51
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Hsu AY, Ho TC, Lai ML, Tan SS, Chen TY, Lee M, Chien YW, Chen YP, Perng GC. Identification and characterization of permissive cells to dengue virus infection in human hematopoietic stem and progenitor cells. Transfusion 2019; 59:2938-2951. [PMID: 31251408 DOI: 10.1111/trf.15416] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Dengue virus (DENV) is a significant threat to public health in tropical and subtropical regions, where the frequency of human migration is increasing. Transmission of DENV from donors to recipients after hematopoietic stem cell transplantation has been steadily described. However, the underlying mechanisms remain unclear. STUDY DESIGN AND METHODS Freshly isolated bone marrow (BM) was subjected to DENV infection, followed by multicolor fluorescence-activated cell sorting (FACS) analysis. Virus in supernatants was collected and analyzed by plaque assay. RESULTS DENV-1 to DENV-4 could effectively infect freshly obtained BM and produced infectious virus. DENV infection did not change the quantitative population of hematopoietic stem and progenitor cells (HSPCs), megakaryocytic progenitor cells (MkPs) and megakaryocytes. Additionally, DENV antigen, nonstructural protein 1, was enriched in HSPCs and MkPs of DENV infected marrow cells. CD34+, CD133+, or CD61+ cells sorted out from BM were not only the major contributing targets facilitating the DENV infection directly but also facilitated the spread of DENV into other cells when cocultured. CONCLUSION Results suggest that DENV can efficiently infect HSPCs, which might jeopardize the recipients if DENV-infected cells were subsequently used. We therefore raise the need for DENV screening for both the donors and recipients of hematopoietic stem cell transplantation, especially for donors exposed to endemic areas, to mitigate DENV infection in immunocompromised recipients.
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Affiliation(s)
- Alan Y Hsu
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Biological Sciences, Purdue University, West Lafayette, Indiana
| | - Tzu-Chuan Ho
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei-Ling Lai
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan
| | - Sia Seng Tan
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan
| | - Tsai-Yun Chen
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meed Lee
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Wen Chien
- Departement of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Ping Chen
- Division of Hematology and Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Guey Chuen Perng
- Department of Microbiology and Immunology, National Cheng Kung University, Tainan, Taiwan.,Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Appassakij H, Silpapojakul K, Promwong C, Rujirojindakul P. The Potential Impact of Chikungunya Virus Outbreaks on Blood Transfusion. Transfus Med Rev 2019; 34:23-28. [PMID: 31303361 DOI: 10.1016/j.tmrv.2019.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 06/11/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
Chikungunya virus (CHIKV) is responsible for large periodic epidemics in both endemic and nonendemic areas where competent mosquitoes are present. Transmission of CHIKV by transfusion during explosive outbreaks has never been documented, and the true impact of CHIKV infection on blood transfusion during an outbreak is unknown. Considerations include not only transfusions in the active outbreak areas but also returning travelers to nonendemic areas. Because there are no documented cases of transfusion-transmitted CHIKV, there are no standard guidelines regarding transfusion policies during a chikungunya fever outbreak. We review current information from studies during outbreaks with the goal of estimating the potential effect of different blood safety interventions (eg, querying donors for possible CHIKV exposure, chikungunya fever-related symptoms, screening for CHIKV RNA).
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Affiliation(s)
- Hatsadee Appassakij
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
| | | | | | - Pairaya Rujirojindakul
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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53
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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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Cohn CS, Allen ES, Cushing MM, Dunbar NM, Friedman DF, Goel R, Harm SK, Heddle N, Hopkins CK, Klapper E, Perumbeti A, Ramsey G, Raval JS, Schwartz J, Shaz BH, Spinella PC, Pagano MB. Critical developments of 2018: A review of the literature from selected topics in transfusion. A committee report from the AABB's Clinical Transfusion Medicine Committee. Transfusion 2019; 59:2733-2748. [PMID: 31148175 DOI: 10.1111/trf.15348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The AABB compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine. An abridged version of this work is being made available in TRANSFUSION, with the full-length report available as Appendix S1 (available as supporting information in the online version of this paper). STUDY DESIGN AND METHODS Papers published in late 2017 and 2018 are included, as well as earlier papers cited for background. Although this synopsis is comprehensive, it is not exhaustive, and some papers may have been excluded or missed. RESULTS The following topics are covered: "big data" and "omics" studies, emerging infections and testing, platelet transfusion and pathogen reduction, transfusion therapy and coagulation, transfusion approach to hemorrhagic shock and mass casualties, therapeutic apheresis, and chimeric antigen receptor T-cell therapy. CONCLUSION This synopsis may be a useful educational tool.
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Affiliation(s)
- Claudia S Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth S Allen
- Department of Pathology, University of California, San Diego, California
| | - Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Nancy M Dunbar
- Department of Pathology and Laboratory Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - David F Friedman
- Blood Bank and Transfusion Medicine Department, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ruchika Goel
- Division of Transfusion Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.,Division of Hematology/Oncology, Mississippi Valley Regional Blood Center, Springfield, Illinois
| | - Sarak K Harm
- University of Vermont Medical Center, Burlington, VT
| | - Nancy Heddle
- McMaster Center for Transfusion Research, McMaster University, Hamilton, Ontario, Canada
| | | | - Ellen Klapper
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ajay Perumbeti
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Glenn Ramsey
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jay S Raval
- Department of Pathology, University of New Mexico, Albuquerque, New Mexico
| | - Joseph Schwartz
- Department of Pathology and Cell Biology, Columbia University, and, New York, New York
| | | | - Philip C Spinella
- Department of Pediatrics, Division of Pediatric Critical Care, Washington University in St Louis School of Medicine, Saint Louis, Missouri
| | - Monica B Pagano
- Transfusion Medicine Division, Department of Laboratory Medicine, University of Washington, Seattle, Washington
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Moura-Neto JA, Braga Silva CA, Moura AF, Rocco Suassuna JH. Emergent Arboviruses and Renal Transplantation: A Global Challenge. Kidney Int Rep 2019; 4:647-655. [PMID: 31080919 PMCID: PMC6506706 DOI: 10.1016/j.ekir.2019.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 12/23/2022] Open
Abstract
In recent years, Zika, Chikungunya, Dengue, West Nile Fever, and Yellow Fever epidemics have generated some concerns. Besides difficulties related to vector control, there are challenges related to behavior of pathologies not yet fully understood. The transplanted population requires additional care due to immunosuppressive drugs. Furthermore, the potential risk of transmission during donation is another source of uncertainty and generates debate among nephrologists in transplant centers. Do the clinical outcomes and prognoses of these infections tend to be more aggressive in this population? Is there a risk of viral transmission via kidney donation? In this review article, we address these issues and discuss the relationship between arbovirus and renal transplantation.
