High estimated prevalence of asymptomatic dengue viremia in blood donors during a dengue epidemic in southern Taiwan, 2015

Chien, Yu Wen; Shu, Yu-Chen; Chuang, Kun Ta; Yeh, Chun Yin; Ko, Wen Chien; Ko, Nai Ying; Perng, Guey Chuen

doi:10.1111/trf.14281

Cited by 10 publications

(8 citation statements)

References 38 publications

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“…We followed up this participant and he did not recall to have any symptoms after blood was drawn. We previously published a mathematical model to estimate the temporal prevalence of asymptomatic dengue viremia in blood donors during the 2015 dengue epidemic in Tainan [11]. This model using a statistical resampling approach with four main parameters including duration of viremia, duration of viremia before symptom onset, apparent-to-inapparent infection ratio, and reporting-to-underreporting ratio.…”

Section: Discussionmentioning

confidence: 99%

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Seroepidemiology of dengue virus infection among adults during the ending phase of a severe dengue epidemic in southern Taiwan, 2015

Chien

Huang

et al. 2019

BMC Infect Dis

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Background A severe dengue epidemic occurred in 2015 which resulted in over 22,000 laboratory-confirmed cases. A cross-sectional seroprevalence study was conducted during the ending phase of this epidemic to evaluate the true incidence of dengue virus (DENV) infection and the level of herd immunity. Methods Adult residents in three administrative districts with high dengue incidence were recruited; workers in two districts with intermediate dengue incidence were also recruited for comparison. DENV-specific IgM and IgG were tested using commercial enzyme-linked immunosorbent assays. DENV RNA was detected using commercial quantitative real-time reverse transcriptase polymerase chain reaction assay. Univariate and multivariate logistic regressions were performed to identify risk factors for recent and past DENV infection. Results The overall seroprevalence of anti-DENV IgM and IgG in 1391 participants was 6.8 and 17.4%, respectively. The risk of recent DENV infection increased with age, with the elderly having the highest risk of infection. Living in areas with high incidence of reported dengue cases and having family members being diagnosed with dengue in 2015 were also independent risk factors for recent DENV infection. One sample was found to have asymptomatic viremia with viral load as high as 10 5 PFU/ml. Conclusions Comparing the seroprevalence of anti-DENV IgM with the incidence of reported dengue cases in 2015, we estimated that 1 out of 3.7 dengue infections were reported to the surveillance system; widespread use of rapid diagnostic tests might contribute to this high reporting rate. The results also indicate that the overall herd immunity remains low and the current approved Dengvaxia® is not quite suitable for vaccination in Taiwan.

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Section: Discussionmentioning

confidence: 99%

“…The 2015 dengue epidemic in Tainan began in May and remained at low activity in June and July; the number of confirmed cases dramatically increased in August and peaked in September, then rapidly declined in early October [11]. A cross-sectional seroepidemiologic survey was conducted between mid-October and late November in 2015.…”

Section: Methodsmentioning

confidence: 99%

Seroepidemiology of dengue virus infection among adults during the ending phase of a severe dengue epidemic in southern Taiwan, 2015

Chien

Huang

et al. 2019

BMC Infect Dis

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“…The prevalence of asymptomatic dengue viremia among people aged 20 to 64 years was estimated to be 15.0 per 10,000 (0.15%), by using an established mathematical model using some parameters and based on assumptions, in Tainan during the 2015 epidemic [ 37 ]. Conversely, our results showed a relatively low frequency of the presence of DENV RNA genome in the asymptomatic blood donors (0.013%).…”

