Q:

1/8/2014
Have there ever been any reports of transmission of any type of infection with HSA as a diluent in IT? Has it ever been considered a blood product requiring consent as such? Is the HSA in ALK diluent bottles a recombitant form or pulled from screened donors?

A:

Thank you for your inquiry.

A similar question was submitted to our Ask the Expert website and was posted on 12/5/2013. For your convenience, I have copied the question and the response below.

When I did a second literature search based upon your question, factoring in specifically human serum albumin (HSA), I received basically the same results. That is, I could find no case of transmission of infection via allergen immunotherapy regardless of whether one used or did not use "human serum albumin" or "allergy diluent" as key words with the searches.

Therefore, I think that the previous answer still stands. Human serum albumin is of course considered a blood product, but normally would not require consent when administered as a diluent for allergen immunotherapy. At least that is my experience and opinion.

There was one difference in my literature search that was unrelated to allergen immunotherapy. I did find that there was a discussion of the possible transmission of infection via human serum albumin administered as a blood product in large amounts for resuscitation in pediatric patients. This is especially true in countries where AIDS is more prevalent. There is a discussion of this issue which is available at no charge online here.

Human serum albumin in the diluent supplied by ALK is obtained via pooled donor sera.

Thank you again for your inquiry and we hope this response is helpful to you.

Previous submission to the Ask the Expert website:
Infection related to allergy injections
Question:
12/5/2013
Are you aware of any case reports, or have you heard any anecdotal reports, of anybody acquiring a bacterial soft tissue infection/bacterial cellulitis, or more infections such as fasciitis/deep tissue bacterial infection/bacteremia/sepsis from an allergy shot injection--anywhere in the world?

(What prompted me to ask this question is that I received a notice today from the JCAAI explaining the allergy shot preparation guidelines.)

Answer:
Thank you for your inquiry. I am not aware of any such case nor could I find any with a literature search. Thank you again for your inquiry.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology