirus from the
Flaviviridae family, genus Flavivirus. It
is transmitted to humans primarily by
the Aedes aegypti mosquito, but it may
also be transmitted by the Aedes
albopictus mosquito.
The global ZIKV epidemic expanded
in the region of the Americas by early
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Federal Register / Vol. 81, No. 169 / Wednesday, August 31, 2016 / Notices
2015 when the first local transmission
was reported in Brazil. Local
transmission of ZIKV has also been
reported in areas outside of the
Americas, including the Pacific Islands
of Samoa, American Samoa, Marshall
Islands and Tonga, and Cape Verde in
Africa, and there are now at least 50
countries and territories worldwide
with active local transmission of the
virus.
The first local transmission of ZIKV in
the United States was reported from
Puerto Rico in December 2015, and soon
thereafter local transmission was also
reported in American Samoa and the
U.S. Virgin Islands. In July 2016, the
first cases of local transmission of ZIKV
occurring in the continental United
States were reported from Miami-Dade
County in Florida. The possibility of
further geographic spread of ZIKV exists
in regions where the Aedes aegypti, and
possibly the Aedes albopictus, mosquito
is present. In January 2016, ZIKV
disease was added to the list of
nationally notifiable conditions in the
United States as a subtype of Arboviral
diseases.
The most common ZIKV disease
symptoms include fever, arthralgia,
maculopapular rash, and conjunctivitis.
In addition, neurological manifestations
and congenital anomalies have been
associated with ZIKV disease outbreaks.
ZIKV infection has been associated with
´
Guillain-Barre syndrome. ZIKV
infection during pregnancy is a cause of
microcephaly and other serious fetal
brain anomalies. Other problems have
been detected in pregnancies and among
fetuses and infants infected with ZIKV
before birth, such as miscarriage,
stillbirth, absent or poorly developed
brain structures, defects of the eye,
hearing deficits, and impaired growth;
however, the full clinical spectrum of
the effects of ZIKV infection during
pregnancy is not yet known.
FDA has identified ZIKV as a
transfusion-transmitted infection under
§ 630.3(l) and RTTI under § 630.3(h)(2).
This determination is based on the
severity of the disease, risk of
transfusion-transmission by blood and
blood components, the availability of
appropriate screening measures, and
significant incidence and prevalence
affecting the potential donor population.
The guidance recommends that blood
establishments test all donations
collected in the United States and its
territories with an investigational
individual donor nucleic acid test (ID–
NAT) for ZIKV under an investigational
new drug application (IND), or when
available, a licensed test. Alternatively,
blood establishments may implement
pathogen reduction technology for
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platelets and plasma using an FDAapproved pathogen reduction device as
specified in the Instructions for Use of
the device. If an FDA-approved
pathogen reduction device becomes
available for Whole Blood or red blood
cells, blood establishments may
implement pathogen reduction
technology for such products rather
than testing the donations. Blood
establishments implementing these
measures may discontinue providing
donor educational material with respect
to ZIKV and screening donors for ZIKV
risk factors such as travel history and
deferring them as previously
recommended in the February 2016
guidance. Under 21 CFR 630.10(a), if a
donor volunteers a recent history of
ZIKV infection, a blood establishment
must not collect blood or blood
components from that donor. For such
donors, the guidance recommends a
deferral period of 120 days after a
positive viral test or the resolution of
symptoms, whichever timeframe is
longer.
