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Viennet E, Frentiu FD, Williams CR, Mincham G, Jansen CC, Montgomery BL, Flower RLP, Faddy HM. Estimation of mosquito-borne and sexual transmission of Zika virus in Australia: Risks to blood transfusion safety. PLoS Negl Trop Dis 2020; 14:e0008438. [PMID: 32663213 PMCID: PMC7380650 DOI: 10.1371/journal.pntd.0008438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 07/24/2020] [Accepted: 06/01/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Since 2015, Zika virus (ZIKV) outbreaks have occurred in the Americas and the Pacific involving mosquito-borne and sexual transmission. ZIKV has also emerged as a risk to global blood transfusion safety. Aedes aegypti, a mosquito well established in north and some parts of central and southern Queensland, Australia, transmits ZIKV. Aedes albopictus, another potential ZIKV vector, is a threat to mainland Australia. Since these conditions create the potential for local transmission in Australia and a possible uncertainty in the effectiveness of blood donor risk-mitigation programs, we investigated the possible impact of mosquito-borne and sexual transmission of ZIKV in Australia on local blood transfusion safety. METHODOLOGY/PRINCIPAL FINDINGS We estimated 'best-' and 'worst-' case scenarios of monthly reproduction number (R0) for both transmission pathways of ZIKV from 1996-2015 in 11 urban or regional population centres, by varying epidemiological and entomological estimates. We then estimated the attack rate and subsequent number of infectious people to quantify the ZIKV transfusion-transmission risk using the European Up-Front Risk Assessment Tool. For all scenarios and with both vector species R0 was lower than one for ZIKV transmission. However, a higher risk of a sustained outbreak was estimated for Cairns, Rockhampton, Thursday Island, and theoretically in Darwin during the warmest months of the year. The yearly estimation of the risk of transmitting ZIKV infection by blood transfusion remained low through the study period for all locations, with the highest potential risk estimated in Darwin. CONCLUSIONS/SIGNIFICANCE Given the increasing demand for plasma products in Australia, the current strategy of restricting donors returning from infectious disease outbreak regions to source plasma collection provides a simple and effective risk management approach. However, if local transmission was suspected in the main urban centres of Australia, potentially facilitated by the geographic range expansion of Ae. aegypti or Ae. albopictus, this mitigation strategy would need urgent review.
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Affiliation(s)
- Elvina Viennet
- Research and Development, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
- * E-mail:
| | - Francesca D. Frentiu
- Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
| | - Craig R. Williams
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Gina Mincham
- Australian Centre for Precision Health, University of South Australia, Adelaide, South Australia, Australia
| | - Cassie C. Jansen
- Communicable Diseases Branch, Queensland Department of Health, Herston, Queensland, Australia
| | - Brian L. Montgomery
- Metro South Public Health Unit, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Robert L. P. Flower
- Research and Development, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
| | - Helen M. Faddy
- Research and Development, Australian Red Cross Lifeblood, Kelvin Grove, Queensland, Australia
- Institute for Health and Biomedical Innovation, School of Biomedical Sciences, Queensland University of Technology, Queensland, Australia
- School of Health and Sport Sciences, University of the Sunshine Coast, Queensland, Australia
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DeSimone RA, Hayden JA, Mazur CA, Vasovic LV, Sachais BS, Zhao Z, Goel R, Hsu YMS, Racine-Brzostek SE, Cushing MM. Red blood cells donated by smokers: A pilot investigation of recipient transfusion outcomes. Transfusion 2019; 59:2537-2543. [PMID: 31074905 DOI: 10.1111/trf.15339] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/10/2019] [Accepted: 04/21/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Current regulations do not require blood collection facilities to ask donors about cigarette smoking, and the prevalence of nicotine and its metabolites in blood products is not well established. Although smokers have higher hemoglobin (Hb) levels, smoking may adversely affect the quality of donated red blood cells through higher carboxyhemoglobin (COHb) content and premature hemolysis. STUDY DESIGN AND METHODS Red blood cell (RBC) unit segments from 100 unique donors were tested for nicotine and its metabolite cotinine by mass spectrometry and for COHb spectrophotometrically. Outcomes were evaluated retrospectively in adult non-bleeding patients receiving single RBC units. RESULTS Thirteen of 100 RBC segments (13%) were positive for cotinine at levels consistent with current smoking (> 10 ng/mL). The cotinine positive RBCs showed significantly greater COHb content compared to cotinine negative units (median 3.0% vs. 0.8%, p = 0.007). For patients transfused cotinine-positive units, there was no significant change in their vital signs following transfusion and no transfusion reactions were observed. However, patients transfused cotinine-positive units showed significantly reduced hematocrit and hemoglobin increments (median +1.2% and +0.4 g/dL) following transfusion compared to patients receiving cotinine negative units (median +3.6% and +1.4 g/dL) (p = 0.014). CONCLUSION Thirteen percent of RBC units tested positive for cotinine at levels consistent with active smoking, accordant with the estimated national smoking rate of 15.5%. Cotinine-positive RBC units had greater COHb content and showed reduced hematocrit and hemoglobin increments following transfusion. These preliminary results should be validated in a larger cohort.