Section: Discussionmentioning

confidence: 99%

Low frequency of asymptomatic dengue virus-infected donors in blood donor centers during the largest dengue outbreak in Taiwan

et al. 2018

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To determine the prevalence of asymptomatic dengue virus-infected blood donors during the largest dengue outbreak in Taiwan history occurred in 2015, we examined the evidence of dengue virus (DENV) infection by the detection of DENV RNA genome using real-time reverse transcription-polymerase chain reaction (real-time RT-PCR), DENV NS1 antigen using rapid diagnosis test (RDT) and anti-dengue antibody using IgM/IgG capture enzyme-linked immunosorbent assay (capture ELISA) and RDT in eight thousand serum samples from blood donations to the blood centers of the Taiwan Blood Services Foundation (TBSF) in Kaohsiung City and Tainan City during the largest dengue outbreak in Taiwan history occurred in 2015. Only one serum sample was positive for DENV RNA detection by using dengue-specific real-time RT-PCR, the virus was DENV-2 determined by serotype-specific real-time RT-PCR and sequencing, and the DENVs in the serum were confirmed as being infectious by a plaque assay. The recipient of this blood did not develop any dengue fever symptom on follow-up. None of the samples was NS1 RDT-reactive. Seventeen IgM-positive samples were identified. There was a low prevalence of asymptomatic confirmed or probable DENV-infected blood donors in our study (0.013% and 0.21%, respectively), and no symptomatic transfusion-transmitted dengue (TT dengue) was developed during the largest dengue outbreak in Taiwan history in highly endemic areas and periods.

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“…DENV infection due to blood product exposure is the most reported nonvector transmitted route threatening 0.3% to 0.6% of all transfusions . The average prevalence of asymptomatic dengue viremia in blood donors has been estimated on average to be 15 per 10,000 after an outbreak in Southern Taiwan, indicating that substantial proportions of asymptomatic donors with DENV infection are donating blood and recipients of the blood are receiving DENV RNA‐positive blood components. The result is similar to other studies conducted during epidemics with detected DENV viremia by polymerase chain reaction (PCR) in 0.04% to 0.8% of asymptomatic blood donors .…”

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confidence: 99%

Identification and characterization of permissive cells to dengue virus infection in human hematopoietic stem and progenitor cells

Hsu

Lai

et al. 2019

Transfusion

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BACKGROUND Dengue virus (DENV) is a significant threat to public health in tropical and subtropical regions, where the frequency of human migration is increasing. Transmission of DENV from donors to recipients after hematopoietic stem cell transplantation has been steadily described. However, the underlying mechanisms remain unclear. STUDY DESIGN AND METHODS Freshly isolated bone marrow (BM) was subjected to DENV infection, followed by multicolor fluorescence‐activated cell sorting (FACS) analysis. Virus in supernatants was collected and analyzed by plaque assay. RESULTS DENV‐1 to DENV‐4 could effectively infect freshly obtained BM and produced infectious virus. DENV infection did not change the quantitative population of hematopoietic stem and progenitor cells (HSPCs), megakaryocytic progenitor cells (MkPs) and megakaryocytes. Additionally, DENV antigen, nonstructural protein 1, was enriched in HSPCs and MkPs of DENV infected marrow cells. CD34+, CD133+, or CD61+ cells sorted out from BM were not only the major contributing targets facilitating the DENV infection directly but also facilitated the spread of DENV into other cells when cocultured. CONCLUSION Results suggest that DENV can efficiently infect HSPCs, which might jeopardize the recipients if DENV‐infected cells were subsequently used. We therefore raise the need for DENV screening for both the donors and recipients of hematopoietic stem cell transplantation, especially for donors exposed to endemic areas, to mitigate DENV infection in immunocompromised recipients.

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High estimated prevalence of asymptomatic dengue viremia in blood donors during a dengue epidemic in southern Taiwan, 2015

Cited by 10 publications

References 38 publications

Seroepidemiology of dengue virus infection among adults during the ending phase of a severe dengue epidemic in southern Taiwan, 2015

Seroepidemiology of dengue virus infection among adults during the ending phase of a severe dengue epidemic in southern Taiwan, 2015

Low frequency of asymptomatic dengue virus-infected donors in blood donor centers during the largest dengue outbreak in Taiwan

Identification and characterization of permissive cells to dengue virus infection in human hematopoietic stem and progenitor cells

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