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Affiliation(s)
| | | | | | - José Hermógenes Rocco Suassuna
- Clinical and Academic Unit of Nephrology, Hospital Universitário Pedro Ernesto, Rio de Janeiro State University, Rio de Janeiro, Brazil
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56
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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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57
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Prevention of transfusion-transmitted infections. Blood 2019; 133:1854-1864. [PMID: 30808637 DOI: 10.1182/blood-2018-11-833996] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/03/2019] [Indexed: 01/10/2023] Open
Abstract
Since the 1970s, introduction of serological assays targeting virus-specific antibodies and antigens has been effective in identifying blood donations infected with the classic transfusion-transmitted infectious agents (TTIs; hepatitis B virus [HBV], HIV, human T-cell lymphotropic virus types I and II, hepatitis C virus [HCV]). Subsequently, progressive implementation of nucleic acid-amplification technology (NAT) screening for HIV, HCV, and HBV has reduced the residual risk of infectious-window-period donations, such that per unit risks are <1 in 1 000 000 in the United States, other high-income countries, and in high-incidence regions performing NAT. NAT screening has emerged as the preferred option for detection of newer TTIs including West Nile virus, Zika virus (ZIKV), and Babesia microti Although there is continual need to monitor current risks due to established TTI, ongoing challenges in blood safety relate primarily to surveillance for emerging agents coupled with development of rapid response mechanisms when such agents are identified. Recent progress in development and implementation of pathogen-reduction technologies (PRTs) provide the opportunity for proactive rather than reactive response to blood-safety threats. Risk-based decision-making tools and cost-effectiveness models have proved useful to quantify infectious risks and place new interventions in context. However, as evidenced by the 2015 to 2017 ZIKV pandemic, a level of tolerable risk has yet to be defined in such a way that conflicting factors (eg, theoretical recipient risk, blood availability, cost, and commercial interests) can be reconciled. A unified approach to TTIs is needed, whereby novel tests and PRTs replace, rather than add to, existing interventions, thereby ameliorating cost and logistical burden to blood centers and hospitals.
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58
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Russell WA, Stramer SL, Busch MP, Custer B. Screening the Blood Supply for Zika Virus in the 50 U.S. States and Puerto Rico: A Cost-Effectiveness Analysis. Ann Intern Med 2019; 170:164-174. [PMID: 30615781 DOI: 10.7326/m18-2238] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In 2016, universal individual donation nucleic acid testing (ID-NAT) of donated blood for Zika virus began in U.S. states and territories. OBJECTIVE To assess the cost-effectiveness of universal ID-NAT in the first year of screening compared with alternatives for the 50 states and separately for Puerto Rico. DESIGN Microsimulation that captured Zika-related harms to transfusion recipients, sexual partners, and their infants. DATA SOURCES National testing results compiled by AABB and costs, utilities, and outcome probabilities estimated from the literature. TARGET POPULATION Transfusion recipients. TIME HORIZON Lifetime. PERSPECTIVE Societal. INTERVENTION Universal ID-NAT, universal mini-pool NAT (MP-NAT), and ID-NAT exclusively for components transfused to women of childbearing age. Seasonally targeted strategies in Puerto Rico and geographically targeted strategies in the 50 states were also considered. OUTCOME MEASURES Costs, quality-adjusted life-years (QALYs), and outcomes. RESULTS OF BASE-CASE ANALYSIS In Puerto Rico, MP-NAT exclusively during high mosquito season was cost-effective at $81 123 per QALY (95% CI, -$49 138 to $978 242 per QALY). No screening policy was cost-effective in the 50 states. Universal ID-NAT cost $341 million per QALY (CI, $125 million to $2.90 billion per QALY) compared with no screening in the 50 states. RESULTS OF SENSITIVITY ANALYSIS In Puerto Rico, MP-NAT only during the season of high mosquito activity was most cost-effective in 64% of probabilistic sensitivity analysis iterations. In the 50 states, no intervention was cost-effective in 99.99% of iterations. Cost-effectiveness was highly dependent on the rate of assumed infectious donations. LIMITATION Data were limited on the component-specific transmissibility of Zika and long-term sequelae of infection. CONCLUSION Screening was cost-effective only in the high mosquito season in Puerto Rico, and no evaluated screening policy was cost-effective in the 50 states. During periods with lower rates of Zika-infectious donations, the cost-effectiveness of screening will be even less favorable. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
| | | | - Michael P Busch
- Vitalant Research Institute and University of California, San Francisco, San Francisco, California (M.P.B., B.C.)
| | - Brian Custer
- Vitalant Research Institute and University of California, San Francisco, San Francisco, California (M.P.B., B.C.)
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Abstract
Mortality from severe dengue is low, but the economic and resource burden on health services remains substantial in endemic settings. Unfortunately, progress towards development of effective therapeutics has been slow, despite notable advances in the understanding of disease pathogenesis and considerable investment in antiviral drug discovery. For decades antibody-dependent enhancement has been the prevalent model to explain dengue pathogenesis, but it was only recently demonstrated in vivo and in clinical studies. At present, the current mainstay of management for most symptomatic dengue patients remains careful observation and prompt but judicious use of intravenous hydration therapy for those with substantial vascular leakage. Various new promising technologies for diagnosis of dengue are currently in the pipeline. New sample-in, answer-out nucleic acid amplification technologies for point-of-care use are being developed to improve performance over current technologies, with the potential to test for multiple pathogens using a single specimen. The search for biomarkers that reliably predict development of severe dengue among symptomatic individuals is also a major focus of current research efforts. The first dengue vaccine was licensed in 2015 but its performance depends on serostatus. There is an urgent need to identify correlates of both vaccine protection and disease enhancement. A crucial assessment of vector control tools should guide a research agenda for determining the most effective interventions, and how to best combine state-of-the-art vector control with vaccination.
