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All Delta Blood Bank employees who are exposed in their work to blood or blood products are offered HBV vaccination without charge. Delta Blood Bank strongly re- commends that vaccination to HBV be accomplished and requires that individuals declining this protection inform the blood bank of this decision in writing. Hepatitis C (Formerly Non-A,Non-B Hepatitis) Although the hepatitis C agent itself has not yet been visualized, scientists at the Chiron Corporation have been able to characterize the major portion of the genome by sophisticated studies of nucleic acid libraries. The agent appears to be a small lipid -enveloped virus less than 60 nanometers in diameter. It has a single positive RNA strand of about 10,000 nucleotides. Until 1990, hepatitis C infection (then called non-A, non-B hepatitis) was diagnosed by indirect means. When an individual had a hepatitis infection, test panels of HAV and HBV serologic markers were run. If these specific tests were negative, by exclusion the patient was said to have non-A,non-B. Using the Chiron HCV nucleotides, a test for anti -HCV antibody was developed. Considered the most common type of hepatitis today, HCV has an incidence believed to be less than 1% following a single -unit transfusion. The major clinical features of HCV hepatitis are subclinical, and jaundice is infrequent. Raised serum enzymes such as ALT typically fluctuate and may be missed. The major significance is the tendency to develop progressive liver disease. One of the major complications of HCV hepatitis is the development of chronic active hepatitis and, subsequently, postnecrotic cirrhosis. Fifteen to 20% of the patients with HCV hepatitis may develop cirrhosis. ral".5mm Cytomegalovirus (CMV) belongs to the Herpes virus group. It is an enveloped, double-stranded DNA virus whose capsid dis- plays icosahedral symmetry and consists of 162 capsomeres. Like other Herpes viruses, CMV is capable of producing latent infection. Most evidence points to mononuclear cells, specifically lymphocytes, as the site of CMV latency. Whole blood or leukocytes from asymptomatic individuals can transmit CMV infection. Extensive efforts to isolate this virus from stored bank blood have not been successful, supporting the hypothesis that the virus is transmitted in a latent state, not actively replicating. CMV infection can cause immunosuppression and has been associated with ",post - perfusion syndrome." The syndrome was first described fol- lowing coronary bypass procedures, but can occur after any BIOSAFETY - INFAGT - 0491 - PAGE 3