Rapid Response Survey for Hepatitis E Virus-Exposure Blood Donors

Hepatitis E Virus-Exposure Survey Questions of Blood Donors

1. In the past 5 years, have you eaten pork, including pork sausages?

Yes: 1A: In the past five years, to your knowledge, have you eaten raw, rare, or undercooked pork, including pork sausages?

Yes

No

No

1. Have you ever had the following symptoms: yellowing of the skin or eyes in combination with fever, fatigue, abdominal tenderness, or dark urine?

Yes:  2A: Did you see your doctor for these symptoms?

Yes: 2B: Did she/he give you a diagnosis of Hepatitis A or Hepatitis E virus

infection?    

Yes:  2C: Did you travel outside the U.S. within a month prior to

having symptoms?

Yes

No

No

No

No

1. Have you had the Hepatitis A virus vaccine?

Yes: 3A: What was the reason you were vaccinated for Hepatitis A:

         Travel

         Work in the food preparation industry

• Child care staff

• Hospital work

• Routine childhood vaccination

• Following exposure

• Other

No

1. Do you work, live, or spend time on farms where there are pigs?

Yes

No