Implications of Dengue Outbreaks for Blood Supply, Australia

Abstract

Dengue outbreaks have increased in size and frequency in Australia, and transfusion-transmitted dengue poses a risk to transfusion safety. Using whole blood samples collected during the large 2008–2009 dengue epidemic, we estimated the risk for a dengue-infectious blood donation as ≈1 in 7,146 (range 2,218–50,021).

Mitigating the Risk of Transfusion-Transmitted Dengue in Australia

“…These results are concordant with earlier studies during previous outbreaks [4]. We previously estimated the risk of collecting a viremic donation during the 2008/2009 DENV outbreak to be 1 in 7,147 (95% CI: 1 in 2,218 to 1 in 50,021) [22], and modelling based on notification data obtained during a DENV outbreak in 2004 estimated the overall transmission risk to be 1 in 19,759 (95% CI: 1 in 3,404 to 75,486) with a peak of 1 in 5,968 (95% CI: 1 in 1,028 to 22,800) [26]. While this previous data suggests a low likelihood of finding a viremic sample in our study the absence of detectable evidence of DENV infection in donors, despite the higher number of reported cases during these outbreaks [6, 8], provides reassurance that our existing risk modelling does not substantially underestimate the risk of TT-DENV.…”

“…Currently, there is no approved DENV test in Australia for blood screening, and although some pathogen inactivation (PI) technologies have been demonstrated to effectively inactivate DENV in plasma and platelet components [18–21] these methods are not approved for use in Australia at present. Our approach of restricting donations from “at-risk” individuals results in fresh component losses and considerable cost, which may potentially impact on the ability to meet clinical demand [22]. However, this approach is deemed suitable in the absence of other approved risk mitigation strategies.…”

Putting a Price on Climate Change: The Cost of Climate Change and Foodborne Diseases in Queensland in Quality-Adjusted Life Years and Dollars

“…The annual incidence rates were between 6 and 114 cases per 100,000 population. Seasonal patterns to cryptosporidiosis cases was evident with substantially higher incidence rates in summer (15) and spring (12) than autumn (6) and winter (2 cases per 100,000 people).…”

“…Annual incidence was relatively stable between 37-55 from 2004-2012 before spiking to 63 cases per 100,000 in 2013 following a large outbreak of cases associated with a Melbourne Cup function in November 2013 [49]. Cases demonstrated seasonal patterns with incidence rates peaking in summer (17) and autumn (15) and decreasing in winter (8) cases per 100,000 population).…”

“…The diseases included in the survey were selected by identifying food-and waterborne diseases which had previously been studied in Australia with regard to how climate change would affect their incidence [10,11,[13][14][15], or if they were notifiable diseases to Queensland Health as evidence of their importance to public health [16]. These steps identified 22 diseases which posed a substantial health risk to humans through current high incidence, likely increased incidence under climate change, or significant adverse effects on health.…”