Fatal transplant-associated west nile virus encephalitis and public health investigation-california, 2010.

TitleFatal transplant-associated west nile virus encephalitis and public health investigation-california, 2010.
Publication TypeJournal Article
Year of Publication2013
AuthorsRabe IB, Schwartz BS, Farnon EC, S Josephson A, Webber AB, Roberts JP, de Mattos AM, Gallay BJ, van Slyck S, Messenger SL, Yen CJ, Bloch EM, Drew CP, Fischer M, Glaser CA, Team WN
Pagination463 - 8
Date Published2013
ISBN Number1534-6080
Other Numberswej, 0132144
Keywords*Kidney Transplantation/ae [Adverse Effects], *Public Health, *Tissue Donors, *West Nile Fever/tm [Transmission], Aged, Female, Humans, Male, Middle Aged

BACKGROUND: In December 2010, a case of West Nile virus (WNV) encephalitis occurring in a kidney recipient shortly after organ transplantation was identified., METHODS: A public health investigation was initiated to determine the likely route of transmission, detect potential WNV infections among recipients from the same organ donor, and remove any potentially infected blood products or tissues. Available serum, cerebrospinal fluid, and urine samples from the organ donor and recipients were tested for WNV infection by nucleic acid testing and serology., RESULTS: Two additional recipients from the same organ donor were identified, their clinical and exposure histories were reviewed, and samples were obtained. WNV RNA was retrospectively detected in the organ donor's serum. After transplantation, the left kidney recipient had serologic and molecular evidence of WNV infection and the right kidney recipient had prolonged but clinically inapparent WNV viremia. The liver recipient showed no clinical signs of infection but had flavivirus IgG antibodies; however, insufficient samples were available to determine the timing of infection. No remaining infectious products or tissues were identified., CONCLUSIONS: Clinicians should suspect WNV as a cause of encephalitis in organ transplant recipients and report cases to public health departments for prompt investigation of the source of infection. Increased use of molecular testing and retaining pretransplantation sera may improve the ability to detect and diagnose transplant-associated WNV infection in organ transplant recipients.

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