Transfusion-transmitted arboviruses: Update and systematic review

Giménez-Richarte, Ángel; Salazar, María Isabel Ortiz de; Giménez-Richarte, María-Paz; Collado, Miriam; Fernández, Pedro; Clavijo, Carlos; Navarro, Luis; Arbona, Cristina; Marco, Pascual; Ramos-Rincón, José-Manuel

doi:10.1371/journal.pntd.0010843

Cited by 25 publications

(26 citation statements)

References 73 publications

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“…The virus can be efficiently transmitted even in donations from recently infected donors in whom virus concentrations are extremely low. Being the arbovirus with the most reported cases of transfusion transmission, particularly in the USA [ 82 ], WNV has significant implications for blood safety and security. Testing for WNV infection has been conducted on stem cell, tissue, and organ donations in several European countries where WNV is endemic.…”

Section: Main Challenges To Overcomementioning

confidence: 99%

Circulation of West Nile Virus and Usutu Virus in Europe: Overview and Challenges

Simonin

2024

Viruses

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West Nile Virus (WNV) and Usutu Virus (USUV) are both neurotropic mosquito-borne viruses belonging to the Flaviviridae family. These closely related viruses mainly follow an enzootic cycle involving mosquitoes as vectors and birds as amplifying hosts, but humans and other mammals can also be infected through mosquito bites. WNV was first identified in Uganda in 1937 and has since spread globally, notably in Europe, causing periodic outbreaks associated with severe cases of neuroinvasive diseases such as meningitis and encephalitis. USUV was initially isolated in 1959 in Swaziland and has also spread to Europe, primarily affecting birds and having a limited impact on human health. There has been a recent expansion of these viruses’ geographic range in Europe, facilitated by factors such as climate change, leading to increased human exposure. While sharing similar biological traits, ecology, and epidemiology, there are significant distinctions in their pathogenicity and their impact on both human and animal health. While WNV has been more extensively studied and is a significant public health concern in many regions, USUV has recently been gaining attention due to its emergence in Europe and the diversity of its circulating lineages. Understanding the pathophysiology, ecology, and transmission dynamics of these viruses is important to the implementation of effective surveillance and control measures. This perspective provides a brief overview of the current situation of these two viruses in Europe and outlines the significant challenges that need to be addressed in the coming years.

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Section: Main Challenges To Overcomementioning

confidence: 99%

Circulation of West Nile Virus and Usutu Virus in Europe: Overview and Challenges

Simonin

2024

Viruses

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“…Humans and animals do not develop significant viremia to transmit the disease (to other humans or viral vectors); however, wild birds, for example, pigeons, house sparrows/finches, robins, and blue jays do develop sufficient viremia to infect mosquitoes that bite them and, thus, act as amplifying hosts in the enzootic cycle of SLE virus. 119 , 120 …”

Section: Flaviviridae Familymentioning

confidence: 99%

Neuroinvasion of emerging and re-emerging arboviruses: A scoping review

Srichawla,

Manan,

Kipkorir

et al. 2024

SAGE Open Medicine

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Background: Arboviruses are RNA viruses and some have the potential to cause neuroinvasive disease and are a growing threat to global health. Objectives: Our objective is to identify and map all aspects of arbovirus neuroinvasive disease, clarify key concepts, and identify gaps within our knowledge with appropriate future directions related to the improvement of global health. Methods: Sources of Evidence: A scoping review of the literature was conducted using PubMed, Scopus, ScienceDirect, and Hinari. Eligibility Criteria: Original data including epidemiology, risk factors, neurological manifestations, neuro-diagnostics, management, and preventive measures related to neuroinvasive arbovirus infections was obtained. Sources of evidence not reporting on original data, non-English, and not in peer-reviewed journals were removed. Charting Methods: An initial pilot sample of 30 abstracts were reviewed by all authors and a Cohen’s kappa of κ = 0.81 (near-perfect agreement) was obtained. Records were manually reviewed by two authors using the Rayyan QCRI software. Results: A total of 171 records were included. A wide array of neurological manifestations can occur most frequently, including parkinsonism, encephalitis/encephalopathy, meningitis, flaccid myelitis, and Guillain-Barré syndrome. Magnetic resonance imaging of the brain often reveals subcortical lesions, sometimes with diffusion restriction consistent with acute ischemia. Vertical transmission of arbovirus is most often secondary to the Zika virus. Neurological manifestations of congenital Zika syndrome, include microcephaly, failure to thrive, intellectual disability, and seizures. Cerebrospinal fluid analysis often shows lymphocytic pleocytosis, elevated albumin, and protein consistent with blood-brain barrier dysfunction. Conclusions: Arbovirus infection with neurological manifestations leads to increased morbidity and mortality. Risk factors for disease include living and traveling in an arbovirus endemic zone, age, pregnancy, and immunosuppressed status. The management of neuroinvasive arbovirus disease is largely supportive and focuses on specific neurological complications. There is a need for therapeutics and currently, management is based on disease prevention and limiting zoonosis.

