Transfusion-transmitted dengue and associated clinical symptoms during the 2012 epidemic in Brazil
Sabino, E. C., Loureiro, P., Lopes, M., Capuani, L., McClure, C., Chowdhury, D., Di-Lorenzo-Oliveira, C., Oliveira, L. C., Linnen, J., Lee, T-H., Goncalez, T., Brambilla, D., Kleinman, S., Busch, M., & Custer, B. (2016). Transfusion-transmitted dengue and associated clinical symptoms during the 2012 epidemic in Brazil. Journal of Infectious Diseases, 213(5), 694-702. https://doi.org/10.1093/infdis/jiv326
BACKGROUND: A linked donor-recipient study was conducted during epidemics in 2 cities in Brazil to investigate transfusion-transmitted (TT) dengue virus (DENV) by DENV RNA-positive donations. METHODS: During February-June 2012, samples were collected from donors and recipients and retrospectively tested for DENV RNA by transcription-mediated amplification. Recipient chart review, using a case (DENV positive)-control (DENV negative and not known to be exposed) design, was conducted to assess symptoms. RESULTS: Of 39 134 recruited blood donors, DENV-4 viremia was confirmed in 0.51% of donations from subjects in Rio de Janeiro and 0.80% of subjects in Recife. Overall, 42 DENV RNA-positive units were transfused into 35 recipients. Of these, 16 RNA-positive units transfused into 16 susceptible recipients were identified as informative: 5 cases were considered probable TT cases, 1 possible TT case, and 10 nontransmissions. The TT rate was 37.5% (95% confidence interval [CI], 15.2%-64.6%), significantly higher than the viremia rate of 0.93% (95% CI, .11%-3.34%) in nonexposed recipients (P < .0001). Chart review did not find significant differences between cases and controls in symptoms or mortality. CONCLUSIONS: During a large epidemic of DENV-4 infection in Brazil, >0.5% of donations were RNA positive, and approximately one third of components resulted in TT. However, no significant clinical differences were evident between RNA-positive and RNA-negative recipients.