Today we will be discussing chikungunya virus, a positive single stranded RNA virus that is normally transmitted by Aedes mosquitoes, especially Aedes aegypti and Aedes albopictus which are common in the tropics, including urban areas. An ongoing outbreak starting in late 2013 in the Caribbean has infected thousands of people and brought renewed medical interest to chikungunya virus.
Dr. Katz describes the illness:
“80% of people have symptoms, for many it will be a non-specific illness–fever, aches and pains. But the really defining clinical characteristic is really extreme muscle and joint pain that gives rise to its name; it’s a Swahili word descriptive of the extreme pain that people have as a result of the infection. The acute infection lasts for several days but the pain can last really for weeks and months.”
No specific treatment or vaccine is available for chikungunya virus, and infection is thought to confer life-long immunity. However, since high titer viremia can last for approximately a week and at least 20% of infected individuals may be asymptomatic, the risk for transfusion-transmission is theoretically high, although no confirmed cases of transfusion-transmission have been reported.
Dr. Katz elaborates:
“We’ve seen literally hundreds of thousands and probably millions of cases in the Indian Ocean and South Asia without documented transfusion-transmission. Same thing in the Caribbean, there’s no recognized transfusion-transmission in the Caribbean, but we know that the virus is in the blood and we know it can be transmitted parenterally in a Macaque primate model, so I think it’s very plausible that transfusion-transmission could occur.”
There are no current standards on donor deferral periods during a chikungunya outbreak, donor screening questions, or licensed screening tests. Since the outbreak is likely to spread, however, the transfusion community needs to be prepared.
The AABB recently released a fact sheet on chikungunya virus on the AABB website. In addition, updated fact sheets have also been added for the dengue virus and hepatitis E virus.
We’ll be back with another edition of Transfusion News on May 15. Thanks for joining us.
1. AABB Resource. Chikungunya Virus. Available from: https://www.aabb.org/resources/bct/eid/Documents/chikungunya-virus.pdf. Accessed April 8, 2014.
2. AABB Resource. Hepatitis E Virus. Available from: http://www.aabb.org/resources/bct/eid/Documents/hepatitis-E-virus.pdf. Accessed April 8, 2014.
3. AABB Resource. Dengue Viruses. Available from: http://www.aabb.org/resources/bct/eid/Documents/dengue-viruses.pdf. Accessed April 8, 2014.