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Affiliation(s)
- Robert A DeSimone
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Joshua A Hayden
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Chase A Mazur
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Ljiljana V Vasovic
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | | | - Zhen Zhao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Ruchika Goel
- Simmons Cancer Institute at Southern Illinois University School of Medicine, Springfield, Illinois.,Department of Pathology, Johns Hopkins University, Baltimore, Maryland
| | - Yen-Michael S Hsu
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
| | - Sabrina E Racine-Brzostek
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York.,New York Blood Center, New York, New York
| | - Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York
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Watson-Brown P, Viennet E, Mincham G, Williams CR, Jansen CC, Montgomery BL, Flower RLP, Faddy HM. Epidemic potential of Zika virus in Australia: implications for blood transfusion safety. Transfusion 2019; 59:648-658. [PMID: 30618208 DOI: 10.1111/trf.15095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/10/2018] [Accepted: 10/18/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND Zika virus (ZIKV) is transfusion-transmissible. In Australia the primary vector, Aedes aegypti, is established in the north-east, such that local transmission is possible following importation of an index case, which has the potential to impact on blood transfusion safety and public health. We estimated the basic reproduction number (R 0 ) to model the epidemic potential of ZIKV in Australian locations, compared this with the ecologically similar dengue viruses (DENV), and examined possible implications for blood transfusion safety. STUDY DESIGN AND METHODS Varying estimates of vector control efficiency and extrinsic incubation period, "best-case" and "worst-case" scenarios of monthly R 0 for ZIKV and DENV were modeled from 1996 to 2015 in 11 areas. We visualized the geographical distribution of blood donors in relation to areas with epidemic potential for ZIKV. RESULTS Epidemic potential (R 0 > 1) existed for ZIKV and DENV throughout the study period in a number of locations in northern Australia (Cairns, Darwin, Rockhampton, Thursday Island, Townsville, and Brisbane) during the warmer months of the year. R 0 for DENV was greater than ZIKV and was broadly consistent with annual estimates in Cairns. Increased vector control efficiency markedly reduced the epidemic potential and shortened the season of local transmission. Australian locations that provide the greatest number of blood donors did not have epidemic potential for ZIKV. CONCLUSION We estimate that areas of north-eastern Australia could sustain local transmission of ZIKV. This early contribution to understanding the epidemic potential of ZIKV may assist in the assessment and management of threats to blood transfusion safety.
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Affiliation(s)
- Peter Watson-Brown
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia.,School of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Elvina Viennet
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Gina Mincham
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Craig R Williams
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Cassie C Jansen
- Communicable Diseases Branch, Department of Health, Queensland Health, Herston, Queensland, Australia
| | - Brian L Montgomery
- Metro South Public Health Unit, Queensland Health, Coopers Plain, Queensland, Australia
| | - Robert L P Flower
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Helen M Faddy
- Research and Development, Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia.,School of Medicine, The University of Queensland, Herston, Queensland, Australia
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Sookaromdee P, Wiwanitkit V. Prevention for zika virus infection. Int J Prev Med 2019; 10:63. [PMID: 31198498 PMCID: PMC6547773 DOI: 10.4103/ijpvm.ijpvm_354_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/14/2017] [Indexed: 11/13/2022] Open
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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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