Epidemiological survey and screening strategy for dengue virus in blood donors from Yunnan Province

Abstract

Background Dengue virus (DENV) infection is increasingly common in southern China and can be transmitted through blood transfusion but is not currently part of donor screening throughout the region. We assessed DENV prevalence among donors at the Xishuangbanna Blood Center, Yunnan, to support development of DENV screening strategies. Methods Blood samples were collected randomly between June 2019 and August 2019. These were screened for anti-DENV IgG and IgM using enzyme-linked immunosorbent assay (ELISA). Then, all reactive samples and some randomly-chosen non-reactive samples were used to detect DENV RNAs using real-time polymerase-chain-reaction (RT-PCR) assays. After RT-PCR, samples were further tested for soluble nonstructural protein 1 (NS1) using the colloidal gold method. Donors demographics were also collected and assessed. Results Over the study period, 2254 donor samples were collected and tested for anti-DENV IgG and IgM by ELISA. This revealed 598 anti-DENV IgG and/or IgM reactive samples, a serological prevalence of 26.53%. Of these, 26 were RT-PCR positive and/or NS1 positive. Significant differences in DENV prevalence were noted by occupation (P = 0.001), education (P < 0.001), and ethnicity (P = 0.026). Conclusion The prevalence of DENV in Xishuangbanna Blood Center was higher than most other blood centers that have implemented DENV donor screening. Our study provides first-hand data about the prevalence of DENV and allows the development of a screening strategy for clinical use.

High seroprevalence of anti-DENV IgM in blood donors in an early outbreak in the Federal District of Brazil, 2019

“…In previous studies, the seroprevalence in Rio de Janeiro and Campo Mourão was 6.2 and 0 %, respectively [9, 10]. A lower prevalence was also observed worldwide, such as in China (0.4–5.0 %), Taiwan (0.2 %), Saudi Arabia (5.5%), India (6.0%), Singapore (2.8 %) Mexico (2.0 %) and Australia (0.2 %) [11–18]. In contrast, a higher prevalence was observed in Cameroon (22.9 %) [19].…”

“…Although DENV NS1 can be useful as an early marker during the first week of an illness, at a later stage of the illness its release from infected cells is low level or non-existent [7]. In addition, during a secondary infection, the detection of DENV NS1 might be limited because of preinduced adaptive immunity [12]. Therefore, the screening of DENV NS1 alone may lead to an underdetection of DENV RNA positive cases [7].…”

“…Further, some studies have demonstrated the presence of DENV NS1 in the absence of DENV RNA in infected individuals. Moreover, there is the possibility that DENV NS1 can be detected in the serum up to 9 days, even after DENV RNA has become negative by PCR detection [12]. Taken together, these contrasting observations about the DENV NS1 detection for screening demonstrate that this tool must be used with caution in asymptomatic blood donors [24], although its use may be cost-effective, which is of particular importance in developing countries [12].…”

Prevalence of dengue NS1 antigenemia among healthy blood donors in a tertiary care hospital in Southern India

“…[ 13 ] However, it is not clear whether this holds good for dengue as well, but similar findings were found in a study in Yunnan province, China. [ 14 ]…”

“…DENV is mainly transmitted by the Aedes Aegyptus, commonly found in residential areas wherein containers are stagnant water tanks, basins, discarded tires, bamboo tubes, tree holes, and stone pools etc., are found. [ 14 ]…”