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“…A number of human and ecological factors have contributed to this phenomenon, including global travel, environmental destruction, agricultural practices and others [ 83 , 84 ]. A number of reports have described the transmission of these emergent infections by blood and component transfusion [ 85 ]. There have been no reports of such transmissions by plasma derivatives produced over the past thirty-year era of robust pathogen-reduction methods, despite the undoubted presence of many of the agents in the plasma pool, given that source plasma from the USA, the source of two-thirds of the global plasma supply, is not screened for these agents.…”

Section: Development Of a Cohesive Framework—the Current Landscape Of...mentioning

confidence: 99%

The Evolution of the Safety of Plasma Products from Pathogen Transmission—A Continuing Narrative

Farrugia

2023

Pathogens

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Chronic recipients of plasma products are at risk of infection from blood-borne pathogens as a result of their inevitable exposure to agents which will contaminate a plasma manufacturing pool made up of thousands of individual donations. The generation of such a pool is an essential part of the large-scale manufacture of these products and is required for good manufacturing practice (GMP). Early observations of the transmission of hepatitis by pooled plasma and serum led to the incorporation of heat treatment of the albumin solution produced by industrial Cohn fractionation of plasma. This led to an absence of pathogen transmission by albumin over decades, during which hepatitis continued to be transmitted by other early plasma fractions, as well as through mainstream blood transfusions. This risk was decreased greatly over the 1960s as an understanding of the epidemiology and viral aetiology of transfusion-transmitted hepatitis led to the exclusion of high-risk groups from the donor population and the development of a blood screening test for hepatitis B. Despite these measures, the first plasma concentrates to treat haemophilia transmitted hepatitis B and other, poorly understood, forms of parenterally transmitted hepatitis. These risks were considered to be acceptable given the life-saving nature of the haemophilia treatment products. The emergence of the human immunodeficiency virus (HIV) as a transfusion-transmitted infection in the early 1980s shifted the focus of attention to this virus, which proved to be vulnerable to a number of inactivation methods introduced during manufacture. Further developments in the field obviated the risk of hepatitis C virus (HCV) which had also infected chronic recipients of plasma products, including haemophilia patients and immunodeficient patients receiving immunoglobulin. The convergence of appropriate donor selection driven by knowledge of viral epidemiology, the development of blood screening now based on molecular diagnostics, and the incorporation of viral inactivation techniques in the manufacturing process are now recognised as constituting a “safety tripod” of measures contributing to safety from pathogen transmission. Of these three components, viral inactivation during manufacture is the major contributor and has proven to be the bulwark securing the safety of plasma derivatives over the past thirty years. Concurrently, the safety of banked blood and components continues to depend on donor selection and screening, in the absence of universally adopted pathogen reduction technology. This has resulted in an inversion in the relative safety of the products of blood banking compared to plasma products. Overall, the experience gained in the past decades has resulted in an absence of pathogen transmission from the current generation of plasma derivatives, but maintaining vigilance, and the surveillance of the emergence of infectious agents, is vital to ensure the continued efficacy of the measures in place and the development of further interventions aimed at obviating safety threats.

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Transfusion-transmitted arboviruses: Update and systematic review

Cited by 25 publications

References 73 publications

Circulation of West Nile Virus and Usutu Virus in Europe: Overview and Challenges

Circulation of West Nile Virus and Usutu Virus in Europe: Overview and Challenges

Neuroinvasion of emerging and re-emerging arboviruses: A scoping review

The Evolution of the Safety of Plasma Products from Pathogen Transmission—A Continuing Narrative

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