FDA recommends that blood
establishments implement the
recommendations in the guidance as
follows: (1) Blood establishments that
collect Whole Blood and blood
components in U.S. States and
territories with one or more reported
locally acquired mosquito-borne cases
of ZIKV should implement the
recommendations immediately. Blood
establishments should cease blood
collection until testing or the use of
pathogen reduction technology is
implemented, consistent with the
recommendations in the guidance. As of
the date of issuance of the guidance, the
recommendations applies to blood
establishments that collect Whole Blood
and blood components in Florida and
Puerto Rico; (2) because of their
proximity to areas with locally acquired
mosquito-borne cases of ZIKV or
because of other epidemiological
linkage to ZIKV, such as the number of
travel-associated cases reported in a
State, blood establishments that collect
Whole Blood and blood components in
Alabama, Arizona, California, Georgia,
Hawaii, Louisiana, Mississippi, New
Mexico, New York, South Carolina, and
Texas should implement the
recommendations as soon as feasible,
but not later than 4 weeks after the
guidance issue date; and (3) blood
establishments that collect Whole Blood
and blood components in all other
States and territories should implement
the recommendations as soon as
feasible, but not later than 12 weeks
after the date of the issuance of this
guidance.
PO 00000
Frm 00032
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60007
This guidance is being issued
consistent with FDA’s good guidance
practices regulation (21 CFR 10.115).
FDA is issuing this guidance for
immediate implementation in
accordance with 21 CFR 10.115(g)(2)
without initially seeking prior comment
because the Agency has determined that
prior public participation is not feasible
or appropriate. The guidance represents
the current thinking of FDA on ‘‘Revised
Recommendations for Reducing the Risk
of Zika Virus Transmission by Blood
and Blood Components.’’ 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
This 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
606.100(b) and 606.160(b)(1) have been
approved under OMB control number
0910–0795; and the collections of
information in 21 CFR 606.122 and
630.30 have been approved under OMB
control number 0910–0116.
III. Electronic Access
Persons with access to the Internet
may obtain the guidance at either https://
www.fda.gov/BiologicsBloodVaccines/
GuidanceComplianceRegulatory
Information/Guidances/default.htm or
https://www.regulations.gov.
Dated: August 25, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016–20914 Filed 8–30–16; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
National Advisory Committee on Rural
Health and Human Services; Notice of
Meeting
In accordance with Section 10(a)(2) of
the Federal Advisory Committee Act
(Pub. L. 92–463), notice is hereby given
of the following meeting:
NAME: National Advisory Committee on
Rural Health and Human Services.
E:\FR\FM\31AUN1.SGM
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Agencies
[Federal Register Volume 81, Number 169 (Wednesday, August 31, 2016)]
[Notices]
[Pages 60005-60007]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-20914]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2016-D-0545]
Revised Recommendations for Reducing the Risk of Zika Virus
Transmission by Blood and Blood Components; Guidance for Industry;
Availability
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice of availability.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing
the availability of a document entitled ``Revised Recommendations for
Reducing the Risk of Zika Virus Transmission by Blood and Blood
Components; Guidance for Industry.'' The guidance document is notifying
blood establishments that collect Whole Blood and blood components,
that FDA has determined Zika virus (ZIKV) to be a relevant transfusion-
transmitted infection (RTTI) and provides FDA's assessment. The
guidance also provides recommendations to reduce the risk of
transmission of ZIKV by Whole Blood and blood components. The guidance
applies to the collection of Whole Blood and blood components. The
guidance does not apply to the collection of Source Plasma. The
guidance supersedes the February 2016 document entitled,
``Recommendations for Donor Screening, Deferral, and Product Management
to Reduce the Risk of Transfusion-Transmission of Zika Virus: Guidance
for Industry'' (February 2016 guidance), and the March 2016 document
entitled, ``Questions and Answers Regarding `Recommendations for Donor
Screening, Deferral, and Product Management to Reduce the Risk of
Transfusion-Transmission of Zika Virus: Guidance for Industry' '' no
later than 12 weeks after the date of the issuance of this guidance.
Implementation of the guidance will be immediate for blood
establishments that collect Whole Blood and blood components in States
and territories with local transmission of ZIKV by mosquitos, and will
be phased in over 4 to 12 weeks in other States and territories using a
tiered, risk-based approach. Blood establishments should follow the
recommendations in the February 2016 guidance until the recommendations
in the guidance document have been fully implemented.
