Probable transfusion‐transmitted Zika virus in Brazil

Abstract

This is a case of probable transmission of ZIKV through blood transfusion. The patient had been transfused with the blood product from an infected donor, most likely in the incubation period after ZIKV infection but prior to clinical disease onset. This report emphasizes the importance of postdonation information and recipient investigations during outbreaks of potentially blood-borne infections.

Zika and chikungunya virus infections in hematopoietic stem cell transplant recipients and oncohematological patients

“…23 Recently, a case of probable TT ZIKV infection to a liver transplant recipient was reported in Brazil, and sequencing confirmed ZIKV in the donor and patient samples. 12 The impact of vector, blood, or transplant transmission of arboviruses can be better evaluated in prospective studies that include a large number of symptomatic and asymptomatic patients. The Brazilian Agency of Health Surveillance stipulated a 30-day period after proven or suspected ZIKV infection or sexual contact with a person with proven or suspected ZIKV infection to define the eligibility of donor cells, organs, or tissues.…”

“…ZIKV infection in a breast cancer patient 11 and a probable case of transfusion-transmitted (TT) ZIKV to a liver transplant recipient have been recently reported. 12 Another 4 cases of putative mosquito-transmitted ZIKV infection have recently been described in solid organ transplant recipients (2 renal and 2 liver), and no patient died or developed neurological symptoms. 13 …”

Zika Virus Pathogenesis and Tissue Tropism

“…In another human-to-human transmission case, ZIKV was acquired from a hospitalized patient via an unknown, non-sexual route through presumed contact with other infected body fluids ( e.g., tears or saliva), which contain infectious virus as well as non-infectious viral nucleic acids (Dudley et al, 2016; Miner et al, 2016b; Sun et al, 2016; Swaminathan et al, 2016). Additionally, ZIKV has been transmitted by blood and platelet transfusion (Barjas-Castro et al, 2016; Motta et al, 2016). Although more study is warranted, the unique ability of ZIKV, relative to other flaviviruses, to spread between humans through non-insect vector routes may reflect one of several factors including its possible enhanced stability in body fluids or its broad cell and tissue tropism (Figure 1).…”

Use of Blood Donor Screening Data to Estimate Zika Virus Incidence, Puerto Rico, April–August 2016

“…In other arbovirus outbreaks, related mosquitoborne flaviviruses, such as West Nile virus and dengue virus, have been transmitted through blood transfusion; the high percentage of asymptomatic infections was a contributing factor ( 7 ). Retrospective nucleic acid testing (NAT) of blood donations after a large Zika virus outbreak in French Polynesia during 2013–2014 found detectable Zika virus RNA in 2.8% of blood donations ( 8 ), and cases of likely transfusion-transmitted Zika virus infection (through whole blood–derived platelets) were documented in Brazil ( 9 , 10 ). …”