BACKGROUND: In the absence of active blood donation screening, dengue viruses (DENV) have been implicated in only a limited number of transfusion transmissions worldwide. This study attempted to identify if blood from donors testing negative by an NS1-antigen (Ag) enzyme-linked immunosorbent assay (ELISA) but confirmed positive for DENV RNA caused DENV-related disease in recipients during the epidemic years of 2010 to 2012 in Puerto Rico. STUDY DESIGN AND METHODS: Donation aliquots testing negative by an investigational NS1-Ag ELISA were stored frozen and retested retrospectively using a research transcription-mediated amplification assay (TMA) detecting DENV RNA. All RNA-reactive donations were subject to confirmatory RNA and antibody testing. Recipient tracing was conducted for all components manufactured from TMA-reactive components. Medical chart review, recipient interview, and follow-up sampling occurred for 42 recipients transfused with TMA-reactive components. RESULTS: Six of 42 recipients developed new-onset fever in the 2 weeks posttransfusion; three (50%) received RNA confirmed-positive, NS1-Ag-negative red blood cell (RBC) units. One recipient of a high-titer unit (7 × 10(7) DENV-4 RNA copies/mL) developed severe dengue, and a second recipient had only fever recorded but had a negative sepsis work-up. New fever attributable to DENV infection in a third recipient was confounded by fever potentially attributable to posttransfusion sepsis. CONCLUSIONS: In our retrospective study, NS1-Ag detected 20% of all RNA confirmed-positive donations demonstrating limitations of NS1-Ag ELISA for blood donation screening. We identified one recipient with a clinical syndrome compatible with severe dengue who had received an NS1-Ag-negative but RNA confirmed-positive RBC unit. This investigation illustrates the difficulty in confirming transfusion transmission in dengue-endemic areas among severely ill transfusion recipients.
BACKGROUND: In the absence of active blood donation screening, dengue viruses (DENV) have been implicated in only a limited number of transfusion transmissions worldwide. This study attempted to identify if blood from donors testing negative by an NS1-antigen (Ag) enzyme-linked immunosorbent assay (ELISA) but confirmed positive for DENV RNA caused DENV-related disease in recipients during the epidemic years of 2010 to 2012 in Puerto Rico. STUDY DESIGN AND METHODS: Donation aliquots testing negative by an investigational NS1-Ag ELISA were stored frozen and retested retrospectively using a research transcription-mediated amplification assay (TMA) detecting DENV RNA. All RNA-reactive donations were subject to confirmatory RNA and antibody testing. Recipient tracing was conducted for all components manufactured from TMA-reactive components. Medical chart review, recipient interview, and follow-up sampling occurred for 42 recipients transfused with TMA-reactive components. RESULTS: Six of 42 recipients developed new-onset fever in the 2 weeks posttransfusion; three (50%) received RNA confirmed-positive, NS1-Ag-negative red blood cell (RBC) units. One recipient of a high-titer unit (7 × 10(7) DENV-4 RNA copies/mL) developed severe dengue, and a second recipient had only fever recorded but had a negative sepsis work-up. New fever attributable to DENVinfection in a third recipient was confounded by fever potentially attributable to posttransfusion sepsis. CONCLUSIONS: In our retrospective study, NS1-Ag detected 20% of all RNA confirmed-positive donations demonstrating limitations of NS1-Ag ELISA for blood donation screening. We identified one recipient with a clinical syndrome compatible with severe dengue who had received an NS1-Ag-negative but RNA confirmed-positive RBC unit. This investigation illustrates the difficulty in confirming transfusion transmission in dengue-endemic areas among severely ill transfusion recipients.
Authors: Michael P Busch; Ester C Sabino; Donald Brambilla; Maria Esther Lopes; Ligia Capuani; Dhuly Chowdhury; Christopher McClure; Jeffrey M Linnen; Harry Prince; Graham Simmons; Tzong-Hae Lee; Steven Kleinman; Brian Custer Journal: J Infect Dis Date: 2016-04-01 Impact factor: 5.226
Authors: Ángel Giménez-Richarte; Mabel Ortiz de Salazar; Cristina Arbona; María P Giménez-Richarte; Miriam Collado; Pedro L Fernández; Francisco Quiles; Carlos Clavijo; Pascual Marco; Jose-Manuel Ramos-Rincon Journal: Blood Transfus Date: 2021-09-22 Impact factor: 5.752
Authors: Stephanie M Pouch; Shalika B Katugaha; Wun-Ju Shieh; Pallavi Annambhotla; William L Walker; Sridhar V Basavaraju; Jefferson Jones; Thanhthao Huynh; Sarah Reagan-Steiner; Julu Bhatnagar; Kacie Grimm; Susan L Stramer; Julie Gabel; G Marshall Lyon; Aneesh K Mehta; Prem Kandiah; David C Neujahr; Jeffrey Javidfar; Ram M Subramanian; Samir M Parekh; Palak Shah; Lauren Cooper; Mitchell A Psotka; Rachel Radcliffe; Carl Williams; Sherif R Zaki; J Erin Staples; Marc Fischer; Amanda J Panella; Robert S Lanciotti; Janeen J Laven; Olga Kosoy; Ingrid B Rabe; Carolyn V Gould Journal: Clin Infect Dis Date: 2019-07-18 Impact factor: 9.079
Authors: Germán Añez; Daniel A R Heisey; Caren Chancey; Rafaelle C G Fares; Luz M Espina; Kátia P R Souza; Andréa Teixeira-Carvalho; David E Krysztof; Gregory A Foster; Susan L Stramer; Maria Rios Journal: PLoS Negl Trop Dis Date: 2016-02-12
Authors: Kelly Rooks; Clive R Seed; Jesse J Fryk; Catherine A Hyland; Robert J Harley; Jerry A Holmberg; Denese C Marks; Robert L P Flower; Helen M Faddy Journal: J Blood Transfus Date: 2016-11-13