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Limothai U, Tachaboon S, Dinhuzen J, Singh J, Leewongworasingh A, Watanaboonyongcharoen P, Fernandez S, Hunsawong T, Farmer AR, Tantawichien T, Thisyakorn U, Srisawat N. Dengue virus transmission risk in blood donation: Evidence from Thailand. J Med Virol 2024; 96:e29689. [PMID: 38818789 DOI: 10.1002/jmv.29689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/28/2024] [Accepted: 05/12/2024] [Indexed: 06/01/2024]
Abstract
Individuals infected with dengue virus (DENV) often show no symptoms, which raises the risk of DENV transfusion transmission (TT-DENV) in areas where the virus is prevalent. This study aimed to determine the evidence of DENV infection in blood donors from different geographic regions of Thailand. A cross-sectional study was conducted on blood donor samples collected from the Thai Red Cross National Blood Center and four regional blood centers between March and September 2020. Screening for DENV nonstructural protein 1 (NS1), anti-DENV immunoglobulin G (IgG), and IgM antibodies was performed on residual blood from 1053 donors using enzyme-linked immunosorbent assay kits. Positive NS1 and IgM samples indicating acute infection were verified using four different techniques, including quantitative real-time (q) RT-PCR, nested PCR, virus isolation in C6/36 cells, and mosquito amplification. DENV IgG seropositivity was identified in 89% (938/1053) of blood donors. Additionally, 0.4% (4/1053) and 2.1% (22/1053) of Thai blood donors tested positive for NS1 and IgM, respectively. The presence of asymptomatic dengue virus infection in healthy blood donors suggests a potential risk of transmission through blood transfusion, posing a concern for blood safety.
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Affiliation(s)
- Umaporn Limothai
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Sasipha Tachaboon
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Janejira Dinhuzen
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Jasleen Singh
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- School of Global Health, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Thailand Public Health Research Fellowship, Health Education England, London, UK
| | - Akarathep Leewongworasingh
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Phandee Watanaboonyongcharoen
- Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University and Transfusion Medicine Unit, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Stefan Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Taweewun Hunsawong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Aaron R Farmer
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand
| | - Terapong Tantawichien
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Usa Thisyakorn
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nattachai Srisawat
- Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
- Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Critical Care Medicine, Center for Critical Care Nephrology, The CRISMA Center, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Academy of Science, Royal Society of Thailand, Bangkok, Thailand
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de Oliveira FN, Ferreira SC, Nishiya AS, Mendrone-Junior A, Batista MV, Rocha V, Costa SF. Evaluation of Dengue, Zika virus, and Chikungunya virus transmission by blood components in recipients of haematopoietic stem cell transplantation. Transfus Med 2023; 33:403-408. [PMID: 37525935 DOI: 10.1111/tme.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 06/12/2023] [Accepted: 07/12/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Brazil has a high prevalence of arboviruses, especially Dengue (DENV), Zika (ZKV), and Chikungunya (CHKV). OBJECTIVES To study the risk of DENV, ZKV, and CHKV transmission by blood components in the haematopoietic stem cell transplantation (HSCT) population. METHODS Prospective cohort of HSCT recipients and donors performed at the Hospital das Clinicas da FMUSP, São Paulo-Brazil. Patients were evaluated by serology and RT-PCR for DENV, ZKV, and CHKV pre-transplantation and once a week until neutrophil grafting. In positive cases (positive RT-PCR and/or serology conversion), an investigation was carried out on the blood components that the patient received to evaluate the possibility of it being transfusion transmitted. RESULTS A total of 93 patients were included during the study period. The mean age was 52 years with a predominance of males (56.9%). We considered five (5.3%) DENV cases positive by seroconversion in our study. One patient had IgM seroconversion and the other four presented IgG seroconversion to DENV. In the investigation of the blood components, 145 individual samples were analysed. None of the investigated blood components showed a positive RT-PCR. CONCLUSION We observed a low prevalence of DENV, ZKV, and CHKV in HSCT donors and recipients by serology and RT-PCR, and no case of blood transfusion transmission by RT-PCR.
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Affiliation(s)
- Fernando Nivaldo de Oliveira
- Laboratório de Investigação Médica (LIM-49), Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Departamento de Biologia Molecular, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil
| | - Suzete Cleusa Ferreira
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia (LIM-31), Departamento de Hematologia, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Anna Shoko Nishiya
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia (LIM-31), Departamento de Hematologia, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alfredo Mendrone-Junior
- Laboratório de Investigação Médica em Patogênese e Terapia dirigida em Onco-Imuno-Hematologia (LIM-31), Departamento de Hematologia, Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marjorie Vieira Batista
- Laboratório de Investigação Médica (LIM-49), Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Departamento de Biologia Molecular, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil
| | - Vanderson Rocha
- Bone Marrow Transplantation Unit, Hospital das Clinicas da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvia Figueiredo Costa
- Laboratório de Investigação Médica (LIM-49), Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Departamento de Biologia Molecular, Fundação Pró-Sangue/Hemocentro de São Paulo, São Paulo, SP, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Pozzetto B, Grard G, Durand G, Paty MC, Gallian P, Lucas-Samuel S, Diéterlé S, Fromage M, Durand M, Lepelletier D, Chidiac C, Hoen B, Nicolas de Lamballerie X. Arboviral Risk Associated with Solid Organ and Hematopoietic Stem Cell Grafts: The Prophylactic Answers Proposed by the French High Council of Public Health in a National Context. Viruses 2023; 15:1783. [PMID: 37766192 PMCID: PMC10536626 DOI: 10.3390/v15091783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 09/29/2023] Open
Abstract
Diseases caused by arboviruses are on the increase worldwide. In addition to arthropod bites, most arboviruses can be transmitted via accessory routes. Products of human origin (labile blood products, solid organs, hematopoietic stem cells, tissues) present a risk of contamination for the recipient if the donation is made when the donor is viremic. Mainland France and its overseas territories are exposed to a complex array of imported and endemic arboviruses, which differ according to their respective location. This narrative review describes the risks of acquiring certain arboviral diseases from human products, mainly solid organs and hematopoietic stem cells, in the French context. The main risks considered in this study are infections by West Nile virus, dengue virus, and tick-borne encephalitis virus. The ancillary risks represented by Usutu virus infection, chikungunya, and Zika are also addressed more briefly. For each disease, the guidelines issued by the French High Council of Public Health, which is responsible for mitigating the risks associated with products of human origin and for supporting public health policy decisions, are briefly outlined. This review highlights the need for a "One Health" approach and to standardize recommendations at the international level in areas with the same viral epidemiology.
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Affiliation(s)
- Bruno Pozzetto
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- GIMAP Team, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet de Saint-Etienne, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, 42023 Saint-Etienne, France
- Department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| | - Gilda Grard
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
| | - Guillaume Durand
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
| | - Marie-Claire Paty
- Santé Publique France, The French Public Health Agency, 94410 Saint-Maurice, France;
| | - Pierre Gallian
- Etablissement Français du Sang, 93218 Saint-Denis, France;
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), 13385 Marseille, France
| | | | | | - Muriel Fromage
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), 93200 Saint-Denis, France;
| | - Marc Durand
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
| | - Didier Lepelletier
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
| | - Christian Chidiac
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- Department of Infectious and Tropical Diseases, University Hospital of Lyon, 69002 Lyon, France
| | - Bruno Hoen
- Haut Conseil de la Santé Publique, Ministère de la Santé et de la Prévention, 75007 Paris, France; (M.D.); (D.L.); (C.C.); (B.H.)
- Department of Infectious Diseases, University Hospital of Nancy, 54500 Vandoeuvre-lès-Nancy, France
| | - Xavier Nicolas de Lamballerie
- National Reference Center for Arboviruses, National Institute of Health and Medical Research (Inserm), 13005 Marseille, France; (G.G.); (G.D.); (X.N.d.L.)
- French Armed Forces Biomedical Research Institute (IRBA), Valérie-André, 91220 Brétigny-sur-Orge, France
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207), 13385 Marseille, France
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Lamarão LM, Corrêa ASM, de Castro RBH, de Melo Amaral CE, Monteiro PDJ, Palmeira MK, Lopes LN, Oliveira AN, de Lima MSM, Moreira-Nunes CA, Burbano RR. Prevalence of Dengue, Chikungunya and Zika Viruses in Blood Donors in the State of Pará, Northern Brazil: 2018-2020. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010079. [PMID: 36676703 PMCID: PMC9866458 DOI: 10.3390/medicina59010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
Arboviruses have been reported over the years as constant threats to blood transfusion recipients, given the high occurrence of asymptomatic cases and the fact that the presence of viremia precedes the onset of symptoms, making it possible that infected blood from donors act as a source of dissemination. This work aims to identify the prevalence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) infection in blood donors during epidemic and non-epidemic periods; classify the donor as symptomatic or asymptomatic; and verify the need to include DENV, CHIKV and ZIKV in the nucleic acid test (NAT) platform in northern Brazil. We investigated 36,133 thousand donations in two years of collection in Northern Brazil. One donor was positive for DENV and one for CHIKV (0.002% prevalence). As the prevalence for arboviruses was low in this study, it would not justify the individual screening of samples from donors in a blood bank. Thus, DENV- and CHIKV-positive samples were simulated in different amounts of sample pools, and both were safely detected by molecular biology even in a pool of 14 samples, which would meet the need to include these three viruses in the routine of blood centers in endemic countries such as Brazil.
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Affiliation(s)
- Leticia Martins Lamarão
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Angelita Silva Miranda Corrêa
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | | | - Carlos Eduardo de Melo Amaral
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Patricia Danin Jordão Monteiro
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Mauricio Koury Palmeira
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Luane Nascimento Lopes
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Angela Neves Oliveira
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Maria Salete Maciel de Lima
- Foundation Center for Hemotherapy and Hematology of Pará, Nucleic Acid Test (NAT) Department, Belém 66033-000, PA, Brazil
| | - Caroline Aquino Moreira-Nunes
- Pharmacogenetics Laboratory, Drug Research and Development Center, Department of Medicine, Federal University of Ceará, Fortaleza 60430-275, CE, Brazil
- Oncology Research Center, Department of Biological Sciences, Federal University of Pará, Belém 66073-005, PA, Brazil
- Correspondence: (C.A.M.-N.); (R.R.B.)
| | - Rommel Rodríguez Burbano
- Molecular Biology Laboratory, Ophir Loyola Hospital, Belém 66063-240, PA, Brazil
- Human Cytogenetics Laboratory, Biological Science Institute, Federal University of Pará, Belém 66075-110, PA, Brazil
- Correspondence: (C.A.M.-N.); (R.R.B.)