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Affiliation(s)
- Annelies Wilder-Smith
- London School of Hygiene & Tropical Medicine, London, UK; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
| | - Eng-Eong Ooi
- Duke-National University of Singapore Medical School, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Olaf Horstick
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Bridget Wills
- Oxford University Clinical Research Unit, Wellcome Trust Asia Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Ferri CA, Formichela MM, Valdez JR, Rocío Medina IM, Dusse GV, Malvasi GN, Zapata PD, Malarczuk EC. Asymptomatic dengue virus cases in misiones, Argentina: a seroprevalence study in the university population. Microbes Infect 2019; 21:184-187. [PMID: 30668989 DOI: 10.1016/j.micinf.2018.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/16/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022]
Abstract
Dengue infection may be asymptomatic and may produce the typical symptoms of a benign illness or serious hemorrhagic and often fatal symptoms. Asymptomatic cases are statistically relevant and quite variable depending on the geographic area under study. However, there are no reports of asymptomatic population infected by the dengue virus in Misiones. In this study, 288 samples were analyzed, and the IgG anti dengue antibodies detected accounted for 6.6% of cases, while 89% corresponded to individuals who lived with people diagnosed or suspected of having contracted dengue, p= <0.001.
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Affiliation(s)
- Cristian Alberto Ferri
- Molecular Biotechnology Laboratory, Misiones Biotechnology Institute, Faculty of Exact, Chemical and Natural Sciences, Universidad Nacional de Misiones, Campus Universitario UNaM, Ruta 12 Km 7.5, 3304, Posadas, Misiones, Argentina; Chair of Medical Biochemistry, Faculty of Health Sciences, Universidad Católica de las Misiones, Avenida Jauretche 1036, Esquina Av. Urquiza, 3300, Posadas, Misiones, Argentina.
| | - María Mercedes Formichela
- Chair of Clinical Biochemistry II, Biochemistry and Pharmacology Module, Faculty of Exact, Chemical and Natural Sciences, UNaM, Av. Mariano Moreno 1375 3300, Posadas, Misiones, Argentina
| | - José Ricardo Valdez
- Chair of Medical Biochemistry, Faculty of Health Sciences, Universidad Católica de las Misiones, Avenida Jauretche 1036, Esquina Av. Urquiza, 3300, Posadas, Misiones, Argentina
| | - Ivana Magalí Rocío Medina
- Chair of Clinical Biochemistry II, Biochemistry and Pharmacology Module, Faculty of Exact, Chemical and Natural Sciences, UNaM, Av. Mariano Moreno 1375 3300, Posadas, Misiones, Argentina
| | - Graciela Viviana Dusse
- Chair of Medical Biochemistry, Faculty of Health Sciences, Universidad Católica de las Misiones, Avenida Jauretche 1036, Esquina Av. Urquiza, 3300, Posadas, Misiones, Argentina; Chair of Clinical Biochemistry II, Biochemistry and Pharmacology Module, Faculty of Exact, Chemical and Natural Sciences, UNaM, Av. Mariano Moreno 1375 3300, Posadas, Misiones, Argentina
| | - Graciela Noemí Malvasi
- Chair of Clinical Biochemistry II, Biochemistry and Pharmacology Module, Faculty of Exact, Chemical and Natural Sciences, UNaM, Av. Mariano Moreno 1375 3300, Posadas, Misiones, Argentina
| | - Pedro Darío Zapata
- Molecular Biotechnology Laboratory, Misiones Biotechnology Institute, Faculty of Exact, Chemical and Natural Sciences, Universidad Nacional de Misiones, Campus Universitario UNaM, Ruta 12 Km 7.5, 3304, Posadas, Misiones, Argentina
| | - Elba Cristina Malarczuk
- Chair of Clinical Biochemistry II, Biochemistry and Pharmacology Module, Faculty of Exact, Chemical and Natural Sciences, UNaM, Av. Mariano Moreno 1375 3300, Posadas, Misiones, Argentina
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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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Shan H, Dodd RY. The Emergence of Zoonotic Pathogens as Agents of Concern in Transfusion Medicine. BLOOD SAFETY 2019. [PMCID: PMC7139442 DOI: 10.1007/978-3-319-94436-4_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A variety of emerging infections are of interest to transfusion medicine clinicians, but zoonotic pathogens, those maintained in nonhuman hosts and transmitted to humans, have dominated recent discussions, especially emerging acute viral infections that can or might spread around a shrinking globe with unprecedented speed, in an infected human or an infected vector or reservoir host. Further, advanced pathogen discovery techniques (e.g., metagenomics) allow the identification of potential pathogens before their recognition as clinically relevant to transfusion medicine. In the aftermath of our experiences with HIV and posttransfusion hepatitis, our windows for response to such agents and infections have contracted rapidly. These characteristics pose difficult challenges for our development of surveillance and control regimes capable of timely, but appropriately nuanced, responses. This monograph surveys a selection of such agents, exploring their apparent relevance to transfusion medicine, closing with a framework for an ongoing approach to their surveillance, recognition, threat evaluation, and mitigation.
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Affiliation(s)
- Hua Shan
- Department of Pathology, Stanford University, Stanford, CA USA
| | - Roger Y. Dodd
- American Red Cross, Medical Office, Rockville, MD USA
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63
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Kim DD, Kimura Jr A, Pontes DKL, Oliveira MLS, Cumino DO. Evaluation of anesthesiologists' knowledge about occupational health: Pilot study. BMC Anesthesiol 2018; 18:193. [PMID: 30567562 PMCID: PMC6300909 DOI: 10.1186/s12871-018-0661-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/03/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND An anesthesiologists' work presents with numerous occupational risks owing to the large amount of time spent inside the operating room where constant noise, anesthetic vapors, ionizing radiation, infectious agents, and psychological stress are present. Herein, we evaluated anesthesiologists' knowledge about occupational health. METHODS A cross-sectional study was conducted to assess 158 anesthesiologists from a tertiary hospital on their knowledge about occupational health using a structured questionnaire. RESULTS The survey revealed a lack of knowledge on the forms of prevention of occupational accidents (74.6% did not know how to act in case of a fire during surgery, 56% failed to identify the post-anesthesia care unit as the place with the highest contamination by inhalation anesthetics, and 42.7% failed to identify all personal protective equipment) and a surprisingly high rate of lack of observance of preventive measures (30.3% washed their hands before touching every patient, 52.5% did not use gloves during intravenous access, and 88.6% used protective equipment against ionizing radiation). CONCLUSIONS Despite improvements in safety standards in healthcare facilities, our research showed lack of knowledge about major topics on occupational health by physicians. Improving safety awareness is an important goal of training programs and continued medical education.
