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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
5 days
Alerting signals, symptoms, evidence of occurrence: 
Desquamating rash, markedly elevated alanine aminotransferase (ALT) greater than 2000 IU/L (normal range <45 IU/L), an elevated troponin I to 0.31mg/L (normal range<0.04mg/L) and a small pericardial effusion
Demonstration of imputability or root cause: 
All sequenced EV PCR products from the donor and two recipients were identified as CVB3. Of the circulating EV strains that were sequenced in the same year, CVB3 accounted only for 8.7% of strains (10 out of 115 EV strains). In order to demonstrate the molecular relatedness of the CVB3 strains from the donor and the two recipients, a phylogenetic analysis compared these strains with all sequenced CVB3 strains from 2008–2013 (Figure 1). The CVB3 strains isolated from the donor and the two recipients were genetically identical and distinct from other circulating CVB3 strains.
Imputability grade: 
3 Definite/Certain/Proven
Suggest references: 
Abbott IJ, Papadakis G, Kaye M, et al. Laboratory identification of donor-derived coxsackievirus b3 transmission. Am J Transplant. 2015 Feb;15(2):555-9
Enterovirus missing among virus taxonomy Ready to upload once taxonomy is sorted (Evi)