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Slavov SN. Viral Metagenomics for Identification of Emerging Viruses in Transfusion Medicine. Viruses 2022; 14:v14112448. [PMID: 36366546 PMCID: PMC9699440 DOI: 10.3390/v14112448] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Viral metagenomics has revolutionized our understanding for identification of unknown or poorly characterized viruses. For that reason, metagenomic studies gave been largely applied for virus discovery in a wide variety of clinical samples, including blood specimens. The emerging blood-transmitted virus infections represent important problem for public health, and the emergence of HIV in the 1980s is an example for the vulnerability of Blood Donation systems to such infections. When viral metagenomics is applied to blood samples, it can give a complete overview of the viral nucleic acid abundance, also named "blood virome". Detailed characterization of the blood virome of healthy donors could identify unknown (emerging) viral genomes that might be assumed as hypothetic transfusion threats. However, it is impossible only by application of viral metagenomics to assign that one viral agent could impact blood transfusion. That said, this is a complex issue and will depend on the ability of the infectious agent to cause clinically important infection in blood recipients, the viral stability in blood derivatives and the presence of infectious viruses in blood, making possible its transmission by transfusion. This brief review summarizes information regarding the blood donor virome and some important challenges for use of viral metagenomics in hemotherapy for identification of transfusion-transmitted viruses.
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Affiliation(s)
- Svetoslav Nanev Slavov
- Department of Cellular and Molecular Therapy (NuCeL), Butantan Institute, São Paulo 05503-900, SP, Brazil; ; Tel.: +55-(16)-2101-9300 (ext. 9365)
- Laboratory of Bioinformatics, Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Rua Tenente Catão Roxo 2501, Ribeirão Preto CEP 14051-140, SP, Brazil
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Giménez-Richarte Á, Ortiz de Salazar MI, Giménez-Richarte MP, Collado M, Fernández PL, Clavijo C, Navarro L, Arbona C, Marco P, Ramos-Rincon JM. Transfusion-transmitted arboviruses: Update and systematic review. PLoS Negl Trop Dis 2022; 16:e0010843. [PMID: 36201547 PMCID: PMC9578600 DOI: 10.1371/journal.pntd.0010843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/18/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
Background The detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics. Material and methods Systematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355. Results A total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety. Discussion In the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety. The transfusion of blood and blood components entails some risks and potential complications, chief among them the transmission of infectious agents. Organizations like the American Association of Blood Banks have warned of the risks posed by emerging and re-emerging viruses for transfusion safety and have classified transmission of several arboviruses as a high or very high risk to the transfusion of blood and blood components. Following recommendations by the World Health Organization (WHO), this study aims to enable safe blood transfusion services, by making available the latest updated information of transfusion-transmitted arboviruses and comprehensive knowledge of the current epidemiology of reported cases. Research revealed case reports of transfusion transmission of 10 arboviruses, with West Nile virus and dengue virus as the most prevalent. Main clinical characteristics of reported cases were collected, including the type of blood component transfused and the state of immunosuppression of the recipient. Research also revealed 18 additional arboviruses with potential risk of transmission through other direct transmission routes. This systematic review provides an updated overview of the clinical characteristics of reported cases of transfusion-transmitted arboviruses. It is the most complete record published to date that assesses the risk posed by arboviruses to blood transfusion.
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Affiliation(s)
| | | | | | - Miriam Collado
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | | | - Carlos Clavijo
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Laura Navarro
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Cristina Arbona
- Valencian Community Blood Transfusion Center, Valencia, Spain
| | - Pascual Marco
- Service of Hematology, General- University Hospital of Alicante-ISABIAL. Alicante, Spain
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
| | - Jose-Manuel Ramos-Rincon
- Clinical Medicine Department, Miguel Hernandez University of Elche, Alicante, Spain
- * E-mail: (AG-R); (J-MR-R)
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7
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OUP accepted manuscript. J Infect Dis 2022; 225:1497-1499. [DOI: 10.1093/infdis/jiac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 11/12/2022] Open
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8
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OUP accepted manuscript. J Infect Dis 2022; 225:1504-1512. [DOI: 10.1093/infdis/jiac014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
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9
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Pozzetto B, Leparc-Goffard I, Laperche S, Chidiac C. [Gestion of arboviral alerts: Experience feedback from the Secproch working group of the French "Haut Conseil de la santé publique" (2019-2021)]. Transfus Clin Biol 2021; 28:334-343. [PMID: 34562626 DOI: 10.1016/j.tracli.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Secproch working group (for "sécurité des produits issus du corps humain") was created in 2019 within the « Haut Conseil de la santé publique » (HCSP) for addressing all the questions related to labile blood products, organs, tissues, cells (OTC) and gametes issued from human body. It is notably in charge of the management of alerts regarding arbovirus infections. These infections due to arthropod-transmitted viruses are responsible for emergence and reemergence, notably in the context of global warming. This review relates the alerts taken into consideration by the Secproch group between 2019 and 2021 following three pathologies due to Flaviviridae : dengue, West Nile virus (WNV) infection and tick-borne encephalitis (TBE). The dengue alerts have occurred in French Indies where the virus is endemic/epidemic, Reunion Island where the population was naïve until 2018 towards the virus, and the metropole where foci of autochthonous cases are observed sporadically. The WNV infection was responsible of both human and equine cases in 2019 in the South of France but with intensity much less than in 2018. At last, the TBE virus was at the origin of a cluster of about 40 cases in the Ain department following a contamination by crude non-pasteurized goat cheese. This review offers the opportunity to reevaluate the risks linked to these three viruses through blood products and organs/tissues/cells and to precise the means recommended by HCSP to secure these products.
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Affiliation(s)
- B Pozzetto
- Service des agents infectieux et d'hygiène, CHU de Saint-Étienne, Saint-Étienne, France.
| | - I Leparc-Goffard
- Centre national de référence des Arbovirus, Institut de recherche biomédicale des armées, Marseille, France
| | - S Laperche
- Institut national de transfusion sanguine, Paris, France
| | - C Chidiac
- Service des maladies infectieuses et tropicales, hôpital de la Croix-Rousse, CHU de Lyon, Lyon, France
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Perera L, De Zoysa N, Jayarajah U, Senanayake N, De Zoysa I, Seneviratne SL. Transfusion-transmissible dengue infections. Trans R Soc Trop Med Hyg 2021; 114:866-882. [PMID: 32879985 DOI: 10.1093/trstmh/traa075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/24/2020] [Accepted: 08/03/2020] [Indexed: 12/16/2022] Open
Abstract
Dengue is an important global health problem and is endemic in many developing and developed countries. Transmission of dengue may occur in several ways and information on transfusion-transmitted dengue is limited. We conducted a literature search on transfusion-related dengue using the PubMed, Scopus, Embase and Google Scholar databases and have summarized the findings. A number of apparently healthy blood donors have been found to be infected with the dengue virus (DENV) and thus may transmit the virus onto recipients of this blood. It is not possible to identify and exclude such donors at the donor selection stage and thus reliable screening tests should be available in highly endemic areas to ensure a safe blood supply.
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Affiliation(s)
- Lakshika Perera
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | | | - Umesh Jayarajah
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | - Nilanthi Senanayake
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka
| | - Ishan De Zoysa
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
| | - Suranjith L Seneviratne
- Department of Surgery, Faculty of Medicine, University of Colombo, Colombo 8, Sri Lanka.,Dengue Research Group, Colombo, Sri Lanka
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11
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Costa-Lima C, Benites BD, Rocha DR, Andrade E, Alvarez P, Magnus MM, Addas-Carvalho M. Postdonation information during dengue outbreaks at a single blood center in Brazil: An ally against transfusion-transmitted infections. Asian J Transfus Sci 2021; 15:82-86. [PMID: 34349462 PMCID: PMC8294429 DOI: 10.4103/ajts.ajts_108_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 06/05/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Brazilian blood banks encourage donors to report postdonation information (PDI) regarding conditions that would lead to deferral in an attempt to retrieve distributed nonconforming blood. OBJECTIVES: This study evaluated the profile of donors reporting PDI, the impact on transfusion safety, and the possible impact on the discard of blood products. SUBJECTS AND METHODS: We analyzed 115 consecutive PDIs between May 2014 and July 2015, a period comprising two dengue-like syndrome (DLS) outbreaks. RESULTS: These PDIs accounted for 87,780 blood donations. The average time for PDIs since donation was 4 (0–23) days and 190 blood components were discarded. DLS accounted for 21.7% of the PDIs analyzed; 11 of the 23 samples tested were nucleic acid test (NAT) positive for dengue and 2 positive for Zika virus (ZIKV). Six of these PDIs were reported after blood components have been transfused: After NAT testing, one of these recipients was diagnosed with dengue and another one with ZIKV infection, both possible transfusions transmitted but without clinical consequences. CONCLUSION: The high number of recovered blood components due to PDI suggests that PDI remains a great ally in the fight against transfusion-transmitted infections and may be particularly useful during outbreaks of emerging potentially blood-borne pathogens.
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Affiliation(s)
- Carolina Costa-Lima
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas, Rio de Janeiro, Brazil
| | - Bruno Deltreggia Benites
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas, Rio de Janeiro, Brazil
| | - Daniele Ramos Rocha
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Elisabete Andrade
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Patricia Alvarez
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Mariana Munari Magnus
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas, Rio de Janeiro, Brazil
| | - Marcelo Addas-Carvalho
- Hematology and Transfusion Medicine Center, University of Campinas, Campinas, Rio de Janeiro, Brazil
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12
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Slavov SN, Santos EV, Hespanhol MR, Rodrigues ES, Haddad R, Ubiali EMA, Covas DT, Kashima S. Dengue RNA detection and seroprevalence in blood donors during an outbreak in the São Paulo State, Brazil, 2016. J Med Virol 2021; 93:3344-3349. [PMID: 33090520 DOI: 10.1002/jmv.26619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/05/2020] [Accepted: 10/20/2020] [Indexed: 11/10/2022]
Abstract
Most dengue virus (DENV) infections remain asymptomatic. This increases the risk of DENV transfusion transmission (TT-DENV) during outbreaks. We evaluated DENV viremia in 8475 blood donations assembled in minipools for the presence of DENV RNA. The tested samples were obtained between February and May, 2016, during a large DENV outbreak in Ribeirão Preto city, northeast region of the São Paulo State, Brazil. The DENV RNA + samples were serotyped and screened for DENV NS1. We also tested a significant number of plasma samples (n = 372) to estimate the DENV seroprevalence among blood donors in the region. We detected three DENV RNA + samples in the tested blood donations (n = 3/8475, 0.04%). From these, two samples were further serotyped as DENV-1 and one sample as DENV-2. All DENV RNA positive samples were negative for anti-DENV IgG, indicating the presence of primary acute infection. Moreover, two of the DENV RNA + samples were also NS1 antigen positive (antigenemia). The anti-DENV IgG seroprevalence among blood donor population was 50.8% (n = 189/372). Our results are in accordance with the presence of DENV primary infection in blood donors which can lead to transfusion transmission of the infection to recipients. Measures to exclude such donors should be adopted to prevent TT-DENV.