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Affiliation(s)
- Daniel Dongiu Kim
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Aldemar Kimura Jr
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Dayanne Karla Lopes Pontes
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Maycon Luiz Silva Oliveira
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
| | - Debora Oliveira Cumino
- Department of Anesthesiology, Irmandade da Santa Casa de Misericordia de Sao Paulo, Rua Dr. Cesario Motta Jr, 112, Sao Paulo, SP Brazil
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64
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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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65
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Tsai JJ, Lin PC, Tsai CY, Wang YH, Liu LT. Low frequency of asymptomatic dengue virus-infected donors in blood donor centers during the largest dengue outbreak in Taiwan. PLoS One 2018; 13:e0205248. [PMID: 30296301 PMCID: PMC6175512 DOI: 10.1371/journal.pone.0205248] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/23/2018] [Indexed: 12/27/2022] Open
Abstract
To determine the prevalence of asymptomatic dengue virus-infected blood donors during the largest dengue outbreak in Taiwan history occurred in 2015, we examined the evidence of dengue virus (DENV) infection by the detection of DENV RNA genome using real-time reverse transcription-polymerase chain reaction (real-time RT-PCR), DENV NS1 antigen using rapid diagnosis test (RDT) and anti-dengue antibody using IgM/IgG capture enzyme-linked immunosorbent assay (capture ELISA) and RDT in eight thousand serum samples from blood donations to the blood centers of the Taiwan Blood Services Foundation (TBSF) in Kaohsiung City and Tainan City during the largest dengue outbreak in Taiwan history occurred in 2015. Only one serum sample was positive for DENV RNA detection by using dengue-specific real-time RT-PCR, the virus was DENV-2 determined by serotype-specific real-time RT-PCR and sequencing, and the DENVs in the serum were confirmed as being infectious by a plaque assay. The recipient of this blood did not develop any dengue fever symptom on follow-up. None of the samples was NS1 RDT-reactive. Seventeen IgM-positive samples were identified. There was a low prevalence of asymptomatic confirmed or probable DENV-infected blood donors in our study (0.013% and 0.21%, respectively), and no symptomatic transfusion-transmitted dengue (TT dengue) was developed during the largest dengue outbreak in Taiwan history in highly endemic areas and periods.
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Affiliation(s)
- Jih-Jin Tsai
- Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ping-Chang Lin
- Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Ching-Yi Tsai
- Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Ying-Hui Wang
- Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Tropical Medicine Center, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Li-Teh Liu
- Center for Dengue Fever Control and Research, Kaohsiung Medical University, Kaohsiung City, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medical Technology, Chung-Hwa University of Medical Technology, Tainan City, Taiwan
- * E-mail:
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66
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Carneiro-Proietti ABF, Kelly S, Miranda Teixeira C, Sabino EC, Alencar CS, Capuani L, Salomon Silva TP, Araujo A, Loureiro P, Máximo C, Lobo C, Flor-Park MV, Rodrigues DOW, Mota RA, Gonçalez TT, Hoppe C, Ferreira JE, Ozahata M, Page GP, Guo Y, Preiss LR, Brambilla D, Busch MP, Custer B. Clinical and genetic ancestry profile of a large multi-centre sickle cell disease cohort in Brazil. Br J Haematol 2018; 182:895-908. [PMID: 30027669 PMCID: PMC8019534 DOI: 10.1111/bjh.15462] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 04/14/2018] [Indexed: 12/31/2022]
Abstract
Approximately 3500 children with sickle cell disease (SCD) are born in Brazil each year, but the burden of SCD morbidity is not fully characterised. A large, multi-centre cohort was established to characterise clinical outcomes in the Brazilian SCD population and create the infrastructure to perform genotype-phenotype association studies. Eligible patients were randomly selected from participating sites and recruited at routine visits. A biorepository of blood samples was created and comprehensive demographic and clinical outcome data were entered in a centralized electronic database. Peripheral blood genome-wide single nucleotide polymorphism (SNP) genotyping was performed using a customized Transfusion Medicine (TM) Array. A total of 2795 participants at six Brazilian sites were enrolled between 2013 and 2015. The cohort included slight predominance of children <18 years (55·9%) and females (53·0%). Haemoglobin (Hb) SS was the most common SCD genotype (70·7%), followed by HbSC (23%), Sβ0 (3·0%) and Sβ+ (2·9%). SNP data from the TM Array were analysed to evaluate the genetic ancestry of the cohort and revealed significant admixture among the population. Demographics and clinical complications, stratified by age and SCD genotype, are summarized and future studies in this cohort are discussed.
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Affiliation(s)
| | - Shannon Kelly
- Blood Systems Research Institute, San Francisco, CA, USA
- BCHO - UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | | | | | | | | | | | | | | | | | | | - Miriam V Flor-Park
- Instituto da Criança, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Carolyn Hoppe
- BCHO - UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | | | | | - Grier P Page
- RTI - Research Triangle Institute International, Triangle Park, NC, USA
| | - Yuelong Guo
- RTI - Research Triangle Institute International, Triangle Park, NC, USA
| | - Liliana R Preiss
- RTI - Research Triangle Institute International, Triangle Park, NC, USA
| | - Donald Brambilla
- RTI - Research Triangle Institute International, Triangle Park, NC, USA
| | | | - Brian Custer
- Blood Systems Research Institute, San Francisco, CA, USA
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67
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. [Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever (French translation of the article)]. J Fr Ophtalmol 2018; 41:659-668. [PMID: 30173871 DOI: 10.1016/j.jfo.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/04/2018] [Accepted: 03/05/2018] [Indexed: 01/12/2023]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tics bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France.
| | - A Donnio
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - A Jean-Charles
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - J Guyomarch
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - R Hage
- EA4537, Inserm CIC 1424, service d'ophtalmologie, université des Antilles, France
| | - F Najioullah
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - R Césaire
- EA4537, Inserm CIC 1424, laboratoire de virologie, université des Antilles, France
| | - A Cabié
- EA4537, Inserm CIC 1424, service des maladies infectieuses et tropicales, université des Antilles, France
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68
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Merle H, Donnio A, Jean-Charles A, Guyomarch J, Hage R, Najioullah F, Césaire R, Cabié A. Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever. J Fr Ophtalmol 2018; 41:e235-e243. [PMID: 29929827 DOI: 10.1016/j.jfo.2018.05.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 04/30/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022]
Abstract
Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.
