Japanese Encephalitis Virus Transmitted Via Blood Transfusion, Hong Kong, China

Cheng, Vincent Chi-Chung; Sridhar, Siddharth; Wong, Shuk-Ching; Wong, Sally Cheuk-Ying; Chan, Jasper Fuk‐Woo; Yip, Cyril Chik-Yan; Chau, CH; Au, Timmy W.K.; Hwang, Y.; Yau, Carol S.W.; Lo, Janice Y.C.; Lee, Cheuk-Kwong; Yuen, Kwok‐Yung

doi:10.3201/eid2401.171297

Cited by 47 publications

(28 citation statements)

References 37 publications

(31 reference statements)

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“…In Hong Kong, JEV was transmitted to a lung transplant recipient by an RBC unit from an asymptomatic blood donor, resulting in encephalitis and death in the recipient. JEV sequences in a sample from the donation were identical to those in the recipient . In the United States, a case of SLEV neuroinvasive disease in a kidney transplant recipient was traced to an RBC unit from an asymptomatic blood donor who was demonstrated to have SLEV immunoglobulin M in a sample collected 77 days after donation .…”

Section: Discussionmentioning

confidence: 85%

Evaluation of a new West Nile virus nucleic acid test for screening of blood donations

Stanley

AuBuchon

Erickson³

et al. 2018

Transfusion

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BACKGROUND: West Nile virus (WNV) is transmitted to humans through mosquito bites and can be further transmitted to humans through transfusion or transplantation. Because most infected individuals are asymptomatic, blood donor screening is important in areas where WNV is endemic. These studies evaluated the performance of a new test for detection of WNV RNA in blood donations. STUDY DESIGN AND METHODS:Analytical performance evaluation included sensitivity, specificity, inclusivity, and correlation. A clinical specificity study was conducted at four blood donor testing laboratories in parallel with the cobas TaqScreen WNV Test (Roche Molecular Systems, Inc.). RESULTS:The 95% and 50% limit of detection for cobas WNV was 12.9 copies/mL (95% confidence interval [CI], 10.8-16.3) and 2.1 copies/mL (95% CI, 1.9-2.4) for WNV lineage 1, respectively, and 6.2 copies/ mL (95% CI, 4.8-8.9) and 1.1 copies/mL (95% CI, 0.8-1.3) for WNV lineage 2, respectively. Clinical specificity was 100% in 10,823 donor samples tested individually (95% CI, 99.966%-100%) and 63,243 tested in pools of 6 (95% CI, 99.994%-100%). Samples of other members of the Japanese encephalitis virus serocomplex, including St Louis encephalitis, Japanese encephalitis, Murray Valley encephalitis, Usutu, and Kunjin viruses were detected by cobas WNV. CONCLUSION:The cobas WNV test for use on the cobas 6800/8800 System, a fully automated test system, demonstrated high sensitivity and specificity and is suitable for the detection of WNV in blood donors. W est Nile virus (WNV) is an arbovirus that belongs to the Flaviviridae family, genus Flavivirus, and is a member of the Japanese encephalitis virus serocomplex. 1,2 The Japanese encephalitis serocomplex also includes Japanese encephalitis virus (JEV), St Louis encephalitis virus (SLEV), Murray Valley encephalitis virus (MVEV), Usutu virus (USUV), 3 and Kunjin virus (KUNV), now known to be a WNV variant. 4-6 WNV consists of several phylogenetic lineages; 7 however, only Lineage 1 (WNVL1) and Lineage 2 (WNVL2) have been associated with significant outbreaks in humans. 1,7 Due to the ability of WNV to infect numerous mosquito and bird species, the virus is distributed widely ABBREVIATIONS: CI = confidence interval; JEV = Japanese encephalitis virus; KUNV = Kunjin virus; LoD = limit of detection; MVEV = Murray Valley encephalitis virus; NAT = nucleic acid testing; SLEV = St Louis encephalitis virus; USUV = Usutu virus; WNV = West Nile virus; WNVL1 = West Nile virus Lineage 1; WNVL2 = West Nile virus Lineage 2.From the

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Section: Discussionmentioning

confidence: 85%

Evaluation of a new West Nile virus nucleic acid test for screening of blood donations

Stanley

AuBuchon

Erickson³

et al. 2018

Transfusion

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“…Had the WNV testing occurred during the period of potential indigenous WNV exposure in Canada (between early June and the end of November, when universal blood donor WNV screening is conducted by CBS), a positive WNV screening minipool assay would also have activated a one‐week period of individual WNV testing for collections in the region where exposure was thought to have occurred. Our findings suggest that proper assessment of the travel history of a WNV‐positive blood donor should also consider the epidemiology of other members of the JEV serocomplex which may also be detected by this donor screening assay, several of which (including JEV and Usutsu), have also been described in blood donors . In the five cases described here, a key relevant consideration is that each donor received Ixiaro JEV vaccine within 3 days prior to donation.…”