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Affiliation(s)
- Svetoslav N Slavov
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Elaine V Santos
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marta R Hespanhol
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Evandra S Rodrigues
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Haddad
- Laboratory of Clinical Analyses, Faculty of Ceilandia, University of Brasilia, Brasilia, Federal District, Brazil
- Center for Tropical Medicine, Faculty of Medicine, University of Brasilia, Brasilia, Federal District, Brazil
| | - Eugênia M A Ubiali
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Dimas T Covas
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Simone Kashima
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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13
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Stanley J, Chongkolwatana V, Duong PT, Kitpoka P, Stramer SL, Dung NTT, Grimm KE, Pojanasingchod A, Suksomboonvong P, Galel SA. Detection of dengue, chikungunya, and Zika RNA in blood donors from Southeast Asia. Transfusion 2021; 61:134-143. [PMID: 33026130 PMCID: PMC7821136 DOI: 10.1111/trf.16110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viruses are of concern due to the potential of transfusion transmission in blood, especially in regions such as Southeast Asia where the viruses are endemic. The recent availability of nucleic acid testing (NAT) to screen blood donations on an automated platform provides the opportunity to detect potentially infectious units in asymptomatic donors. STUDY DESIGN AND METHODS Three thousand blood donations from Vietnam and 6000 from Thailand were screened with a real-time polymerase chain reaction (PCR) test (cobas CHIKV/DENV, Roche Diagnostics, Indianapolis, IN) and equal numbers on cobas Zika (Roche Diagnostics). Reactive samples were tested by alternative NAT with resolution of discordant results by heminested PCR. Throughput of simultaneous testing of the two assays on the cobas 8800 system (Roche Diagnostics) was evaluated. RESULTS In Vietnam, 9 of 3045 samples were reactive for DENV and all were confirmed, for a prevalence (with 95% confidence interval [CI]) of 0.296% (0.135-0.560). In Thailand, 2 of 6000 samples were reactive for CHIKV, 4 of 6000 for DENV, and 1 of 6005 for ZIKV, and all confirmed. The prevalence of CHIKV is 0.033% (0.004-0.120), DENV 0.067% (0.018-0.171), and ZIKV 0.017% (0.000-0.093). The overall specificity for the cobas CHIKV/DENV and cobas Zika tests was 100% (99.959-100). For the simultaneous assay testing, 960 test results were available in 7 hours and 53 minutes. CONCLUSION Detection of CHIKV, DENV, and ZIKV RNA in donor samples in Vietnam and Thailand indicate the presence of the virus in asymptomatic blood donors. The cobas 6800/8800 systems (Roche Molecular Systems, Pleasanton, CA) enable screening blood donations in endemic areas for these viruses together or separately.
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Affiliation(s)
- Jean Stanley
- Medical and Scientific AffairsRoche Molecular DiagnosticsPleasantonCaliforniaUSA
| | | | - Pham Tuan Duong
- Blood ScreeningNational Institute of Hematology and Blood TransfusionHanoiVietnam
| | - Pimpun Kitpoka
- Faculty of MedicineRamathibodi Hospital, Mahidol UniversityBangkokThailand
| | | | | | - Kacie E. Grimm
- Scientific AffairsAmerican Red CrossGaithersburgMarylandUSA
| | | | | | - Susan A. Galel
- Medical and Scientific AffairsRoche Molecular DiagnosticsPleasantonCaliforniaUSA
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14
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Santos FLS, Slavov SN, Bezerra RS, Santos EV, Silva-Pinto AC, Morais ALL, Sá MB, Ubiali EMA, De Santis GC, Covas DT, Kashima S. Vaso-occlusive crisis in a sickle cell patient after transfusion-transmitted dengue infection. Transfusion 2020; 60:2139-2143. [DOI: 10.1111/trf.15968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/20/2020] [Accepted: 06/20/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Flávia L. S. Santos
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Svetoslav N. Slavov
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Rafael S. Bezerra
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Elaine V. Santos
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Ana C. Silva-Pinto
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Ana L. L. Morais
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Mariana B. Sá
- Hospital Estadual de Ribeirão Preto; Ribeirão Preto Brazil
| | - Eugênia M. A. Ubiali
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Gil C. De Santis
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - Dimas T. Covas
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
- Ribeirão Preto Medical School, University of São Paulo; Ribeirão Preto Brazil
| | - Simone Kashima
- Regional Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
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15
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Sawadogo S, Baguiya A, Yougbare F, Bicaba BW, Nebie K, Millogo T, Kamba I, Kaba L, Sangare L, Kafando E, Deneys V. Seroprevalence and factors associated with IgG anti-DENV positivity in blood donors in Burkina Faso during the 2016 dengue outbreak and implications for blood supply. Transfus Med 2019; 30:37-45. [PMID: 31709647 DOI: 10.1111/tme.12646] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 08/23/2019] [Accepted: 10/07/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Our study aimed to update the seroprevalence and factors associated with anti-dengue virus (DENV) antibody positivity among blood donors and to discuss their implications for blood supply. BACKGROUND Questions on the potential transmission of DENV by transfusion increased after the documentation of the risk of transmission of the West Nile virus. This risk was estimated after transfusion of DENV RNA-positive blood units of up to 37.5%. In Burkina Faso, very few studies on DENV in blood donors have been conducted. As a result, there were no reliable data on DENV to allow the implementation of appropriate measures to control the risk of transmission of the dengue virus by blood transfusion. METHODS We conducted a 4-week cross-sectional study from December 4 to 30, 2016. Blood donors of both genders, aged 18-60 years, accepted for blood donation after medical selection were consecutively enrolled. RESULTS Our study included a total of 1007 blood donors, in which donors living in urban areas represented 78.2%. The mean age was 26.1 ± 8.1 years. After adjustment in a multiple regression logistic model, the odds of having IgG anti-DENV increased as age increased. The odds of DENV was 53% lower in rural areas (OR = 0.47; P = .000) compared to urban settings and 42% lower in mobile sites (OR = 0.58; P = .03) compared to fixed ones. CONCLUSION Our study provides new and useful insights for future research on the risk of TT-DENV throughout blood transfusion.
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Affiliation(s)
- Salam Sawadogo
- Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Adama Baguiya
- Research Institute of Health Sciences, Ouagadougou, Burkina Faso
| | - Fiffou Yougbare
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | | | - Koumpingnin Nebie
- Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
| | - Tieba Millogo
- African Institute of Public Health, Ouagadougou, Burkina Faso
| | - Ibrahim Kamba
- Joseph KI-ZERBO University, Ouagadougou, Burkina Faso
| | - Losseni Kaba
- National Blood Transfusion Center, Ouagadougou, Burkina Faso
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16
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Benites BD, Rocha D, Andrade E, Godoy DT, Alvarez P, Addas-Carvalho M. Zika Virus and the Safety of Blood Supply in Brazil: A Retrospective Epidemiological Evaluation. Am J Trop Med Hyg 2019; 100:174-177. [PMID: 30398138 DOI: 10.4269/ajtmh.17-0843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The potential for transfusion transmission of dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV) has raised concerns about the safety of the blood supply in endemic areas. In this study, nucleic acid testing (NAT) for ZIKV, DENV, and CHIKV RNA was performed in asymptomatic blood donor samples in the city of Campinas, located in the southeast region of Brazil (1962 in 2015 and 1775 in 2016). The prevalence of reactive NAT was 0.15% in 2015 and 0.62% in 2016 for dengue, 0.05% in 2015 and 0.17% in 2016 for Zika, and 0% in both years for chikungunya. These results demonstrate the weakness of the clinical interview in screening these blood donors. Furthermore, positivity for ZIKV was detected in March 2015, 1 year before the first reported cases in the region. These data attest the feasibility of using donor samples held in library as a tool for retrospective epidemiological evaluation, which is particularly interesting considering emerging pathogens, for which data on their spread and penetrance are initially scarce.
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Affiliation(s)
| | - Daniele Rocha
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Elisabete Andrade
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Daniela T Godoy
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
| | - Patrícia Alvarez
- Institute of Technology in Immunobiology Bio-Manguinhos, Oswaldo Cruz Foundation/Fiocruz, Rio de Janeiro, Brazil
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17
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Shaji Mathew J, Menon VP, Menon VP, Mallick S, Sivasankara Pillai Thankamony Amma B, Balakrishnan D, Gopalakrishnan U, Narayana Menon R, Athira PP, Jagan OA, Surendran S. Dengue virus transmission from live donor liver graft. Am J Transplant 2019; 19:1838-1846. [PMID: 30672135 DOI: 10.1111/ajt.15270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 01/25/2023]
Abstract
Arboviral transmission through transplanted organs is rare. We report a highly probable case of dengue viral transmission during live donor liver transplantation. Fever with severe thrombocytopenia was observed in the donor and recipient within 6 and 9 days after transplantation, respectively. Dengue diagnosis was confirmed by testing blood and explant tissue from the donor and recipient using dengue-specific NAT (nucleic acid testing) and serology. Serology indicated the donor had secondary dengue infection that ran a mild course. However, the dengue illness in the recipient was severe and deteriorated rapidly, eventually proving fatal. The recipient's explant liver tissue tested negative for viral RNA indicative of a pretransplant naïve status. The prM-Envelope gene sequence analysis of the donor and recipient viral RNA identified a similar serotype (DENV1) with almost 100% sequence identity in the envelope region. Molecular phylogenetic analysis of donor and recipient viral envelope sequences with regional and local dengue strains further confirmed their molecular similarity, suggesting a probable donor-to-recipient transmission via organ transplantation. Screening of living donors for dengue virus may be considered in endemic regions.
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Affiliation(s)
- Johns Shaji Mathew
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Vidya P Menon
- Department of Clinical Infectious Diseases, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Veena P Menon
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Shweta Mallick
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | | | - Dinesh Balakrishnan
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Unnikrishnan Gopalakrishnan
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Ramachandran Narayana Menon
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Padmanabhan P Athira
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Ozhiparambil A Jagan
- Department of Virology, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
| | - Sudhindran Surendran
- Department of Solid Organ Transplant, Amrita Institute of Medical Sciences & Research Centre, Amrita University, Kochi, India
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18
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Slavov SN, Cilião-Alves DC, Gonzaga FAC, Moura DR, de Moura ACAM, de Noronha LAG, Cassemiro ÉM, Pimentel BMS, Costa FJQ, da Silva GA, Ramos DDAR, de Araújo WN, Kashima S, Haddad R. Dengue seroprevalence among asymptomatic blood donors during an epidemic outbreak in Central-West Brazil. PLoS One 2019; 14:e0213793. [PMID: 30908528 PMCID: PMC6433220 DOI: 10.1371/journal.pone.0213793] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/28/2019] [Indexed: 11/18/2022] Open
Abstract
Dengue virus (DENV) transmission by blood transfusion is an important route of viral acquisition during outbreaks. The prevalence of DENV markers (viral RNA, NS1, anti-DENV IgM, and IgG) among blood donors in Central-West Brazil has never been evaluated. Our aim was to evaluate the full set of serological and molecular markers for DENV among blood donors of the Federal District of Brazil during an extensive outbreak in 2016. We found an anti-DENV IgM prevalence of 6.74% (n = 32/475). Of 475, 20 samples (4.21%) were also anti-DENV IgG positive. All samples were non-reactive for NS1 and DENV RNA. Our results imply that a significant proportion of the tested donors had experienced asymptomatic infection. More studies are necessary to evaluate the real prevalence of DENV viremia in blood donors from the Federal District of Brazil and if specific measures are needed to routinely test the blood donors for DENV RNA during outbreaks.
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Affiliation(s)
- Svetoslav Nanev Slavov
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Filipe Almeida Carvalho Gonzaga
- Faculty of Ceilândia, University of Brasilia, Brasilia, Federal District, Brazil
- Center for Tropical Medicine, University of Brasilia, Brasilia, Federal District, Brazil
| | | | | | | | - Évelin Mota Cassemiro
- Faculty of Ceilândia, University of Brasilia, Brasilia, Federal District, Brazil
- Center for Tropical Medicine, University of Brasilia, Brasilia, Federal District, Brazil
| | | | | | - Grasiela Araújo da Silva
- Central Public Health Laboratory of Federal District – LACEN-DF, Brasilia, Federal District, Brazil
| | - Doralina do Amaral Rabello Ramos
- Laboratory of Molecular Pathology of Cancer, Faculty of Health Sciences and Medicine, University of Brasilia, Brasilia, Federal District, Brazil
| | - Wildo Navegantes de Araújo
- Faculty of Ceilândia, University of Brasilia, Brasilia, Federal District, Brazil
- Center for Tropical Medicine, University of Brasilia, Brasilia, Federal District, Brazil
| | - Simone Kashima
- Blood Center of Ribeirão Preto, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Clinical, Toxicological and Bromatological Analyses, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Rodrigo Haddad
- Faculty of Ceilândia, University of Brasilia, Brasilia, Federal District, Brazil
- Center for Tropical Medicine, University of Brasilia, Brasilia, Federal District, Brazil
- * E-mail:
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19
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Stramer SL, Stanley J, Nguyen ML, Bertuzis R, Huynh N, Duncan JR, Albrecht P, Pate LL, Galel SA. Duplex nucleic acid test for the detection of chikungunya and dengue RNA viruses in blood donations. Transfusion 2019; 59:1283-1290. [PMID: 30610766 PMCID: PMC6850471 DOI: 10.1111/trf.15128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/11/2018] [Accepted: 12/02/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chikungunya (CHIKV) and dengue (DENV) viruses are primarily mosquito‐borne, but transfusion transmission can occur (DENV) or is likely (CHIKV). In the absence of commercially available blood screening assays, a variety of strategies to ensure recipient safety in the face of expanding CHIKV and/or DENV outbreaks have been used. STUDY DESIGN AND METHODS Performance of cobas CHIKV/DENV, a qualitative RNA detection assay for use on the cobas 6800/8800 Systems, was evaluated at two sites (Roche Molecular Systems, Inc. [RMS], and the American Red Cross [ARC]). Analytical sensitivity, genotype inclusion, correlation with other assays, and reproducibility used clinical CHIKV‐ or DENV‐positive samples and secondary standards for DENV Types 1 to 4 and for three CHIKV genotypes (Asian; East Central South African; and West African); each secondary standard was traceable to international reference panels or reagents. Evaluation of analytic specificity assessed other microorganisms for interference and cross‐reactivity; clinical specificity was determined by individually testing 10,528 volunteer blood donations from the continental United States. RESULTS The 50 and 95% limit of detection (LoD) obtained by RMS for CHIKV, Asian genotype was 1.8 and 6.8 Detectable Units (DU)/mL, respectively, and 0.14 and 0.63 International Units (IU)/mL, respectively for DENV‐1. No significant differences in detection occurred by testing at a second site, the ARC (2.4 and 10.5 DU/mL for CHIKV and 0.15 and 0.60 IU/mL for DENV). Clinical specificity was 100% (95% confidence interval, 99.965%‐100%) for CHIKV and DENV. CONCLUSIONS The high sensitivity and specificity of the cobas CHIKV/DENV test, as demonstrated in these evaluations, indicate its suitability for blood donation screening.
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Affiliation(s)
- Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | - Jean Stanley
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
| | - Megan L Nguyen
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland
| | - Rasa Bertuzis
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
| | - Nancy Huynh
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
| | - John R Duncan
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
| | | | - Lisa L Pate
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
| | - Susan A Galel
- Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, California
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20
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Kulkarni R, Tiraki D, Wani D, Mishra AC, Arankalle VA. Risk of transfusion-associated dengue: screening of blood donors from Pune, western India. Transfusion 2018; 59:458-462. [PMID: 30727040 DOI: 10.1111/trf.15007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/31/2018] [Accepted: 09/10/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Dengue, a mosquito-borne viral disease, is endemic in >125 countries worldwide. The threat of blood-borne transmission of dengue virus (DENV) has been documented. STUDY DESIGN AND METHODS This study was conducted to assess the potential magnitude of transfusion-associated dengue, by determination of DENV seromarkers in blood donations from Pune, India, during two dengue seasons (2016 and 2017). These included DENV nonstructural protein 1 (NS1), anti-DENV immunoglobulin (Ig) M, anti-DENV IgG (enzyme-linked immunosorbent assay), and DENV RNA (reverse transcription-polymerase chain reaction). RESULTS NS1 (IgM) reactivity was 1 of 209, 0.48% (11/209, 5.3%) in 2016 and 2 of 311, 0.64% (20/311, 6.4%) in 2017. Of the 34 NS1/IgM reactives, 1 NS1-reactive donor and 10 IgM-reactive donors exhibited evidence of secondary infection. DENV RNA was not detected in any of the 34 NS1/IgM reactives. Among the NS1/IgM negatives, anti-DENV IgG reactivity was high in 2016 (75%) and further increased in 2017 (87%, p = 0.002). CONCLUSION Although RNA negative, detection of 34 NS1/IgM-reactive donations, of which 11 had evidence of secondary infection, suggests the need for further evaluation on the basis of potential risk to recipients of either dengue transmission or increased risk of secondary infection. These would include multicenter studies followed by cost-benefit analyses.
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Affiliation(s)
- Ruta Kulkarni
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed To Be University), Pune, India
| | - Divya Tiraki
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed To Be University), Pune, India
| | - Dileep Wani
- Department of Immunohaematology and Blood Transfusion, Bharati Medical College and Research Center, Bharati Vidyapeeth (Deemed To Be University), Pune, India
| | - Akhilesh C Mishra
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed To Be University), Pune, India
| | - Vidya A Arankalle
- Department of Communicable Diseases, Interactive Research School for Health Affairs, Bharati Vidyapeeth (Deemed To Be University), Pune, India
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Darrigo LG, de Sant'Anna Carvalho AM, Machado CM. Chikungunya, Dengue, and Zika in Immunocompromised Hosts. Curr Infect Dis Rep 2018; 20:5. [PMID: 29551005 PMCID: PMC5857271 DOI: 10.1007/s11908-018-0612-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW Describe the characteristics of chikungunya, dengue, and Zika in transplant recipients and immunocompromised hosts. RECENT FINDINGS Stem cell/bone marrow grafts, organs, and blood transfusions can transmit CHIKV/DENV/ZIKV infections, which are clinically similar, resembling influenza-like illness. Laboratory confirmation is necessary. In the acute phase, RT-PCR is preferred. DENV and ZIKV serology may cross-react. Delayed engraftment and extended viruria is observed in ZIKV+/HSCT recipients, while longer viremia is observed in DENV+/HSCT patients. Arbovirus persistence in organ tissues is generally unknown. Vaccine development is in early stages for CHIKV/ZIKV. No data is available to recommend the licensed DENV vaccine in transplant recipients. In endemic areas, the assessment of epidemiological risk is mandatory. Donor deferral for 120 days in suspected or confirmed ZIKV+ has been recommended, while CHIKV+ donors should wait 30 days. No deferral is recommended for DENV+ donors. CHIKV/DENV/ZIKV tests should be included in the differential of febrile neutropenia and other transplant syndromes. Reassessment of DENV serology is urgently needed. Prospective studies are necessary to determine the impact of CHIKV/DENV/ZIKV in this special population.
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Affiliation(s)
- Luiz Guilherme Darrigo
- Bone Marrow Transplant Unit - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Machado de Sant'Anna Carvalho
- Virology Laboratory - Institute of Tropical Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 470 - 2nd floor, São Paulo, SP, 05403-000, Brazil
| | - Clarisse Martins Machado
- Virology Laboratory - Institute of Tropical Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 470 - 2nd floor, São Paulo, SP, 05403-000, Brazil.
- HSCT Program, Amaral Carvalho Foundation, Jahu, São Paulo, Brazil.
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22
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Levi JE. Emerging Infectious Agents and Blood Safety in Latin America. Front Med (Lausanne) 2018; 5:71. [PMID: 29594126 PMCID: PMC5861148 DOI: 10.3389/fmed.2018.00071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/01/2018] [Indexed: 12/05/2022] Open
Abstract
Historically, emerging infectious agents have been an important driving force toward the enhancement of blood safety, illustrated by the sharp reduction in the transmission of infectious agents by blood transfusion after human immunodeficiency virus (HIV) epidemics. In general, Latin American (LATAM) countries have introduced screening for microorganisms with proven blood transmission with some delay in comparison to developed countries, but, nowadays, all LATAM countries comply with a minimum standard of screening which includes Hepatitis B, C, HIV, Treponema pallidum, and Trypanosoma cruzi. Noticeably, all those agents, in addition to HTLV, cause chronic infections. By contrast, in the last decade, the region has witnessed explosive outbreaks of arboviral diseases, representing a new challenge to the blood system, threatening not only blood safety but also availability. So far, the clinical impact of transfusion-transmitted Dengue, Chikungunya, or Zika has not been evident, precluding immediate reaction from the authorities. A number of other arboviruses are endemic in the region and may, unpredictably, originate new epidemics. Several measures must be taken in preparedness for the potential emergence of another arbodisease.
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23
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Aubry M, Laughhunn A, Santa Maria F, Lanteri MC, Stassinopoulos A, Musso D. Pathogen inactivation of Dengue virus in red blood cells using amustaline and glutathione. Transfusion 2017; 57:2888-2896. [DOI: 10.1111/trf.14318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/29/2017] [Accepted: 08/02/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Maite Aubry
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti, Polynésie Française
| | | | | | - Marion C. Lanteri
- Scientific Affairs Department; Cerus Corporation; Concord California
| | | | - Didier Musso
- Pôle de Recherche et de Veille sur les Maladies Infectieuses Émergentes, Institut Louis Malardé; Tahiti, Polynésie Française
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24
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Chien YW, Shu YC, Chuang KT, Yeh CY, Ko WC, Ko NY, Perng GC. High estimated prevalence of asymptomatic dengue viremia in blood donors during a dengue epidemic in southern Taiwan, 2015. Transfusion 2017; 57:2649-2656. [PMID: 28840606 DOI: 10.1111/trf.14281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/26/2017] [Accepted: 06/27/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Southern Taiwan experienced a severe dengue epidemic in 2015. Adult asymptomatic cases would raise concerns on transfusion-transmitted dengue virus (DENV) infection. The aim of this study was to evaluate the magnitude of such a risk in Tainan City during this epidemic. STUDY DESIGN AND METHODS The daily prevalence of asymptomatic dengue viremia in blood donors in Tainan City and in selected high-incidence districts during the 2015 dengue epidemic was estimated by an established mathematical model. Duration of viremia, duration of viremia before symptom onset, apparent-to-inapparent infection ratio, and reporting-to-underreporting ratio were four main parameters used in the model. RESULTS The estimated maximal and mean daily prevalence of asymptomatic dengue viremia in blood donors in Tainan during this dengue epidemic was 74.4 (95% confidence interval [CI], 60.8-88.0) and 15.0 (95% CI, 12.3-17.7) per 10,000, respectively. In the district with the highest incidence, the maximal and mean daily prevalence of asymptomatic viremia was 328.8 (95% CI, 271.1-386.2) and 55.3 (95% CI, 43.4-63.3) per 10,000, respectively. Approximately 234 (95% CI, 191-276) blood components containing DENV were produced during the epidemic. CONCLUSION Although dengue is currently not endemic in Taiwan, physicians need to be aware of the risk of transfusion-transmitted DENV infection. Our results suggest that screening measures to ensure blood safety should be evaluated and implemented during dengue epidemics even in nonendemic areas. Timely estimation of daily asymptomatic viremia prevalence by districts can help to select high-risk areas for such measures and to evaluate cost-effectiveness.
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Affiliation(s)
- Yu-Wen Chien
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yu-Chen Shu
- Department of Mathematics, National Cheng Kung University, Tainan
| | - Kun-Ta Chuang
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan
| | - Chun-Yin Yeh
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan
| | - Wen-Chien Ko
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan
| | - Guey-Chuen Perng
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University
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25
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Fryk JJ, Marks DC, Hobson-Peters J, Watterson D, Hall RA, Young PR, Reichenberg S, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Faddy HM. Reduction of Zika virus infectivity in platelet concentrates after treatment with ultraviolet C light and in plasma after treatment with methylene blue and visible light. Transfusion 2017; 57:2677-2682. [PMID: 28718518 DOI: 10.1111/trf.14256] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Zika virus (ZIKV) has emerged as a potential threat to transfusion safety worldwide. Pathogen inactivation is one approach to manage this risk. In this study, the efficacy of the THERAFLEX UV-Platelets system and THERAFLEX MB-Plasma system to inactivate ZIKV in platelet concentrates (PCs) and plasma was investigated. STUDY DESIGN AND METHODS PCs spiked with ZIKV were treated with the THERAFLEX UV-Platelets system at 0.05, 0.10, 0.15, and 0.20 J/cm2 UVC. Plasma spiked with ZIKV was treated with the THERAFLEX MB-Plasma system at 20, 40, 60, and 120 J/cm2 light at 630 nm with at least 0.8 µmol/L methylene blue (MB). Samples were taken before the first and after each illumination dose and tested for residual virus. For each system the level of viral reduction was determined. RESULTS Treatment of PCs with THERAFLEX UV-Platelets system resulted in a mean of 5 log reduction in ZIKV infectivity at the standard UVC dose (0.20 J/cm2 ), with dose dependency observed with increasing UVC dose. For plasma treated with MB and visible light, ZIKV infectivity was reduced by a mean of at least 5.68 log, with residual viral infectivity reaching the detection limit of the assay at 40 J/cm2 (one-third the standard dose). CONCLUSIONS Our study demonstrates that the THERAFLEX UV-Platelets system and THERAFLEX MB-Plasma system can reduce ZIKV infectivity in PCs and pooled plasma to the detection limit of the assays used. These findings suggest both systems have the capacity to be an effective option to manage potential ZIKV transfusion transmission risk.
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Affiliation(s)
- Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service
| | - Jody Hobson-Peters
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paul R Young
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | | | | | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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26
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de Souza Pereira BB, Darrigo Junior LG, de Mello Costa TC, Felix AC, Simoes BP, Stracieri AB, da Silva PM, Mauad M, Machado CM. Prolonged viremia in dengue virus infection in hematopoietic stem cell transplant recipients and patients with hematological malignancies. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12721] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 01/28/2023]
Affiliation(s)
| | | | | | - Alvina Clara Felix
- Virology Laboratory; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
| | - Belinda P. Simoes
- Faculty of Medicine of Ribeirão Preto; University of São Paulo; São Paulo Brazil
| | | | | | - Marcos Mauad
- HSCT Program; Amaral Carvalho Foundation; São Paulo Brazil
| | - Clarisse M. Machado
- Virology Laboratory; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
- HSCT Program; Amaral Carvalho Foundation; São Paulo Brazil
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27
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Abstract
Transfusion reactions are common occurrences, and clinicians who order or transfuse blood components need to be able to recognize adverse sequelae of transfusion. The differential diagnosis of any untoward clinical event should always consider adverse sequelae of transfusion, even when transfusion occurred weeks earlier. There is no pathognomonic sign or symptom that differentiates a transfusion reaction from other potential medical problems, so vigilance is required during and after transfusion when a patient presents with a change in clinical status. This review covers the presentation, mechanisms, and management of transfusion reactions that are commonly encountered, and those that can be life-threatening.
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Affiliation(s)
- William J Savage
- Transfusion Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Amory 260, Boston, MA 02115, USA.
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28
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Kiely P, Gambhir M, Cheng AC, McQuilten ZK, Seed CR, Wood EM. Emerging Infectious Diseases and Blood Safety: Modeling the Transfusion-Transmission Risk. Transfus Med Rev 2017; 31:154-164. [PMID: 28545882 PMCID: PMC7126009 DOI: 10.1016/j.tmrv.2017.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/11/2017] [Accepted: 05/11/2017] [Indexed: 12/28/2022]
Abstract
While the transfusion-transmission (TT) risk associated with the major transfusion-relevant viruses such as HIV is now very low, during the last 20 years there has been a growing awareness of the threat to blood safety from emerging infectious diseases, a number of which are known to be, or are potentially, transfusion transmissible. Two published models for estimating the transfusion-transmission risk from EIDs, referred to as the Biggerstaff-Petersen model and the European Upfront Risk Assessment Tool (EUFRAT), respectively, have been applied to several EIDs in outbreak situations. We describe and compare the methodological principles of both models, highlighting their similarities and differences. We also discuss the appropriateness of comparing results from the two models. Quantitating the TT risk of EIDs can inform decisions about risk mitigation strategies and their cost-effectiveness. Finally, we present a qualitative risk assessment for Zika virus (ZIKV), an EID agent that has caused several outbreaks since 2007. In the latest and largest ever outbreak, several probable cases of transfusion-transmission ZIKV have been reported, indicating that it is transfusion-transmissible and therefore a risk to blood safety. We discuss why quantitative modeling the TT risk of ZIKV is currently problematic. During the last 20 years there has been a growing awareness of the threat to blood safety from emerging infectious diseases (EIDs), a number of which are known to be, or are potentially, transfusion-transmissible. The transfusion-transmission risk of EID agents can be estimated by risk modeling which can form an important part of risk assessments and inform decisions regarding risk mitigation strategies. We describe and compare the methodological principles of two published risk models for estimating the transfusion transmission risk of EIDs. We use Zika virus as a case study to demonstrate that reliable risk modeling for EID agents can be problematic due to the uncertainty of the input parameters.
