Dengue, a Flavivirus circulating in more than 100 countries, has recently been identified as a potentially serious threat to the global blood supply.
Dengue is spread by mosquitoes in sub-tropical and tropical climates and infections have been reemerging for the last 25 years.
Dengue infections tend to be asymptomatic in 53-87% of cases, but can cause hemorrhagic fever, shock syndrome, and in the worst cases can even be fatal.
Transfusion-transmitted dengue poses a risk in endemic and non-endemic areas, as demonstrated by recent outbreaks in Texas and Florida.
AABB recently categorized dengue as a high priority agent threatening transfusion recipient safety in the United States.
In a recent editorial, Dr. Michael Busch discussed the need for further research on the risk posed by transfusion-transmitted dengue.[1]
Dr. Busch is Director of Blood Systems Research Institute and Vice-President for Research and Scientific Affairs of Blood Systems, Inc.
He noted that because dengue outbreaks have typically occurred in developing countries, where other needs may be more urgent and infections are often caused by mosquitos instead of transfusions, blood donor screening has not been previously implemented.
Dr. Busch went on to say:
“Considerable effort is now being deployed to further evaluate the risk for and consequences of transfusion-transmitted dengue.”
“Scientists in the blood community are currently gathering the key data that is needed to determine based on prospective studies and sound evidence, whether or not dengue donor screening needs to be implemented to protect blood recipients in the U.S. and throughout the world.”
Dr. Busch’s editorial discussed four major studies evaluating dengue virus in the blood supply in Puerto Rico and Brazil, areas that experienced recent Dengue outbreaks.[2,3]
In Brazil, scientists identified Dengue RNA from healthy donors. It was found that 0.4% of the tested blood donors have circulating DENV-3, one strain of Dengue.[4]
Researchers in Puerto Rico examined the prevalence of Dengue over a 16 year period and determined that, on average, 7 out of every 10,000 blood donations contain the virus.
Another study also based in Puerto Rico, showed that 92% of 300 randomly selected Red Cross Blood Donors had been previously exposed to dengue.
Lastly, a study tested more than 15,000 donor blood samples from the Red Cross in Puerto Rico, and demonstrated high rates of viremia within blood donors.[5]
These studies and editorial emphasize the threat of transfusion-transmitted dengue and the importance of future research to assist in guiding decisions in implementing dengue screening.
We’ll be back on August 30th with another edition of Transfusion News. In the meantime, you can always keep up to date with all of the latest news by visiting transfusionnews.com. Thanks for joining us.
References
1. Lanteri MC, Busch MP: Dengue in the context of “safe blood” and global epidemiology: To screen or not to screen? Transfusion 2012;52:1634-1639
2. Petersen LR, Tomashek KM, Biggerstaff BJ: Estimated prevalence of dengue viremia in puerto rican blood donations, 1995 through 2010. Transfusion 2012;52:1647-1651.
3. Mohammed H, Tomashek KM, Stramer SL, Hunsperger E: Prevalence of anti-dengue immunoglobulin g antibodies among american red cross blood donors in puerto rico, 2006. Transfusion 2012;52:1652-1656.
4. Dias LL, Amarilla AA, Poloni TR, Covas DT, Aquino VH, Figueiredo LT: Detection of dengue virus in sera of brazilian blood donors. Transfusion 2012;52:1667-1671.
5. Stramer SL, Linnen JM, Carrick JM, Foster GA, Krysztof DE, Zou S, Dodd RY, Tirado-Marrero LM, Hunsperger E, Santiago GA, Munoz-Jordan JL, Tomashek KM: Dengue viremia in blood donors identified by rna and detection of dengue transfusion transmission during the 2007 dengue outbreak in puerto rico. Transfusion 2012;52:1657-1666.