DATES: The Agency is soliciting public comment, but is implementing
this guidance immediately because the
[[Page 60006]]
Agency has determined that prior public participation is not feasible
or appropriate. Submit either electronic or written comments on Agency
guidances at any time.
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-2016-D-0545 for ``Revised Recommendations for Reducing the Risk of
Zika Virus; 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.
Submit written requests for single copies of the guidance to the
Office of Communication, Outreach and Development, Center for Biologics
Evaluation and Research (CBER), Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 3128, Silver Spring, MD 20993-0002. Send
one self-addressed adhesive label to assist the office in processing
your requests. The guidance may also be obtained by mail by calling
CBER at 1-800-835-4709 or 240-402-8010. See the SUPPLEMENTARY
INFORMATION section for electronic access to the guidance document.
FOR FURTHER INFORMATION CONTACT: Jonathan McKnight, 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 guidance entitled ``Revised
Recommendations for Reducing the Risk of Zika Virus Transmission by
Blood and Blood Components; Guidance for Industry.'' The guidance is
notifying blood establishments that collect Whole Blood and blood
components that FDA has determined ZIKV to be an RTTI under 21 CFR
630.3(h)(2) and provides FDA's assessment. The guidance provides
recommendations to reduce the risk of transmission of ZIKV by Whole
Blood and blood components. The guidance does not apply to the
collection of Source Plasma, which is used for further manufacture of
plasma-derived products. If, based upon the available scientific
evidence, the risk of ZIKV transmission by blood and blood components
significantly changes, FDA may update the recommendations as warranted.
In making this determination, FDA will consider available epidemiologic
and other scientific evidence.
The guidance supersedes the February 2016 guidance entitled,
``Recommendations for Donor Screening, Deferral, and Product Management
to Reduce the Risk of Transfusion-Transmission of Zika Virus; Guidance
for Industry'' and the March 2016 guidance entitled, ``Questions and
Answers Regarding `Recommendations for Donor Screening, Deferral, and
Product Management to Reduce the Risk of Transfusion-Transmission of
Zika Virus: Guidance for Industry' '' no later than 12 weeks after the
date of the issuance of this guidance. Implementation of the guidance
will be immediate for blood establishments that collect Whole Blood and
blood components in States and territories with local transmission of
ZIKV by mosquitos, and will be phased in over 4 to 12 weeks in other
States and territories using a tiered, risk-based approach. Blood
establishments should follow the recommendations in the February 2016
guidance until they fully implement the recommendations in the guidance
document currently being issued.
ZIKV is an arbovirus from the Flaviviridae family, genus
Flavivirus. It is transmitted to humans primarily by the Aedes aegypti
mosquito, but it may also be transmitted by the Aedes albopictus
mosquito.
The global ZIKV epidemic expanded in the region of the Americas by
early
[[Page 60007]]
2015 when the first local transmission was reported in Brazil. Local
transmission of ZIKV has also been reported in areas outside of the
Americas, including the Pacific Islands of Samoa, American Samoa,
Marshall Islands and Tonga, and Cape Verde in Africa, and there are now
at least 50 countries and territories worldwide with active local
transmission of the virus.
The first local transmission of ZIKV in the United States was
reported from Puerto Rico in December 2015, and soon thereafter local
transmission was also reported in American Samoa and the U.S. Virgin
Islands. In July 2016, the first cases of local transmission of ZIKV
occurring in the continental United States were reported from Miami-
Dade County in Florida. The possibility of further geographic spread of
ZIKV exists in regions where the Aedes aegypti, and possibly the Aedes
albopictus, mosquito is present. In January 2016, ZIKV disease was
added to the list of nationally notifiable conditions in the United
States as a subtype of Arboviral diseases.
