Zika Virus and the Safety of Blood Supply in Brazil: A Retrospective Epidemiological Evaluation

Benites, Bruno Deltreggia; Rocha, Daniele; Andrade, Elisabete; Godoy, Daniela Tupy de; Álvarez, Patrícia; Addas‐Carvalho, Marcelo

doi:10.4269/ajtmh.17-0843

Cited by 12 publications

(10 citation statements)

References 28 publications

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“…Regular and reliable Zika surveillance was not established until December 2015, by which time ZIKV had already been circulating in Brazil for 9–22 months [31–33], causing an unknown number of cases. Using the rate of reported MWSD cases and the ZIKV–microcephaly association quantified above, we estimated the number of cases that would have been identified had the surveillance system been in place since January 2015 and assuming Zika was the only cause of the excess microcephaly rates observed (i.e., no unmeasured confounding; S2 Text, section 2.5).…”

Section: Resultsmentioning

confidence: 99%

“…Here we found no evidence that the association between ZIKV and microcephaly was modified by arboviral exposure nor did we find strong evidence of alternative causes, and thus we hypothesize that the most likely reason why Northeast Brazil reported higher microcephaly rates was because it had more cases of Zika. We know that ZIKV circulated undetected, and thus uncontrolled, in the region for 9–22 months [31–33], and that year-round transmission suitability [46] in the Northeast region has historically led to higher dengue attack rates [47]. However, only seroprevalence surveys across the country can confirm this hypothesis and help us understand why the Northeast region was so adversely impacted.…”

Section: Discussionmentioning

confidence: 99%

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The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births

et al. 2019

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Background In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. Reported microcephaly rates in other Zika-affected areas were significantly lower, suggesting alternate causes or the involvement of arboviral cofactors in exacerbating microcephaly rates. Methods and findings We merged data from multiple national reporting databases in Brazil to estimate exposure to 9 known or hypothesized causes of microcephaly for every pregnancy nationwide since the beginning of the ZIKV outbreak; this generated between 3.6 and 5.4 million cases (depending on analysis) over the time period 1 January 2015–23 May 2017. The association between ZIKV and microcephaly was statistically tested against models with alternative causes or with effect modifiers. We found no evidence for alternative non-ZIKV causes of the 2015–2017 microcephaly outbreak, nor that concurrent exposure to arbovirus infection or vaccination modified risk. We estimate an absolute risk of microcephaly of 40.8 (95% CI 34.2–49.3) per 10,000 births and a relative risk of 16.8 (95% CI 3.2–369.1) given ZIKV infection in the first or second trimester of pregnancy; however, because ZIKV infection rates were highly variable, most pregnant women in Brazil during the ZIKV outbreak will have been subject to lower risk levels. Statistically significant associations of ZIKV with other birth defects were also detected, but at lower relative risks than that of microcephaly (relative risk < 1.5). Our analysis was limited by missing data prior to the establishment of nationwide ZIKV surveillance, and its findings may be affected by unmeasured confounding causes of microcephaly not available in routinely collected surveillance data. Conclusions This study strengthens the evidence that congenital ZIKV infection, particularly in the first 2 trimesters of pregnancy, is associated with microcephaly and less frequently with other birth defects. The finding of no alternative causes for geographic differences in microcephaly rate leads us to hypothesize that the Northeast region was disproportionately affected by this Zika outbreak, with 94% of an estimated 8.5 million total cases occurring in this region, suggesting a need for seroprevalence surveys to determine the underlying reason.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births

et al. 2019

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“…The prevalence of DENV in blood donors varies according to the location and the epidemic and non-epidemic period. The prevalence in these locations ranged from 0.04 to 0.9% [ 2 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. In the case of DENV, it is known that transmission by blood transfusion in recipients aggravates the disease [ 1 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence in these locations ranged from 0.04 to 0.9% [ 2 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. In the case of DENV, it is known that transmission by blood transfusion in recipients aggravates the disease [ 1 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Dengue, Chikungunya and Zika Viruses in Blood Donors in the State of Pará, Northern Brazil: 2018–2020

et al. 2022

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Arboviruses have been reported over the years as constant threats to blood transfusion recipients, given the high occurrence of asymptomatic cases and the fact that the presence of viremia precedes the onset of symptoms, making it possible that infected blood from donors act as a source of dissemination. This work aims to identify the prevalence of dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) infection in blood donors during epidemic and non-epidemic periods; classify the donor as symptomatic or asymptomatic; and verify the need to include DENV, CHIKV and ZIKV in the nucleic acid test (NAT) platform in northern Brazil. We investigated 36,133 thousand donations in two years of collection in Northern Brazil. One donor was positive for DENV and one for CHIKV (0.002% prevalence). As the prevalence for arboviruses was low in this study, it would not justify the individual screening of samples from donors in a blood bank. Thus, DENV- and CHIKV-positive samples were simulated in different amounts of sample pools, and both were safely detected by molecular biology even in a pool of 14 samples, which would meet the need to include these three viruses in the routine of blood centers in endemic countries such as Brazil.

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“…These diseases have vectors as their main form of transmission but they can also be transmitted vertically and by transfusion of blood products. The haematopoietic stem cell transplantation (HSCT) population is frequently exposed to these infectious agents, either by frequent exposure to blood components or by the endemic vector presence in our country 2–5 …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Dengue, Zika virus, and Chikungunya virus transmission by blood components in recipients of haematopoietic stem cell transplantation

Oliveira

Ferreira

Nishiya

et al. 2023

Transfusion Medicine

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BackgroundBrazil has a high prevalence of arboviruses, especially Dengue (DENV), Zika (ZKV), and Chikungunya (CHKV).ObjectivesTo study the risk of DENV, ZKV, and CHKV transmission by blood components in the haematopoietic stem cell transplantation (HSCT) population.MethodsProspective cohort of HSCT recipients and donors performed at the Hospital das Clinicas da FMUSP, São Paulo‐Brazil. Patients were evaluated by serology and RT‐PCR for DENV, ZKV, and CHKV pre‐transplantation and once a week until neutrophil grafting. In positive cases (positive RT‐PCR and/or serology conversion), an investigation was carried out on the blood components that the patient received to evaluate the possibility of it being transfusion transmitted.ResultsA total of 93 patients were included during the study period. The mean age was 52 years with a predominance of males (56.9%). We considered five (5.3%) DENV cases positive by seroconversion in our study. One patient had IgM seroconversion and the other four presented IgG seroconversion to DENV. In the investigation of the blood components, 145 individual samples were analysed. None of the investigated blood components showed a positive RT‐PCR.ConclusionWe observed a low prevalence of DENV, ZKV, and CHKV in HSCT donors and recipients by serology and RT‐PCR, and no case of blood transfusion transmission by RT‐PCR.

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Zika Virus and the Safety of Blood Supply in Brazil: A Retrospective Epidemiological Evaluation

Cited by 12 publications

References 28 publications

The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births

The association between Zika virus infection and microcephaly in Brazil 2015–2017: An observational analysis of over 4 million births

Prevalence of Dengue, Chikungunya and Zika Viruses in Blood Donors in the State of Pará, Northern Brazil: 2018–2020

Evaluation of Dengue, Zika virus, and Chikungunya virus transmission by blood components in recipients of haematopoietic stem cell transplantation

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