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Affiliation(s)
- H Merle
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France.
| | - A Donnio
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Jean-Charles
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - J Guyomarch
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Hage
- Ophthalmology Service, hôpital Pierre-Zobda-Quitman, centre hospitalier universitaire de Martinique, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - F Najioullah
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - R Césaire
- Virology Laboratory, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort-de-France cedex, Martinique, France
| | - A Cabié
- EA4537, INSERM CIC 1424, Tropical and Infectious Disease Service, University of the Antilles, centre hospitalier universitaire de Martinique, hôpital Pierre-Zobda-Quitman, BP 632, 97261 Fort de France cedex, Martinique, France
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69
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Bloch EM, Ness PM, Tobian AAR, Sugarman J. Revisiting Blood Safety Practices Given Emerging Data about Zika Virus. N Engl J Med 2018; 378:1837-1841. [PMID: 29742377 DOI: 10.1056/nejmsb1704752] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Evan M Bloch
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Paul M Ness
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Aaron A R Tobian
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
| | - Jeremy Sugarman
- From the Johns Hopkins University School of Medicine (E.M.B., P.M.N., A.A.R.T., J.S.) and the Berman Institute of Bioethics, Johns Hopkins University (J.S.), Baltimore
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70
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Sharma R, Costa Santos L, da Silva RA, Gonçalves CV, de Melo Calado S, Santos DP, de Andrade de Melo JP, de Cássia Pontello Rampazzo R, Requião L, Krieger MA, Barral-Netto M, de Oliveira CI. Surveillance of donated blood during the 2016 arbovirus outbreak in Brazil. J Med Virol 2018; 90:1406-1410. [DOI: 10.1002/jmv.25193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/31/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Rohit Sharma
- Instituto Gonçalo Moniz-IGM/FIOCRUZ; Salvador, BA Brazil
| | | | - Robson A. da Silva
- IMS-Instituto Multidisciplinar em Saúde, UFBA; Vitória da Conquista, BA Brazil
| | | | | | - Denisar P. Santos
- IMS-Instituto Multidisciplinar em Saúde, UFBA; Vitória da Conquista, BA Brazil
| | | | | | - Luciana Requião
- IBMP-Instituto de Biologia Molecular do Paraná; Curitiba, PR Brazil
| | - Marco A. Krieger
- IBMP-Instituto de Biologia Molecular do Paraná; Curitiba, PR Brazil
- Instituto Carlos Chagas-ICC/FIOCRUZ; Curitiba, PR Brazil
| | - Manoel Barral-Netto
- Instituto Gonçalo Moniz-IGM/FIOCRUZ; Salvador, BA Brazil
- Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia; São Paulo, SP Brazil
| | - Camila I. de Oliveira
- Instituto Gonçalo Moniz-IGM/FIOCRUZ; Salvador, BA Brazil
- Instituto Nacional de Ciência e Tecnologia de Investigação em Imunologia; São Paulo, SP Brazil
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71
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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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72
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Slavov SN, Hespanhol MR, Ferreira AR, Rodrigues ES, Covas DT, Kashima S. Silent dengue virus circulation among asymptomatic blood donors from a hyperendemic Brazilian region. Transfus Med 2018. [DOI: 10.1111/tme.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S. N. Slavov
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
- Department of Internal Medicine, Faculty of Medicine of Ribeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
| | - M. R. Hespanhol
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
| | - A. R. Ferreira
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
| | - E. S. Rodrigues
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
| | - D. T. Covas
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
- Department of Internal Medicine, Faculty of Medicine of Ribeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
| | - S. Kashima
- Blood Center of Ribeirão Preto, Faculty of Medicine of Rbeirão PretoUniversity of São Paulo Ribeirão Preto São Paulo Brazil
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73
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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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74
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Faddy HM, Tran TV, Hoad VC, Seed CR, Viennet E, Chan HT, Harley R, Hewlett E, Hall RA, Bielefeldt-Ohmann H, Flower RLP, Prow NA. Ross River virus in Australian blood donors: possible implications for blood transfusion safety. Transfusion 2018; 58:485-492. [PMID: 29350414 DOI: 10.1111/trf.14472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 10/05/2017] [Accepted: 10/13/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Emerging transfusion-transmissible pathogens, including arboviruses such as West Nile, Zika, dengue, and Ross River viruses, are potential threats to transfusion safety. The most prevalent arbovirus in humans in Australia is Ross River virus (RRV); however, prevalence varies substantially around the country. Modeling estimated a yearly risk of 8 to 11 potentially RRV-viremic fresh blood components nationwide. This study aimed to measure the occurrence of RRV viremia among donors who donated at Australian collection centers located in areas with significant RRV transmission during one peak season. STUDY DESIGN AND METHODS Plasma samples were collected from donors (n = 7500) who donated at the selected collection centers during one peak season. Viral RNA was extracted from individual samples, and quantitative reverse transcription-polymerase chain reaction was performed. RESULTS Regions with the highest rates of RRV transmission were not areas where donor centers were located. We did not detect RRV RNA among 7500 donations collected at the selected centers, resulting in a zero risk estimate with a one-sided 95% confidence interval of 0 to 1 in 2019 donations. CONCLUSION Our results suggest that the yearly risk of collecting a RRV-infected blood donation in Australia is low and is at the lower range of previous risk modeling. The majority of Australian donor centers were not in areas known to be at the highest risk for RRV transmission, which was not taken into account in previous models based on notification data. Therefore, we believe that the risk of RRV transfusion transmission in Australia is acceptably low and appropriately managed through existing risk management, including donation restrictions and recall policies.
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Affiliation(s)
- Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Thu V Tran
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Veronica C Hoad
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Clive R Seed
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Elvina Viennet
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Hiu-Tat Chan
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Robert Harley
- Clinical Services and Research, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Elise Hewlett
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia.,Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Roy A Hall
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Helle Bielefeldt-Ohmann
- Australian Infectious Disease Research Centre, School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert L P Flower
- Research and Development, Australian Red Cross Blood Service, Brisbane, Queensland, Australia
| | - Natalie A Prow
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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75
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Ware AD, Jacquot C, Tobian AAR, Gehrie EA, Ness PM, Bloch EM. Pathogen reduction and blood transfusion safety in Africa: strengths, limitations and challenges of implementation in low-resource settings. Vox Sang 2017; 113:3-12. [PMID: 29193128 DOI: 10.1111/vox.12620] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/27/2017] [Accepted: 11/06/2017] [Indexed: 12/31/2022]
Abstract
Transfusion-transmitted infection risk remains an enduring challenge to blood safety in Africa. A high background incidence and prevalence of the major transfusion-transmitted infections (TTIs), dependence on high-risk donors to meet demand, suboptimal testing and quality assurance collectively contribute to the increased risk. With few exceptions, donor testing is confined to serological evaluation of human immunodeficiency virus (HIV), hepatitis B and C (HBV and HCV) and syphilis. Barriers to implementation of broader molecular methods include cost, limited infrastructure and lack of technical expertise. Pathogen reduction (PR), a term used to describe a variety of methods (e.g. solvent detergent treatment or photochemical activation) that may be applied to blood following collection, offers the means to diminish the infectious potential of multiple pathogens simultaneously. This is effective against different classes of pathogen, including the major TTIs where laboratory screening is already implemented (e.g. HIV, HBV and HCV) as well pathogens that are widely endemic yet remain unaddressed (e.g. malaria, bacterial contamination). We sought to review the available and emerging PR techniques and their potential application to resource-constrained parts of Africa, focusing on the advantages and disadvantages of such technologies. PR has been slow to be adopted even in high-income countries, primarily given the high costs of use. Logistical considerations, particularly in low-resourced parts of Africa, also raise concerns about practicality. Nonetheless, PR offers a rational, innovative strategy to contend with TTIs; technologies in development may well present a viable complement or even alternative to targeted screening in the future.
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Affiliation(s)
- A D Ware
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - C Jacquot
- Children's National Health System and George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - A A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E A Gehrie
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - P M Ness
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E M Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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76
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Faria NR, da Costa AC, Lourenço J, Loureiro P, Lopes ME, Ribeiro R, Alencar CS, Kraemer MUG, Villabona-Arenas CJ, Wu CH, Thézé J, Khan K, Brent SE, Romano C, Delwart E, Custer B, Busch MP, Pybus OG, Sabino EC. Genomic and epidemiological characterisation of a dengue virus outbreak among blood donors in Brazil. Sci Rep 2017; 7:15216. [PMID: 29123142 PMCID: PMC5680240 DOI: 10.1038/s41598-017-15152-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/20/2017] [Indexed: 01/20/2023] Open
Abstract
Outbreaks caused by Dengue, Zika and Chikungunya viruses can spread rapidly in immunologically naïve populations. By analysing 92 newly generated viral genome sequences from blood donors and recipients, we assess the dynamics of dengue virus serotype 4 during the 2012 outbreak in Rio de Janeiro. Phylogenetic analysis indicates that the outbreak was caused by genotype II, although two isolates of genotype I were also detected for the first time in Rio de Janeiro. Evolutionary analysis and modelling estimates are congruent, indicating a reproduction number above 1 between January and June, and at least two thirds of infections being unnoticed. Modelling analysis suggests that viral transmission started in early January, which is consistent with multiple introductions, most likely from the northern states of Brazil, and with an increase in within-country air travel to Rio de Janeiro. The combination of genetic and epidemiological data from blood donor banks may be useful to anticipate epidemic spread of arboviruses.
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Affiliation(s)
- Nuno R Faria
- Department of Zoology, University of Oxford, Oxford, United Kingdom.
| | - Antonio Charlys da Costa
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil. .,LIM46, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - José Lourenço
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Paula Loureiro
- Faculdade de Ciências Médicas, Fundação Hemope, Recife, Brazil
| | | | - Roberto Ribeiro
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,LIM46, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Chieh-Hsi Wu
- Department of Statistics, University of Oxford, Oxford, United Kingdom
| | - Julien Thézé
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Kamran Khan
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Division of Infectious Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Shannon E Brent
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Camila Romano
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Eric Delwart
- Blood Systems Research Institute, San Francisco, California, USA.,University of California San Francisco, San Francisco, California, USA
| | - Brian Custer
- Blood Systems Research Institute, San Francisco, California, USA.,University of California San Francisco, San Francisco, California, USA
| | - Michael P Busch
- Blood Systems Research Institute, San Francisco, California, USA.,University of California San Francisco, San Francisco, California, USA
| | - Oliver G Pybus
- Department of Zoology, University of Oxford, Oxford, United Kingdom
| | - Ester C Sabino
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil. .,LIM46, Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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77
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Coghlan A, Hoad VC, Seed CR, Flower RL, Harley RJ, Herbert D, Faddy HM. Emerging infectious disease outbreaks: estimating disease risk in Australian blood donors travelling overseas. Vox Sang 2017; 113:21-30. [PMID: 29052242 DOI: 10.1111/vox.12571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 07/21/2017] [Accepted: 07/26/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES International travel assists spread of infectious pathogens. Australians regularly travel to South-eastern Asia and the isles of the South Pacific, where they may become infected with infectious agents, such as dengue (DENV), chikungunya (CHIKV) and Zika (ZIKV) viruses that pose a potential risk to transfusion safety. In Australia, donors are temporarily restricted from donating for fresh component manufacture following travel to many countries, including those in this study. We aimed to estimate the unmitigated transfusion-transmission (TT) risk from donors travelling internationally to areas affected by emerging infectious diseases. MATERIALS AND METHODS We used the European Up-Front Risk Assessment Tool, with travel and notification data, to estimate the TT risk from donors travelling to areas affected by disease outbreaks: Fiji (DENV), Bali (DENV), Phuket (DENV), Indonesia (CHIKV) and French Polynesia (ZIKV). RESULTS We predict minimal risk from travel, with the annual unmitigated risk of an infected component being released varying from 1 in 1·43 million to <1 in one billion and the risk of severe consequences ranging from 1 in 130 million to <1 in one billion. CONCLUSION The predicted unmitigated likelihood of infection in blood components manufactured from donors travelling to the above-mentioned areas was very low, with the possibility of severe consequences in a transfusion recipient even smaller. Given the increasing demand for plasma products in Australia, the current strategy of restricting donors returning from select infectious disease outbreak areas to source plasma collection provides a simple and effective risk management approach.
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Affiliation(s)
- A Coghlan
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - V C Hoad
- Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia
| | - C R Seed
- Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia
| | - R Lp Flower
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia
| | - R J Harley
- Medical Services, Australian Red Cross Blood Service, Brisbane, QLD, Australia
| | - D Herbert
- Medical Services, Australian Red Cross Blood Service, Melbourne, VIC, Australia
| | - H M Faddy
- Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
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78
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Abstract
Arboviruses are emerging infectious diseases with the ability to expand geographically and rapidly affect large populations. The recent epidemic caused by the Zika virus in the Americas and congenital Zika syndrome associated with maternal infection has called out attention to the importance of studying arboviruses during pregnancy. This is a review on selected arboviruses infections during gestation, including Zika, Chikungunya, Dengue and Yellow Fever viruses. Issues such as historical overview, pathogenesis, transmission, clinical conditions, diagnosis, treatment and prevention are addressed.
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79
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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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80
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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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81
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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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82
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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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83
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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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84
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He M, Wang J, Chen L, Liu J, Zeng P. The Impact of Emerging Infectious Diseases on Chinese Blood Safety. Transfus Med Rev 2017; 31:94-101. [PMID: 27923518 PMCID: PMC7126663 DOI: 10.1016/j.tmrv.2016.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/19/2016] [Accepted: 10/24/2016] [Indexed: 12/16/2022]
Abstract
Emerging infectious diseases (EIDs) have always been one of the major threats to public health. Although the implementation of mandatory testing for 4 classical transfusion-transmitted infectious-human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis-has reduced the transfusion risk of these pathogens, the potential threat of various EID agents and their constantly evolving variants to blood safety in China is not fully understood. This review presents 9 representative EID agents that are autochthonous and epidemic nationally or regionally in China. The epidemiologic status and distribution of these EID agents among donors and/or healthy populations are summarized. The potential risks of these EID agents to blood safety are discussed. The review also explores strategies to strengthen hemovigilance systems and studies to further evaluate the impact of EID agents on blood safety.
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Affiliation(s)
- Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jingxing Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Limin Chen
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jing Liu
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Peibin Zeng
- West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
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85
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Felix AC, Souza NCS, Figueiredo WM, Costa AA, Inenami M, da Silva RM, Levi JE, Pannuti CS, Romano CM. Cross reactivity of commercial anti-dengue immunoassays in patients with acute Zika virus infection. J Med Virol 2017; 89:1477-1479. [DOI: 10.1002/jmv.24789] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/06/2017] [Accepted: 02/10/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Alvina Clara Felix
- Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo Brazil
| | | | - Walter M. Figueiredo
- Serviço Especial de Saúde de Araraquara-SESA; Faculdade de Saúde Pública da USP; São Paulo Brazil
| | - Angela A. Costa
- Serviço Especial de Saúde de Araraquara-SESA; Faculdade de Saúde Pública da USP; São Paulo Brazil
| | - Marta Inenami
- Serviço Especial de Saúde de Araraquara-SESA; Faculdade de Saúde Pública da USP; São Paulo Brazil
| | - Rosangela M.G. da Silva
- Serviço Especial de Saúde de Araraquara-SESA; Faculdade de Saúde Pública da USP; São Paulo Brazil
| | - José Eduardo Levi
- Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo Brazil
| | - Claudio Sergio Pannuti
- Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo Brazil
| | - Camila Malta Romano
- Instituto de Medicina Tropical de São Paulo; Universidade de São Paulo; São Paulo Brazil
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86
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Ashshi AM, Alghamdi S, El-Shemi AG, Almdani S, Refaat B, Mohamed AM, Ghazi HO, Azhar EI, Al-Allaf FA. Seroprevalence of Asymptomatic Dengue Virus Infection and Its Antibodies Among Healthy/Eligible Saudi Blood Donors: Findings From Holy Makkah City. Virology (Auckl) 2017; 8:1-5. [PMID: 28469422 PMCID: PMC5348084 DOI: 10.1177/1178122x17691261] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 01/08/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Threat to blood transfusion-transmitted dengue virus (DENV) and its antibodies has recently emerged worldwide. Dengue fever is an endemic disease in Saudi Arabia, particularly in its Western region. The aim of this study was to estimate the seroprevalence of asymptomatic DENV infection and its antibodies among eligible Saudi blood donors. METHODS Serum samples from 910 healthy/eligible adult male Saudi blood donors, who reside in Holy Makkah City of Saudi Arabia, were collected between March 2015 and August 2016 and screened for the detection of DENV nonstructural protein 1 (NS1) antigen and anti-DENV IgM and IgG antibodies using commercial enzyme-linked immunosorbent assay kits (Panbio, Brisbane, QLD, Australia). RESULTS Among the tested donors, 48 (5.3%) were seropositive for DENV-NS1 antigen, whereas 50 (5.5%) and 354 (38.9%) were seropositive for anti-DENV IgM and IgG antibodies, respectively. Seropositivity for DENV-NS1 antigen and/or anti-DENV IgM antibody among the tested donors reflects their ongoing asymptomatic viremic infectious stage with DENV during their donation time, whereas high prevalence of anti-DENV IgG seropositivity reflects the high endemicity of dengue disease in this region of Saudi Arabia. CONCLUSIONS These results show high prevalence of asymptomatic DENV infection and its antibodies among Saudi blood donors, raising the importance of establishing blood screening for dengue disease at different blood donation services and units in Saudi Arabia to improve the guarantee of blood transfusions and to control DENV dissemination.
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Affiliation(s)
- Ahmed M Ashshi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Holy Makkah, Saudi Arabia
| | - Saad Alghamdi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Holy Makkah, Saudi Arabia
| | - Adel G El-Shemi
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Holy Makkah, Saudi Arabia.,Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Sabir Almdani
- Immunology Unit, Regional Laboratory of Holy Makkah, Holy Makkah, Saudi Arabia
| | - Bassem Refaat
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Holy Makkah, Saudi Arabia
| | - Amr M Mohamed
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Holy Makkah, Saudi Arabia.,Department of Animal Medicine, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt
| | - Hani O Ghazi
- Department of Medical Microbiology, College of Medicine, Umm Al-Qura University, Holy Makkah, Saudi Arabia
| | - Esam I Azhar
- Medical Laboratory Technology Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faisal A Al-Allaf
- Department of Human Genetics, College of Medicine, Umm Al-Qura University, Holy Makkah, Saudi Arabia
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87
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Montague BT, Salas CM, Montague TL, Mileno MD. The immunosuppressed patient. Infect Dis (Lond) 2017. [DOI: 10.1002/9781119085751.ch28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Brian T. Montague
- Division of Infectious Diseases; University of Colorado; Aurora Colorado USA
| | | | | | - Maria D. Mileno
- Warren Alpert Medical School; Brown University; Providence Rhode Island USA
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88
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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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89
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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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90
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Transfusion transmitted dengue: One donor infects two patients. Transfus Apher Sci 2016; 56:151-153. [PMID: 27825640 DOI: 10.1016/j.transci.2016.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 11/22/2022]
Abstract
Dengue virus can be transmitted via blood transfusion. We report an interesting case where two surgical patients developed possible transfusion transmitted dengue when transfused blood components of the same donor. Dengue remains a threat to blood supply especially in endemic region.