The most common ZIKV disease symptoms include fever, arthralgia,
maculopapular rash, and conjunctivitis. In addition, neurological
manifestations and congenital anomalies have been associated with ZIKV
disease outbreaks. ZIKV infection has been associated with Guillain-
Barr[eacute] syndrome. ZIKV infection during pregnancy is a cause of
microcephaly and other serious fetal brain anomalies. Other problems
have been detected in pregnancies and among fetuses and infants
infected with ZIKV before birth, such as miscarriage, stillbirth,
absent or poorly developed brain structures, defects of the eye,
hearing deficits, and impaired growth; however, the full clinical
spectrum of the effects of ZIKV infection during pregnancy is not yet
known.
FDA has identified ZIKV as a transfusion-transmitted infection
under Sec. 630.3(l) and RTTI under Sec. 630.3(h)(2). This
determination is based on the severity of the disease, risk of
transfusion-transmission by blood and blood components, the
availability of appropriate screening measures, and significant
incidence and prevalence affecting the potential donor population.
The guidance recommends that blood establishments test all
donations collected in the United States and its territories with an
investigational individual donor nucleic acid test (ID-NAT) for ZIKV
under an investigational new drug application (IND), or when available,
a licensed test. Alternatively, blood establishments may implement
pathogen reduction technology for platelets and plasma using an FDA-
approved pathogen reduction device as specified in the Instructions for
Use of the device. If an FDA-approved pathogen reduction device becomes
available for Whole Blood or red blood cells, blood establishments may
implement pathogen reduction technology for such products rather than
testing the donations. Blood establishments implementing these measures
may discontinue providing donor educational material with respect to
ZIKV and screening donors for ZIKV risk factors such as travel history
and deferring them as previously recommended in the February 2016
guidance. Under 21 CFR 630.10(a), if a donor volunteers a recent
history of ZIKV infection, a blood establishment must not collect blood
or blood components from that donor. For such donors, the guidance
recommends a deferral period of 120 days after a positive viral test or
the resolution of symptoms, whichever timeframe is longer.
FDA recommends that blood establishments implement the
recommendations in the guidance as follows: (1) Blood establishments
that collect Whole Blood and blood components in U.S. States and
territories with one or more reported locally acquired mosquito-borne
cases of ZIKV should implement the recommendations immediately. Blood
establishments should cease blood collection until testing or the use
of pathogen reduction technology is implemented, consistent with the
recommendations in the guidance. As of the date of issuance of the
guidance, the recommendations applies to blood establishments that
collect Whole Blood and blood components in Florida and Puerto Rico;
(2) because of their proximity to areas with locally acquired mosquito-
borne cases of ZIKV or because of other epidemiological linkage to
ZIKV, such as the number of travel-associated cases reported in a
State, blood establishments that collect Whole Blood and blood
components in Alabama, Arizona, California, Georgia, Hawaii, Louisiana,
Mississippi, New Mexico, New York, South Carolina, and Texas should
implement the recommendations as soon as feasible, but not later than 4
weeks after the guidance issue date; and (3) blood establishments that
collect Whole Blood and blood components in all other States and
territories should implement the recommendations as soon as feasible,
but not later than 12 weeks after the date of the issuance of this
guidance.
This guidance is being issued consistent with FDA's good guidance
practices regulation (21 CFR 10.115). FDA is issuing this guidance for
immediate implementation in accordance with 21 CFR 10.115(g)(2) without
initially seeking prior comment because the Agency has determined that
prior public participation is not feasible or appropriate. The guidance
represents the current thinking of FDA on ``Revised Recommendations for
Reducing the Risk of Zika Virus Transmission by Blood and Blood
Components.'' 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
This 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
606.100(b) and 606.160(b)(1) have been approved under OMB control
number 0910-0795; and the collections of information in 21 CFR 606.122
and 630.30 have been approved under OMB control number 0910-0116.
III. Electronic Access
Persons with access to the Internet may obtain the guidance at
either https://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/default.htm or https://www.regulations.gov.
Dated: August 25, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016-20914 Filed 8-30-16; 8:45 am]
BILLING CODE 4164-01-P