Arboviral Risk Associated with Solid Organ and Hematopoietic Stem Cell Grafts: The Prophylactic Answers Proposed by the French High Council of Public Health in a National Context

Abstract

Diseases caused by arboviruses are on the increase worldwide. In addition to arthropod bites, most arboviruses can be transmitted via accessory routes. Products of human origin (labile blood products, solid organs, hematopoietic stem cells, tissues) present a risk of contamination for the recipient if the donation is made when the donor is viremic. Mainland France and its overseas territories are exposed to a complex array of imported and endemic arboviruses, which differ according to their respective location. This narrative review describes the risks of acquiring certain arboviral diseases from human products, mainly solid organs and hematopoietic stem cells, in the French context. The main risks considered in this study are infections by West Nile virus, dengue virus, and tick-borne encephalitis virus. The ancillary risks represented by Usutu virus infection, chikungunya, and Zika are also addressed more briefly. For each disease, the guidelines issued by the French High Council of Public Health, which is responsible for mitigating the risks associated with products of human origin and for supporting public health policy decisions, are briefly outlined. This review highlights the need for a “One Health” approach and to standardize recommendations at the international level in areas with the same viral epidemiology.

Abrupt Increase in Detection of Locally Acquired West-Nile-Virus-Lineage-2-Mediated Neuroinvasive Disease in a Previously Non-Endemic Area of Southern Italy (2023)

“…Mosquito-borne diseases are an emerging threat in Europe. In recent years, global climate change, a dramatic expansion in the range of certain competent vectors, and the migration of people and goods have led to an increase in the transmission of viruses [ 21 ]. In particular, temperature and precipitation played a crucial role in WNV spreading in horses and humans [ 5 ].…”

Recommendations for Dengue Screening Protocol for Donors and Recipients in Solid Organ Transplantation

“…The potential for transmission through organ transplantation exists as dengue fever evolves with viremia, with the virus persisting in the tissue after blood bleaching. Additionally, up to 75% of individuals are asymptomatic, allowing asymptomatic viremic organ donors not to be identified by clinical screening 18 .…”

“…These cases could represent false-negative cases or cases of low viremia with the presence of the virus in organs and tissues. In this way, the combined identification IgM class antibodies could identify potentially at-risk donors, mitigating transmission through organ transplantation 18 .…”

Recomendações de Triagem de Dengue de Doador e Receptor no Transplante de Órgãos Sólidos

“…O potencial de transmissão por meio de transplante de órgãos existe, visto que a dengue evolui com viremia, com o vírus persistindo no tecido após clareamento do sangue. Além disso, até 75% dos indivíduos são assintomáticos, permitindo que os doadores de órgãos virêmicos assintomáticos não sejam identificados pela triagem clínica 18 .…”

“…Esses casos poderiam representar casos falso-negativos ou casos de baixa viremia com presença do vírus em órgãos e tecidos. Dessa forma, a identificação combinada dos anticorpos da classe IgM poderia identificar doadores potencialmente de risco, mitigando a transmissão pelo transplante de órgãos 18 .…”