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91
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Abstract
Zika virus can be transmitted by transfusion, but the harm caused to recipients is not clear in most cases. It is very likely that the virus could also be transmitted by transplanted organs. Sensitivity to the risk from transfusion is elevated by consideration of possible severe neurologic damage in fetuses. Strategies for dealing with transfusion risk vary with the presence of Zika in the region. In nonendemic areas, risks can be reduced by excluding donors who have exposure through travel or sexual contact with someone at risk. In both endemic and nonendemic areas, the risk can be further reduced by nucleic acid testing of donors, or pathogen reduction of platelet and plasma products. The real risk to the population depends on the frequency of infection as well as the efficacy of these interventions. The interventions chosen will depend on the risk assessment for any situation; in the United States at this time, a combination of travel deferrals, testing, and, to a lesser extent, pathogen reduction is being used, but universal testing of US blood donors under investigational use has been mandated by the US Food and Drug Administration, beginning with states most at risk of local transmission. Canada is largely using travel deferrals. A precautionary approach may be taken; however, a formal decision-making framework has been suggested. The situation globally is clearly very fluid, as the epidemic continues to spread and we continue to learn how to best protect recipients of blood and transplants.
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Affiliation(s)
| | - Susan N Rossmann
- From America's Blood Centers, Washington DC, and the Department of Medicine, Division of Infectious Diseases, Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa (Dr Katz); and the Gulf Coast Regional Blood Center, Houston, Texas (Dr Rossmann)
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92
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Tezuka K, Kuramitsu M, Okuma K, Nojima K, Araki K, Shinohara N, Matsumoto C, Satake M, Takasaki T, Saijo M, Kurane I, Hamaguchi I. Development of a novel dengue virus serotype-specific multiplex real-time reverse transcription-polymerase chain reaction assay for blood screening. Transfusion 2016; 56:3094-3100. [PMID: 27774649 DOI: 10.1111/trf.13875] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/22/2016] [Accepted: 07/28/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dengue fever is caused by four related RNA viruses of the genus Flavivirus, dengue virus (DENV)-1, -2, -3, and -4, which are transmitted to humans by mosquitoes. Although DENV is not endemic in Japan, an autochthonous dengue outbreak occurred in 2014. Several transfusion-transmitted cases have also been reported after the use of blood and plasma products in DENV-endemic countries. The aim of this study was to develop a novel multiplex reverse transcription-polymerase chain reaction (RT-PCR) assay for DENV blood screening. STUDY DESIGN AND METHODS Large-scale oligonucleotide screening was performed to obtain DENV-specific primers and probes using a variety of DENV clinical isolates. A multiplex RT-PCR assay was then developed using the identified oligonucleotides and the ability of this assay to detect DENV RNA was evaluated. RESULTS A number of oligonucleotides suitable for DENV RNA detection were identified and a novel DENV serotype-specific multiplex RT-PCR assay was successfully established. Comparative analysis revealed that the multiplex assay could detect levels of viral contamination as low as 100 viral copies/mL. CONCLUSION This established serotype-specific multiplex RT-PCR assay provides a simple, sensitive, and quantitative detection method for DENV, which could be applied in the screening of blood samples to prevent transfusion-transmitted DENV infection.
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Affiliation(s)
- Kenta Tezuka
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Madoka Kuramitsu
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazu Okuma
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kiyoko Nojima
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kumiko Araki
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
| | - Naoya Shinohara
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Chieko Matsumoto
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Tomohiko Takasaki
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Ichiro Kurane
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Isao Hamaguchi
- Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Tokyo, Japan
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93
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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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94
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Jimenez A, Shaz BH, Bloch EM. Zika Virus and the Blood Supply: What Do We Know? Transfus Med Rev 2016; 31:1-10. [PMID: 27569055 DOI: 10.1016/j.tmrv.2016.08.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/30/2016] [Accepted: 08/01/2016] [Indexed: 02/03/2023]
Abstract
Zika virus (ZIKV), a mosquito-borne Flavivirus and emerging infectious disease, is the focus of an international public health emergency after its rapid spread through the Americas and the Caribbean. Although most ZIKV infections are subclinical or characterized by mild febrile illness, ZIKV has been implicated in severe complications, most notably microcephaly in babies born to incident infected mothers during pregnancy. As yet, the extent to which ZIKV is transfusion transmissible remains undefined. Nonetheless, a high prevalence of asymptomatic infection during outbreaks, the demonstration of ZIKV in blood donors, and 4 possible cases of transfusion-transmitted ZIKV in Brazil have raised concern for risk to the blood supply. Consequently, a proactive response is underway by blood collection agencies, regulatory bodies, national funding agencies, and industry alike. Mitigation strategies differ between endemic and nonendemic areas. In the continental United States, the American Association of Blood Banks and Food and Drug Administration guidelines recommend travel-based deferral for those returning from affected areas, and nucleic acid testing is being initiated under an investigational new drug application in Puerto Rico and selected areas of the United States. Options are less clear for countries where autochthonous vector-borne transmission is active. The burden of Zika falls in low-resource countries where high cost and technical barriers associated with testing and pathogen reduction pose barriers to implementation. Additional strategies include maintaining selective inventory for high-risk recipients (eg, pregnant women). We review the available data as of July 2016 on ZIKV in relation to the blood supply including risk, mitigation strategies, and barriers to implementation in addition to the research that is needed to address current uncertainty.
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Affiliation(s)
| | - Beth H Shaz
- Columbia University Medical Center and New York Blood Center, New York, NY
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95
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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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96
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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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97
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Lanteri MC, Kleinman SH, Glynn SA, Musso D, Keith Hoots W, Custer BS, Sabino EC, Busch MP. Zika virus: a new threat to the safety of the blood supply with worldwide impact and implications. Transfusion 2016; 56:1907-14. [PMID: 27282638 DOI: 10.1111/trf.13677] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/26/2016] [Accepted: 05/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Marion C Lanteri
- Blood Systems Research Institute and.,Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California
| | | | - Simone A Glynn
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Didier Musso
- Unit of Emerging Infectious Diseases, Institut Louis Malardé, Tahiti, French Polynesia
| | - W Keith Hoots
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Brian S Custer
- Blood Systems Research Institute and.,Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California
| | - Ester C Sabino
- Departmento de Molestias Infecciosas e Parasitarias, Instituto de Medicina Tropical, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Michael P Busch
- Blood Systems Research Institute and.,Department of Laboratory Medicine, University of California at San Francisco, San Francisco, California
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98
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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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99
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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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100
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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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