Two platelet transfusion recipients acquired the Zika virus from their transfusions, as recently reported in The New England Journal of Medicine. Both patients were transfused with leukoreduced platelets from one presymptomatic Zika-infected donor. Both recipients were negative for the virus pre-transfusion, but samples collected from both recipients after transfusion were positive for Zika virus. Furthermore, sequencing data confirmed that Zika virus isolates were related between the donor and both patients. Since transfusion-transmission of the Zika virus has been confirmed in Brazil, along with numerous mosquito-borne and travel-related cases of Zika in the United States, the U.S. Food and Drug Administration (FDA) has revised their guidance recommendations. The FDA now recommends universal testing of all donated blood products using an investigational individual donor nucleic acid test (ID-NAT) for Zika virus. Universal ID-NAT testing for Zika virus shall be implemented nationwide in phases over the next 12 weeks. As an alternative option to ID-NAT testing, the FDA also endorses using an FDA-approved pathogen reduction technology for plasma and platelets. Under these recommendations, donors will not need to be deferred due to Zika virus risk factors. The transfusion medicine community should continue to monitor updates from the Centers for Disease and Control, FDA and other government officials.
- Motta IJ, Spencer BR, Cordeiro da Silva SG, Arruda MB, Dobbin JA, Gonzaga YB, Arcuri IP, Tavares RC, Atta EH, Fernandes RF, Costa DA, Ribeiro LJ, Limonte F, Higa LM, Voloch CM, Brindeiro RM, Tanuri A, Ferreira OC, Jr. Evidence for Transmission of Zika Virus by Platelet Transfusion. N Engl J Med 2016.
- CDC website. Zika Virus Disease in the United States, 2015-2016. July 27, 2016. Accessed online August 21, 2016. http://www.cdc.gov/zika/geo/united-states.html
- U.S. Department of Health and Human Services Food and Drug Administration. Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components. Accessed online August 28, 2016. http://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Blood/UCM518213.pdf