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Affiliation(s)
- Philip Kiely
- Australian Red Cross Blood Service, Melbourne, VIC, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Manoj Gambhir
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Allen C Cheng
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Infectious Diseases, Alfred Health, Australia
| | - Zoe K McQuilten
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Clive R Seed
- Australian Red Cross Blood Service, Melbourne, VIC, Australia
| | - Erica M Wood
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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29
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Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients. Blood Adv 2017; 1:624-627. [PMID: 29296705 DOI: 10.1182/bloodadvances.2016003285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 02/11/2017] [Indexed: 12/30/2022] Open
Abstract
Aedes mosquitoes are well adapted in domestic environments and widespread in tropical regions. Since 2015, Brazil has been experiencing a triple epidemic of dengue (DENV), chikungunya (CHKV), and Zika (ZIKV) viruses. The last 2 viruses are likely following the path of DENV, which has been endemic in most parts of the country since the 1980s. Given this triple epidemic, we proposed a prospective and collaborative study to assess the prevalence, morbidity, and mortality of DENV, CHKV, and ZIKV infections in hematopoietic stem cell transplant (HSCT) recipients and oncohematological patients. A case definition strategy (fever and rash) was used to prompt diagnostic investigation of DENV, ZIKV, and CHKV, which was accomplished by real-time polymerase chain reaction with plasma and urine samples. Clinical follow-up was performed 7 and 30 days after symptom onset. We report here the first cases of ZIKV and CHKV infections diagnosed in this ongoing study. From February to May 2016, 9 of the 26 patients (34.6%) fulfilling case definition criteria were diagnosed with DENV (3 cases), ZIKV (4 cases), or CHKV (2 cases) infections. Prolonged viremia and viruria were observed in dengue and Zika fever cases, respectively. Thrombocytopenia was the most frequent complication. Delayed engraftment was noted in 1 patient who acquired ZIKV 25 days before HSCT. All patients survived without sequelae. With the geographic expansion of arboviruses, donor and recipient screening may become mandatory. Patients living in areas where these viruses are not endemic are also at risk, since these viruses can be transmitted by blood as well as organ or tissue transplantation.
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30
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Affiliation(s)
- J. E. Levi
- Hospital Israelita Albert Einstein; São Paulo Brazil
- Fundação Pró-Sangue/Hemocentro de São Paulo; São Paulo Brazil
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31
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Mitigating the Risk of Transfusion-Transmitted Dengue in Australia. JOURNAL OF BLOOD TRANSFUSION 2016; 2016:3059848. [PMID: 27957384 PMCID: PMC5124463 DOI: 10.1155/2016/3059848] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/16/2016] [Indexed: 12/16/2022]
Abstract
Dengue viruses (DENV 1–4) are a risk to transfusion safety, with several transfusion-transmitted (TT) cases reported globally. DENV 1–4 are endemic in over 100 countries, with seasonal outbreaks occurring in northeastern Australia. To mitigate TT-DENV risk in Australia, fresh blood components are not manufactured from donors returning from any area (domestic/overseas) with known dengue transmission. Alternatively, TT-DENV risk may be mitigated using an appropriate blood donor screening assay. We aimed to determine the rate of dengue infection in donors during dengue outbreaks in Australia. Plasma samples were collected from blood donors during local dengue outbreaks. All samples were tested for the presence of DENV RNA and selected samples were tested for DENV antigen (nonstructural protein 1, NS1) with two assays. No donors residing in high risk areas had detectable levels of DENV RNA or NS1 and no cases of DENV viremia were detected in blood donors residing in areas of Australia experiencing DENV outbreaks. Definitive conclusions could not be drawn from this study; however, the lack of detection of DENV RNA or antigen in donations suggests that the current risk of TT-DENV is low and maintaining the fresh component restriction for “at-risk” donors is appropriate.
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32
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Hospital-Acquired Vector-Transmitted Dengue Fever: An Overlooked Problem? Infect Control Hosp Epidemiol 2016; 37:1387-1389. [DOI: 10.1017/ice.2016.173] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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33
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Chen LH, Wilson ME. Update on non-vector transmission of dengue: relevant studies with Zika and other flaviviruses. Trop Dis Travel Med Vaccines 2016; 2:15. [PMID: 28883959 PMCID: PMC5530933 DOI: 10.1186/s40794-016-0032-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/13/2016] [Indexed: 12/31/2022] Open
Abstract
Human dengue virus infection without mosquito vector has been reported to occur as a result of mucocutaneous transmission, needlestick in patient care and laboratory accident, blood transfusion, bone marrow transplant, organ transplant, intrapartum and perinatal transmission, and breastfeeding. The emergence of Zika virus, another mosquito-borne flavivirus, has illustrated additional potential routes of non-vector transmission in humans. A recent study in another flavivirus, Japanese encephalitis virus, in pigs has also demonstrated non-vector transmission. We highlight some reports on dengue virus that have documented non-vector transmission and that are relevant to the transmission of Zika virus and other flaviviruses.
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Affiliation(s)
- Lin H. Chen
- Travel Medicine Center, Mount Auburn Hospital, Cambridge, MA USA
- Faculty of Medicine, Harvard Medical School, Boston, MA USA
- Division of Infectious Diseases, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138 USA
| | - Mary Elizabeth Wilson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Department of Epidemiology and Biostatistics at University of California San Francisco, San Francisco, CA USA
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34
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Abstract
Dengue is the world's most prevalent mosquito-borne disease, with more than 200 million people each year becoming infected. We used a mechanistic virus transmission model to determine whether climate warming would change dengue transmission in Australia. Using two climate models each with two carbon emission scenarios, we calculated future dengue epidemic potential for the period 2046-2064. Using the ECHAM5 model, decreased dengue transmission was predicted under the A2 carbon emission scenario, whereas some increases are likely under the B1 scenario. Dengue epidemic potential may decrease under climate warming due to mosquito breeding sites becoming drier and mosquito survivorship declining. These results contradict most previous studies that use correlative models to show increased dengue transmission under climate warming. Dengue epidemiology is determined by a complex interplay between climatic, human host, and pathogen factors. It is therefore naive to assume a simple relationship between climate and incidence, and incorrect to state that climate warming will uniformly increase dengue transmission, although in general the health impacts of climate change will be negative.
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35
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Fryk JJ, Marks DC, Hobson-Peters J, Prow NA, Watterson D, Hall RA, Young PR, Reichenberg S, Sumian C, Faddy HM. Dengue and chikungunya viruses in plasma are effectively inactivated after treatment with methylene blue and visible light. Transfusion 2016; 56:2278-85. [PMID: 27456861 DOI: 10.1111/trf.13729] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 05/12/2016] [Accepted: 05/20/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Arboviruses, such as dengue viruses (DENV) and chikungunya virus (CHIKV), pose a risk to the safe transfusion of blood components, including plasma. Pathogen inactivation is an approach to manage this transfusion transmission risk, with a number of techniques being used worldwide for the treatment of plasma. In this study, the efficacy of the THERAFLEX MB-Plasma system to inactivate all DENV serotypes (DENV-1, DENV-2, DENV-3, DENV-4) or CHIKV in plasma, using methylene blue and light illumination at 630 nm, was investigated. STUDY DESIGN AND METHODS Pooled plasma units were spiked with DENV-1, DENV-2, DENV-3 DENV-4, or CHIKV and treated with the THERAFLEX MB-Plasma system at four light illumination doses: 20, 40, 60, and 120 (standard dose) J/cm(2) . Pre- and posttreatment samples were collected and viral infectivity was determined. The reduction in viral infectivity was calculated for each dose. RESULTS Treatment of plasma with the THERAFLEX MB-Plasma system resulted in at least a 4.46-log reduction in all DENV serotypes and CHIKV infectious virus. The residual infectivity for each was at the detection limit of the assay used at 60 J/cm(2) , with dose dependency also observed. CONCLUSIONS Our study demonstrated the THERAFLEX MB-Plasma system can reduce the infectivity of all DENV serotypes and CHIKV spiked into plasma to the detection limit of the assay used at half of the standard illumination dose. This suggests this system has the capacity to be an effective option for managing the risk of DENV or CHIKV transfusion transmission in plasma.
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Affiliation(s)
- Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service, Australia
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service, Australia
| | - Jody Hobson-Peters
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | - Paul R Young
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, and the
| | | | | | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Australia. .,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
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36
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Faddy HM, Fryk JJ, Watterson D, Young PR, Modhiran N, Muller DA, Keil SD, Goodrich RP, Marks DC. Riboflavin and ultraviolet light: impact on dengue virus infectivity. Vox Sang 2016; 111:235-241. [PMID: 27281512 DOI: 10.1111/vox.12414] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dengue viruses (DENV 1-4) are emerging across the world, and these viruses pose a risk to transfusion safety. Pathogen inactivation may be an alternative approach for managing the risk of DENV transfusion transmission. This study aimed to investigate the ability of riboflavin and UV light to inactivate DENV 1-4 in platelet concentrates. MATERIALS AND METHODS DENV 1-4 were spiked into buffy coat-derived platelet concentrates in additive solution (SSP+) before being treated with riboflavin and UV light. Infectious virus was quantified pre- and posttreatment, and the reduction in viral infectivity was calculated. RESULTS All four DENV serotypes were modestly reduced after treatment. The greatest amount of reduction in infectivity was observed for DENV-4 (1·81 log reduction) followed by DENV-3 (1·71 log reduction), DENV-2 (1·45 log reduction) and then DENV-1 (1·28 log reduction). CONCLUSION Our study demonstrates that DENV 1-4 titres are modestly reduced following treatment with riboflavin and UV light. With the increasing number of transfusion-transmitted cases of DENV around the globe, and the increasing incidence and geographical distribution of DENV, additional approaches for maintaining blood safety may be required in the future.
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Affiliation(s)
- H M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Qld, Australia. .,School of Medicine, University of Queensland, Brisbane, Qld, Australia.
| | - J J Fryk
- Research and Development, Australian Red Cross Blood Service, Brisbane, Qld, Australia
| | - D Watterson
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - P R Young
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - N Modhiran
- Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Qld, Australia
| | - D A Muller
- Australian Institute for Bioengineering and Nanotechnology, The University of Queensland, Brisbane, Qld, Australia
| | | | | | - D C Marks
- Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia
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37
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Abstract
PURPOSE OF REVIEW To review data about transfusion-transmitted infections so as to assess potential safety benefits of applying pathogen inactivation technology to platelets. RECENT FINDINGS Residual bacterial risk still exists. Multiple arbovirus epidemics continue to occur and challenge blood safety policy makers in nonendemic developed countries. There is new documentation of transfusion transmission of dengue and Ross River viruses, and new or increased concern about chikungunya and Zika viruses. Pathogen inactivation has been shown to inactivate almost all bacterial species and several epidemic arboviruses that pose a transfusion transmission risk. The two available platelet pathogen inactivation technologies show different levels of pathogen inactivation as measured by in-vitro infectivity assays; the clinical significance of this finding is not known. SUMMARY Pathogen inactivation can mitigate infectious risk and should do so more completely than other interventions such as donor questioning, donor/component recall, or donor testing. However, pathogen inactivation increases the cost of the pathogen-reduced blood component, which is a significant obstacle in the current healthcare environment. This may inhibit the ability to move forward with an effective new paradigm for blood safety that fulfills the implicit public trust in the blood system.
