The prevalence of dengue virus serotypes in asymptomatic blood donors reveals the emergence of serotype 4 in Saudi Arabia

Abstract

BackgroundTransmission of dengue virus (DENV) through blood transfusion has been documented and hence screening for DENV during blood donation has been recently recommended by the American Association of Blood Banks and Centres of Disease Control and Prevention. DENV is endemic in the Western province of the Kingdom of Saudi Arabia (KSA) and serotypes 1, 2 and 3, but not 4, have been detected. However, little is known regarding the rates of DENV during blood donation in the kingdom. The aim of this study was therefore to measure the prevalence of dengue virus and its serotypes in eligible Saudi blood donors in the endemic Western region of KSA.MethodsThis was a cross-sectional study and serum samples were collected from 910 eligible Saudi male blood donors. DENV IgM and IgG antibodies were measured serologically by ELISA while viral serotypes were detected by a single step IVD CE certified multiplex RT-PCR kit.ResultsThe overall prevalence was 39 and 5.5% for IgG+ and IgM+, respectively. There were 12 (1.3%) with exclusively IgM+, 317 (34.8%) exclusively IgG+ and 38 (4.2%) with dual IgM+/IgG+ donors. The overall prevalence was 3.2% (n = 29) and 2.3% (n = 21) for primary and secondary infections. PCR was positive in 5.5% (n = 50) and, DENV-2 (n = 24; 48%) was the most frequent serotype and was significantly higher than DENV-1 (20%; P = 0.02) and DENV-3 (2%; P = 0.1 × 10−5) but not DENV-4 (30%; P = 0.2). There was no significant difference between both DENV-4 and DENV-1 (P = 0.4). The combination of the PCR and serology findings showed that 22 (2.4%) and 28 (3.1%) donors had primary and secondary viremic infections, respectively.ConclusionsThe detected rates of DENV by PCR suggest a potential high risk of viral transmission by blood transfusion. To the best of our knowledge, this study is the first to report the detection of DENV-4 serotype in Saudi Arabia. More studies are required to measure the precise prevalence of DENV serotypes and their potential transmission rate during blood donation in the kingdom.

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

“…To our knowledge, this is the first study to survey the prevalence of asymptomatic confirmed and/or probable DENV-infected blood donors in the dengue endemic time periods in the blood centers in Taiwan. The prevalence of the DENV RNA, NS1 antigen and anti-dengue antibody in blood donors in highly endemic cities in this study was relatively low compared to that in other countries or areas such as Honduras[ 14 ], Brazil [ 14 , 38 , 39 ], Puerto Rico [ 15 ], Guangzhou [ 35 ], Saudi Arabia [ 33 ] and India [ 40 ]( S1 Table ).…”

Seroprevalence and factors associated with IgG anti‐DENV positivity in blood donors in Burkina Faso during the 2016 dengue outbreak and implications for blood supply

“…7 The asymptomatic and subclinical cases, estimated at around 50-85% of DENV infections, constitute the main concern regarding transfusion safety as symptomatic cases are assumed to be rejected at the pre-donation screening 15 Previous studies reported the presence of DENV in blood donors in Honduras, Brazil, Australia, 16 Puerto Rico 17,18 and Saudi Arabia. 19,20 Viraemic donor rate may be as high as 0.4% during outbreaks, 21 with a risk of transfusion-transmitted DENV (TT-DENV) calculated as 1 in 1300 donations in Puerto Rico. 22 Questions on the potential transmission of DENV by transfusion increased after the documentation of the risk of transmission of the West Nile virus (WNV) by Biggerstaff & Petersen 23 and Biggerstaff & Petersen.…”

Laboratory Tests Used in the Diagnostic and Research of Dengue Virus: Present and Future

“…In endemic areas, dengue studies in blood banking are essential especially in epidemic outbreaks so that when there is a large amount of asymptomatic DENV, the virus may be transmitted through blood transfusions [41].…”