West Nile Virus

Record number: 
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
8 - 16 days
Alerting signals, symptoms, evidence of occurrence: 
Left Kidney Recipient: confusion on posttransplantation day (PTD) 8, progressive deterioration of patient's mental status, coma with limited brainstem reflexes and quadriplegia. The patient died on PTD 113. Right Kidney Recipient: on PTD 16, the patient complained of headache and backache. Head computed tomography scan without contrast revealed no abnormality, was discharged in stable condition on PTD 27.
Demonstration of imputability or root cause: 
Sera of the recipients tested positive for WNV IgM and IgG antibodies. The donor was not screened for WNV infection before organ recovery; however, a retained serum specimen collected 3 days before organ procurement tested positive for WNV RNA by individual (nonpooled) nucleic acid amplification testing (NAT).
Imputability grade: 
3 Definite/Certain/Proven
Suggest references: 
Rabe, Ingrid B.; Schwartz, Brian S.; Farnon, Eileen C.; Josephson, S. Andrew; Webber, Allison B.; Roberts, John Paul; de Mattos, Angelo M.; Gallay, Brian J.; van Slyck, Sean; Messenger, Sharon L.; Yen, Cynthia J.; Bloch, Evan M.; Drew, Clifton P.; Fischer, Marc; Glaser, Carol A (2013). Fatal Transplant-Associated West Nile Virus Encephalitis and Public Health Investigation-California, 2010. Transplantation 96(5):463-468. doi: 10.1097/TP.0b013e31829b4142.