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38
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Busch MP, Sabino EC, Brambilla D, Lopes ME, Capuani L, Chowdhury D, McClure C, Linnen JM, Prince H, Simmons G, Lee TH, Kleinman S, Custer B. Duration of Dengue Viremia in Blood Donors and Relationships Between Donor Viremia, Infection Incidence and Clinical Case Reports During a Large Epidemic. J Infect Dis 2016; 214:49-54. [PMID: 27302934 DOI: 10.1093/infdis/jiw122] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/22/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Dengue viruses (DENV-1-4) pose a transfusion-transmission risk. This study estimated the dengue RNA detection period in asymptomatic blood donors and relationships between donor viremia and dengue incidence during a large epidemic. METHODS Donor samples from the 2012 dengue transmission season in Rio de Janeiro, Brazil, were tested for DENV RNA by a transcription-mediated amplification (TMA) assay, with DENV types and viral loads determined by polymerase chain reaction. Samples collected during the first and last weeks of enrollment were tested for DENV immunoglobulin (Ig) G and IgM to estimate incidence during the study period, which was analyzed relative to nucleic acid amplification technology (NAT) yield to estimate the duration of NAT-detectable viremia and compared with reported clinical dengue cases in Rio. RESULTS Samples from 16 241 donations were tested; 87 (0.54%) were confirmed as DENV-4 RNA positive. Dengue IgM-positive/IgG-positive reactivity increased from 2.8% to 8.8%, indicating a 6.2% incidence (95% confidence interval [CI], 3.2%-9.1%) during the study period. Based on these data, we estimated a 9.1-day period (95% CI, 4.4-13.9 days) of RNA detectable with TMA. With 100 475 reported cases of clinical dengue, 1 RNA-positive donation was identified per 800 DENV cases. CONCLUSIONS These parameters allow projections of dengue incidence from donor NAT yield data and vice versa, and suggest that viremic donations will be rare relative to clinical disease cases.
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Affiliation(s)
- Michael P Busch
- Blood Systems Research Institute Department of Laboratory Medicine, University of California, San Francisco
| | - Ester C Sabino
- Department of Infectious Diseases and Institute of Tropical Medicine, University of Sao Paulo
| | | | | | - Ligia Capuani
- Department of Infectious Diseases and Institute of Tropical Medicine, University of Sao Paulo
| | | | | | | | - Harry Prince
- Focus Diagnostics, San Juan Capistrano, California
| | - Graham Simmons
- Blood Systems Research Institute Department of Laboratory Medicine, University of California, San Francisco
| | | | | | - Brian Custer
- Blood Systems Research Institute Department of Laboratory Medicine, University of California, San Francisco
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Faddy HM, Fryk JJ, Prow NA, Watterson D, Young PR, Hall RA, Tolksdorf F, Sumian C, Gravemann U, Seltsam A, Marks DC. Inactivation of dengue, chikungunya, and Ross River viruses in platelet concentrates after treatment with ultraviolet C light. Transfusion 2016; 56:1548-55. [PMID: 26926832 DOI: 10.1111/trf.13519] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/04/2015] [Accepted: 01/04/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Arboviruses, including dengue (DENV 1-4), chikungunya (CHIKV), and Ross River (RRV), are emerging viruses that are a risk for transfusion safety globally. An approach for managing this risk is pathogen inactivation, such as the THERAFLEX UV-Platelets system. We investigated the ability of this system to inactivate the above mentioned arboviruses. STUDY DESIGN AND METHODS DENV 1-4, CHIKV, or RRV were spiked into buffy coat (BC)-derived platelet (PLT) concentrates in additive solution and treated with the THERAFLEX UV-Platelets system at the following doses: 0.05, 0.1, 0.15, and 0.2 J/cm(2) (standard dose). Pre- and posttreatment samples were taken for each dose, and the level of viral infectivity was determined. RESULTS At the standard ultraviolet C (UVC) dose (0.2 J/cm(2) ), viral inactivation of at least 4.43, 6.34, and 5.13 log or more, was observed for DENV 1-4, CHIKV, and RRV, respectively. A dose dependency in viral inactivation was observed with increasing UVC doses. CONCLUSIONS Our study has shown that DENV, CHIKV, and RRV, spiked into BC-derived PLT concentrates, were inactivated by the THERAFLEX UV-Platelets system to the limit of detection of our assay, suggesting that this system could contribute to the safety of PLT concentrates with respect to these emerging arboviruses.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Jesse J Fryk
- Research and Development, Australian Red Cross Blood Service
| | - Natalie A Prow
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Daniel Watterson
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | - Paul R Young
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland
| | | | | | - Ute Gravemann
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Axel Seltsam
- German Red Cross Blood Service NSTOB, Springe, Germany
| | - Denese C Marks
- Research and Development, Australian Red Cross Blood Service
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40
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Añez G, Heisey DAR, Chancey C, Fares RCG, Espina LM, Souza KPR, Teixeira-Carvalho A, Krysztof DE, Foster GA, Stramer SL, Rios M. Distribution of Dengue Virus Types 1 and 4 in Blood Components from Infected Blood Donors from Puerto Rico. PLoS Negl Trop Dis 2016; 10:e0004445. [PMID: 26871560 PMCID: PMC4752498 DOI: 10.1371/journal.pntd.0004445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/19/2016] [Indexed: 01/07/2023] Open
Abstract
Background Dengue is a mosquito-borne viral disease caused by the four dengue viruses (DENV-1 to 4) that can also be transmitted by blood transfusion and organ transplantation. The distribution of DENV in the components of blood from infected donors is poorly understood. Methods We used an in-house TaqMan qRT-PCR assay to test residual samples of plasma, cellular components of whole blood (CCWB), serum and clot specimens from the same collection from blood donors who were DENV-RNA-reactive in a parallel blood safety study. To assess whether DENV RNA detected by TaqMan was associated with infectious virus, DENV infectivity in available samples was determined by culture in mosquito cells. Results DENV RNA was detected by TaqMan in all tested blood components, albeit more consistently in the cellular components; 78.8% of CCWB, 73.3% of clots, 86.7% of sera and 41.8% of plasma samples. DENV-1 was detected in 48 plasma and 97 CCWB samples while DENV-4 was detected in 21 plasma and 31 CCWB samples. In mosquito cell cultures, 29/111 (26.1%) plasma and 32/97 (32.7%) CCWB samples were infectious. A subset of samples from 29 donors was separately analyzed to compare DENV viral loads in the available blood components. DENV viral loads did not differ significantly between components and ranged from 3–8 log10 PCR-detectable units/ml. Conclusions DENV was present in all tested components from most donors, and viral RNA was not preferentially distributed in any of the tested components. Infectious DENV was also present in similar proportions in cultured plasma, clot and CCWB samples, indicating that these components may serve as a resource when sample sizes are limited. However, these results suggest that the sensitivity of the nucleic acid tests (NAT) for these viruses would not be improved by testing whole blood or components other than plasma. Dengue is a febrile disease caused by the four dengue viruses (DENV-1 to 4) transmitted by mosquitoes from the genus Aedes that can also be transmitted by blood transfusion and organ transplantation. DENV is present in the blood of infected individuals without symptoms, meaning that infected donors may pose a risk to the safety of the donor blood supply. Current methods for detecting transfusion-transmitted viruses by nucleic acid testing use plasma as the testing specimen, and the number of tests that can be performed without reducing availability of blood for transfusion is limited. To determine whether blood components other than plasma could be suitable for testing, we quantified and compared the concentrations of DENV RNA in the residual components of blood collected from subjects previously identified as infected in a parallel blood safety study. Additionally, when available, samples were also evaluated for infectivity in tissue culture. The results showed that DENV RNA and infectious virions were detected comparably in all blood components, suggesting that using alternate specimens may improve sample availability but may not improve testing sensitivity.
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Affiliation(s)
- Germán Añez
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Daniel A R Heisey
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Caren Chancey
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Rafaelle C G Fares
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Luz M Espina
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Kátia P R Souza
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
| | | | - David E Krysztof
- American Red Cross, Gaithersburg, Maryland, United States of America
| | - Gregory A Foster
- American Red Cross, Gaithersburg, Maryland, United States of America
| | - Susan L Stramer
- American Red Cross, Gaithersburg, Maryland, United States of America
| | - Maria Rios
- U.S. Food and Drug Administration, Silver Spring, Maryland, United States of America
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41
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Kashima S, Slavov SN, Covas DT. Zika virus and its implication in transfusion safety. Rev Bras Hematol Hemoter 2016; 38:90-1. [PMID: 26969782 PMCID: PMC4786766 DOI: 10.1016/j.bjhh.2016.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022] Open
Affiliation(s)
- Simone Kashima
- Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
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42
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Abstract
Viral safety remains a major concern in transfusion of blood products. Over years, the control measures applied to blood products were made more and more sophisticated; however, the number of infectious agents, and notably of viruses, that can be transmitted by transfusion is increasing continuously. The aim of this review paper is to actualize that published in the same journal by the same authors in 2011 with more details on some of actual vs virtual viral threats that were identified recently in the field of blood transfusion. The main subjects that are covered successively concern the transmission via transfusion of hepatitis E virus, the frequency of transfusion transmitted arboviruses, transfusion at the time of the Ebola epidemics in West Africa, the debated role of Marseillevirus (giant viruses infecting amoebae and suspected to infect human blood latently), and, finally, the recent report of the identification in blood donors of a new member of the Flaviviridae family. The addition of these new viral risks to those already identified-partially controlled or not-pleads for the urgent need to move forward to considering inactivation of infectious agents in blood products.