Section: Discussionmentioning

confidence: 89%

A case series of inactivated Japanese encephalitis virus vaccination associated with positive West Nile virus blood donor screening nucleic acid tests

Drews

Makowski²,

Wood³

et al. 2020

Transfusion

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BACKGROUND: West Nile Virus (WNV) is a member of the Japanese Encephalitis (JE) serocomplex within the Flaviviridae family. We report four whole blood donors and one plasma donor with WNV nucleic acid test (NAT)-reactive donations between September 2018 and November 2019, following recent Japanese Encephalitis virus (JEV) vaccination.CASE SERIES: Cases 1 and 4 had reactive WNV NAT donations 1 day after receiving the JEV vaccine. Case 2 had a reactive WNV donation 3 days after receiving the JEV vaccine. Case 3 had a reactive WNV NAT donation 3 days after returning from Arizona and 1 day after receiving the JEV vaccine. Case 5 had a reactive WNV donation the same day as receiving the JEV vaccine.STUDY DESIGN AND METHODS: WNV screening used the Roche cobas WNV nucleic acid test (NAT) (Roche Molecular Systems). Reference testing on WNV-reactive donations was carried out by the National Microbiology Laboratory (NML). JEV vaccine dilutions were also analyzed. RESULTS: Supplemental NAT was negative for WNVand JEV for Cases 1, 3, and 5. Case 2 had a weak amplification curve for one of two JEV NAT targets. Case 4 was JEV NAT-positive, WNV NAT-negative. Serologic testing on donation specimens for Cases 2, 4, and 5 did not support recent or remote WNV infection. JEV vaccine dilutions were detected by both cobas and supplemental NAT. CONCLUSIONS:We recommend implementing a temporary blood donor deferral following a JEV vaccination, if screening utilizes a WNV assay with the capability of detecting other members of the JE serocomplex.From the 1 Canadian Blood Services; the

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“…Furthermore, JEV can be passed directly from an infected female Culex or non- Culex mosquito to her eggs, suggesting the transovarial transmission as a mechanism by which the virus overwinters in the environment [ 70 , 71 , 72 , 73 ]. In addition, in terms of non-vector-borne transmission, a recent report has indicated that JEV can be transmitted through the transfusion of contaminated blood products [ 74 ].…”

Section: Jev Is a Zoonotic Pathogen Capable Of Infecting A Wide Ramentioning

confidence: 99%

Early Events in Japanese Encephalitis Virus Infection: Viral Entry

Yun

Lee

2018

Pathogens

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Japanese encephalitis virus (JEV), a mosquito-borne zoonotic flavivirus, is an enveloped positive-strand RNA virus that can cause a spectrum of clinical manifestations, ranging from mild febrile illness to severe neuroinvasive disease. Today, several killed and live vaccines are available in different parts of the globe for use in humans to prevent JEV-induced diseases, yet no antivirals are available to treat JEV-associated diseases. Despite the progress made in vaccine research and development, JEV is still a major public health problem in southern, eastern, and southeastern Asia, as well as northern Oceania, with the potential to become an emerging global pathogen. In viral replication, the entry of JEV into the cell is the first step in a cascade of complex interactions between the virus and target cells that is required for the initiation, dissemination, and maintenance of infection. Because this step determines cell/tissue tropism and pathogenesis, it is a promising target for antiviral therapy. JEV entry is mediated by the viral glycoprotein E, which binds virions to the cell surface (attachment), delivers them to endosomes (endocytosis), and catalyzes the fusion between the viral and endosomal membranes (membrane fusion), followed by the release of the viral genome into the cytoplasm (uncoating). In this multistep process, a collection of host factors are involved. In this review, we summarize the current knowledge on the viral and cellular components involved in JEV entry into host cells, with an emphasis on the initial virus-host cell interactions on the cell surface.

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Japanese Encephalitis Virus Transmitted Via Blood Transfusion, Hong Kong, China

Cited by 47 publications

References 37 publications

Evaluation of a new West Nile virus nucleic acid test for screening of blood donations

Evaluation of a new West Nile virus nucleic acid test for screening of blood donations

A case series of inactivated Japanese encephalitis virus vaccination associated with positive West Nile virus blood donor screening nucleic acid tests

Early Events in Japanese Encephalitis Virus Infection: Viral Entry

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