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Adverse Occurrence type:
Transfusion transmission from donors with DENV viremia to recipients was 37% in a hyperendemic area during seasonal outbreak
Time to detection:
5-6 days based on presence of virus; no cases were symptomatic
Alerting signals, symptoms, evidence of occurrence:
Not applicable; DENV RNA-positive recipients had the same rate of Dengue symptoms ad DENV RNA-negative controls. In no case or control did the physician record any suspected Dengue in the medical chart. Sixteen units containing DENV RNA were transfused to 16 susceptible recipients from whom samples were available for testing; transmission rate was calculated at 37% with no association with component type and viral load or duration of storage prior to transfusion. In terms of inhibition of infection by preexisting or cotransfused DENV antibodies, approximately 90% of donor and recipient samples had DENV IgG, reflecting past infection. A rate of community acquired acquisition of dengue infection in recipients transfused with DENV RNA negative units was 0.93% (95% CI, .11%–3.34%) which was significantly lower than the 37.5% rate of DENV RNA detected among susceptible recipients who received positive units (P < .0001).
Demonstration of imputability or root cause:
This was a study during the height of the 2012 Dengue epidemic in Brazil; Rate of DENV-4 viremia in blood donors was 0.51 to 0.80%. Donors and recipients were tested for Dengue RNA and IgM. Of 16 units transfused into susceptible recipients, 5 were classified as Probably and 1 as Possible transfusion transmissions; 10 were classed as non transfusion-transmitted.
Suggest new keywords:
Dengue, hemorrhagic fever, Dengue fever,
Dengue IgG, Dengue IgM, Dengue RNA
Transfusion-Transmitted Dengue and Associated Clinical Symptoms During the 2012 Epidemic in Brazil
Expert comments for publication:
As the authors pointed out, caution needs to be applied when interpreting these results as this study was conducted in a DENV-hyperendemic setting with high rates of past exposure resulting in partial immunity and large numbers of community-acquired DENV infections; a direct extrapolation to non-endemic areas cannot be made, where local epidemiology is very different and clinical outcomes of TTI may be very different.