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Affiliation(s)
- B Pozzetto
- EA3064, Groupe immunité des muqueuses et agents pathogènes (GIMAP), faculté de médecine de Saint-Étienne, université de Lyon, 42023 Saint-Étienne, France; Laboratoire des agents infectieux et d'hygiène, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne, France.
| | - O Garraud
- EA3064, Groupe immunité des muqueuses et agents pathogènes (GIMAP), faculté de médecine de Saint-Étienne, université de Lyon, 42023 Saint-Étienne, France; Institut national de la transfusion sanguine (INTS), 75015 Paris, France
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43
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Oei W, Lieshout-Krikke RW, Kretzschmar ME, Zaaijer HL, Coutinho RA, Eersel M, Jubithana B, Halabi Y, Gerstenbluth I, Maduro E, Tromp M, Janssen MP. Estimating the risk of dengue transmission from Dutch blood donors travelling to Suriname and the Dutch Caribbean. Vox Sang 2016; 110:301-9. [PMID: 26765798 DOI: 10.1111/vox.12370] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The risk of dengue transmitted by travellers is known. Methods to estimate the transmission by transfusion (TT) risk from blood donors travelling to risk areas are available, for instance, the European Up-Front Risk Assessment Tool (EUFRAT). This study aimed to validate the estimated risk from travelling donors obtained from EUFRAT. METHODS Surveillance data on notified dengue cases in Suriname and the Dutch Caribbean islands (Aruba, Curaçao, St. Maarten, Bonaire, St. Eustatius and Saba) in 2001-2011 was used to calculate local incidence rates. Information on travel and donation behaviour of Dutch donors was collected. With the EUFRAT model, the TT risks from Dutch travelling donors were calculated. Model estimates were compared with the number of infections in Dutch travellers found by laboratory tests in the Netherlands. RESULTS The expected cumulative number of donors becoming infected during travels to Suriname and the Dutch Caribbean from 2001 to 2011 was estimated at 5 (95% CI, 2-11) and 86 (45-179), respectively. The infection risk inferred from the laboratory-based study was 19 (9-61) and 28 (14-92). Given the independence of the data sources, these estimates are remarkably close. The model estimated that 0·02 (0·001-0·06) and 0·40 (0·01-1·4) recipients would have been infected by these travelling donors. CONCLUSIONS The EUFRAT model provided an estimate close to actual observed number of dengue infections. The dengue TT risk among Dutch travelling donors can be estimated using basic transmission, travel and donation information. The TT risk from Dutch donors travelling to Suriname and the Dutch Caribbean is small.
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Affiliation(s)
- W Oei
- Transfusion Technology Assessment Unit, Sanquin Research, Amsterdam, the Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - R W Lieshout-Krikke
- Department of blood-borne infections, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - M E Kretzschmar
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.,National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - H L Zaaijer
- Department of blood-borne infections, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands
| | - R A Coutinho
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - M Eersel
- Department of Public Health Suriname, Epidemiology Unit, Paramaribo, Suriname
| | - B Jubithana
- Department of Public Health Suriname, Epidemiology Unit, Paramaribo, Suriname
| | - Y Halabi
- Epidemiology and Research Unit, Ministry of Health, The Environment and Nature, Willemstad, Curaçao
| | - I Gerstenbluth
- Epidemiology and Research Unit, Ministry of Health, The Environment and Nature, Willemstad, Curaçao
| | - E Maduro
- Department of Public Health Aruba, Epidemiology and Research Unit, Oranjestad, Aruba
| | - M Tromp
- Department of Public Health Aruba, Epidemiology and Research Unit, Oranjestad, Aruba
| | - M P Janssen
- Transfusion Technology Assessment Unit, Sanquin Research, Amsterdam, the Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
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44
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Matos D, Tomashek KM, Perez-Padilla J, Muñoz-Jordán J, Hunsperger E, Horiuchi K, Noyd D, Winton C, Foster G, Lanteri M, Linnen JM, Stramer SL. Probable and possible transfusion-transmitted dengue associated with NS1 antigen-negative but RNA confirmed-positive red blood cells. Transfusion 2015; 56:215-22. [PMID: 26469514 DOI: 10.1111/trf.13288] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/13/2015] [Accepted: 07/19/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND In the absence of active blood donation screening, dengue viruses (DENV) have been implicated in only a limited number of transfusion transmissions worldwide. This study attempted to identify if blood from donors testing negative by an NS1-antigen (Ag) enzyme-linked immunosorbent assay (ELISA) but confirmed positive for DENV RNA caused DENV-related disease in recipients during the epidemic years of 2010 to 2012 in Puerto Rico. STUDY DESIGN AND METHODS Donation aliquots testing negative by an investigational NS1-Ag ELISA were stored frozen and retested retrospectively using a research transcription-mediated amplification assay (TMA) detecting DENV RNA. All RNA-reactive donations were subject to confirmatory RNA and antibody testing. Recipient tracing was conducted for all components manufactured from TMA-reactive components. Medical chart review, recipient interview, and follow-up sampling occurred for 42 recipients transfused with TMA-reactive components. RESULTS Six of 42 recipients developed new-onset fever in the 2 weeks posttransfusion; three (50%) received RNA confirmed-positive, NS1-Ag-negative red blood cell (RBC) units. One recipient of a high-titer unit (7 × 10(7) DENV-4 RNA copies/mL) developed severe dengue, and a second recipient had only fever recorded but had a negative sepsis work-up. New fever attributable to DENV infection in a third recipient was confounded by fever potentially attributable to posttransfusion sepsis. CONCLUSIONS In our retrospective study, NS1-Ag detected 20% of all RNA confirmed-positive donations demonstrating limitations of NS1-Ag ELISA for blood donation screening. We identified one recipient with a clinical syndrome compatible with severe dengue who had received an NS1-Ag-negative but RNA confirmed-positive RBC unit. This investigation illustrates the difficulty in confirming transfusion transmission in dengue-endemic areas among severely ill transfusion recipients.
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Affiliation(s)
| | - Kay M Tomashek
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Janice Perez-Padilla
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Jorge Muñoz-Jordán
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Elizabeth Hunsperger
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Kalanthe Horiuchi
- Division of Vector-Borne Disease Information Technology Support, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - David Noyd
- Dengue Branch, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Colleen Winton
- American Red Cross Scientific Support Office, Gaithersburg, Maryland
| | - Gregory Foster
- American Red Cross Scientific Support Office, Gaithersburg, Maryland
| | - Marion Lanteri
- Blood Systems Research Institute, San Francisco, California
| | | | - Susan L Stramer
- American Red Cross Scientific Support Office, Gaithersburg, Maryland
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45
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Epidemiological Scenario of Dengue in Brazil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:321873. [PMID: 26413514 PMCID: PMC4568054 DOI: 10.1155/2015/321873] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/09/2015] [Indexed: 01/12/2023]
Abstract
Dengue is the most important reemerging mosquito-borne viral disease worldwide. It is caused by any of four Dengue virus types or serotypes (DENV-1 to DENV-4) and is transmitted by mosquitoes from the genus Aedes. Ecological changes have favored the geographic expansion of the vector and, since the dengue pandemic in the Asian and Pacific regions, the infection became widely distributed worldwide, reaching Brazil in 1845. The incidence of dengue in Brazil has been frequently high, and the number of cases in the country has at some point in time represented up to 60% of the dengue reported cases worldwide. This review addresses vector distribution, dengue outbreaks, circulating serotypes and genotypes, and prevention approaches being utilized in Brazil.
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46
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Levi JE. Dengue Virus and Blood Transfusion. J Infect Dis 2015; 213:689-90. [PMID: 26908779 DOI: 10.1093/infdis/jiv322] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 06/02/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- José Eduardo Levi
- Fundação Pró-Sangue/Hemocentro de São Paulo Hospital Israelita Albert Einstein Virology Laboratory, Instituto de Medicina Tropical da Universidade de São Paulo, Brazil
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47
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Sabino EC, Loureiro P, Lopes ME, Capuani L, McClure C, Chowdhury D, Di-Lorenzo-Oliveira C, Oliveira LC, Linnen JM, Lee TH, Gonçalez T, Brambilla D, Kleinman S, Busch MP, Custer B. Transfusion-Transmitted Dengue and Associated Clinical Symptoms During the 2012 Epidemic in Brazil. J Infect Dis 2015; 213:694-702. [PMID: 26908780 DOI: 10.1093/infdis/jiv326] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 04/16/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A linked donor-recipient study was conducted during epidemics in 2 cities in Brazil to investigate transfusion-transmitted (TT) dengue virus (DENV) by DENV RNA-positive donations. METHODS During February-June 2012, samples were collected from donors and recipients and retrospectively tested for DENV RNA by transcription-mediated amplification. Recipient chart review, using a case (DENV positive)-control (DENV negative and not known to be exposed) design, was conducted to assess symptoms. RESULTS Of 39 134 recruited blood donors, DENV-4 viremia was confirmed in 0.51% of donations from subjects in Rio de Janeiro and 0.80% of subjects in Recife. Overall, 42 DENV RNA-positive units were transfused into 35 recipients. Of these, 16 RNA-positive units transfused into 16 susceptible recipients were identified as informative: 5 cases were considered probable TT cases, 1 possible TT case, and 10 nontransmissions. The TT rate was 37.5% (95% confidence interval [CI], 15.2%-64.6%), significantly higher than the viremia rate of 0.93% (95% CI, .11%-3.34%) in nonexposed recipients (P < .0001). Chart review did not find significant differences between cases and controls in symptoms or mortality. CONCLUSIONS During a large epidemic of DENV-4 infection in Brazil, >0.5% of donations were RNA positive, and approximately one third of components resulted in TT. However, no significant clinical differences were evident between RNA-positive and RNA-negative recipients.
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Affiliation(s)
- Ester C Sabino
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo
| | - Paula Loureiro
- Faculdade de Ciências Médicas-UPE/Fundação Hemope, Recife
| | | | - Ligia Capuani
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo
| | | | | | | | - Lea C Oliveira
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo
| | | | - Tzong-Hae Lee
- Blood Systems Research Institute, San Francisco, California
| | | | | | - Steve Kleinman
- Blood Systems Research Institute, San Francisco, California University of British Columbia, Vancouver, Canada
| | - Michael P Busch
- Blood Systems Research Institute, San Francisco, California Department of Laboratory Medicine, University of California-San Francisco
| | - Brian Custer
- Blood Systems Research Institute, San Francisco, California Department of Laboratory Medicine, University of California-San Francisco
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