First cases of Zika virus–infected US blood donors outside states with areas of active transmission

Abstract

This report describes the first ZIKV-positive donors detected outside areas with active transmission. These donors most likely represent travel-acquired "tail-end infections" with prolonged RBC-associated ZIKV RNA. The lack of transmission to the recipient of an apheresis PLT may suggest that these units are not infectious.

Zika virus infection studies with CD34+ hematopoietic and megakaryocyte‐erythroid progenitors, red blood cells and platelets

“…Importantly, our data also suggest that vRNA detection does not always mean the presence of infectious particles and does not necessarily imply a risk for ZIKV transmission. This is in line with a previous study, stating that a platelet transfusion received from a donor with detectable levels of ZIKV RNA in plasma and RBCs fraction did not result in infection of the recipient . Further, as implied by our analysis and suggested by a report about West Nile virus RNA in RBC samples, erythrocytes appear to be rather “sticky” for the very stable flavivirus RNA providing an explanation for prolonged ZIKV RNA detection in RBC and whole blood samples as compared to plasma—especially when considering the about 115 days erythrocyte lifespan.…”

“…Its occasionally severe pathogenicity in combination with the detection of asymptomatic but viremic blood donors in French Polynesia, Martinique, Puerto Rico and the US and three probable cases of ZIKV transfusion‐transmission in Brazil have made ZIKV a concern for blood safety. Guidelines and countermeasures have been published by the European Centre for Disease Prevention and Control (ECDC), the WHO, and the American Food and Drug Administration (FDA) to reduce the blood safety risk originating from ZIKV .…”

Zika in the Americas, year 2: What have we learned? What gaps remain? A report from the Global Virus Network

“…Two studies looking at the presence of ZIKV RNA in donated blood in the United States (U.S.) concluded that few samples tested positive (1 in 93,000 and 1 in ~25,000) and screening of donors’ travel history should prevent contaminated blood and infection of recipients; hence blood transfusion is not believed to be a major mode of transmission in the U.S. (Galel et al, 2017; Williamson et al, 2017). Specific guidelines to handle blood products are being reviewed and updated (Petersen et al, 2016b; Vasquez et al, 2016).…”

Decision making in the face of uncertainty: the challenge of emerging infectious diseases

“…Although a publication has appeared describing the incidence of blood donations positive for Zika virus in Puerto Rico, to date there has not been a scientific publication regarding blood donations in the rest of the United States . The articles by Galel and colleagues and Williamson and colleagues represent the initial positive results from the commercial investigational blood screening tests of Roche Molecular Systems, Inc., and Hologic, Inc., respectively. The Roche test was the first to be implemented, and its use was allowed to proceed under an investigational new drug application in March 2016, just 3 months after the report of the first case in Puerto Rico .…”