Transmission of Dengue Virus without a Mosquito Vector: Nosocomial Mucocutaneous Transmission and Other Routes of Transmission

Abstract

We report a case of dengue fever in a Boston-area health care worker with no recent history of travel but with mucocutaneous exposure to infected blood from a febrile traveler who had recently returned from Peru. Serologic tests confirmed acute dengue virus infection in both the traveler and the health care worker. We believe that this is the first documented case of dengue virus transmission via the mucocutaneous route. We present case reports and review other ways that dengue virus has been transmitted without a mosquito vector.

Dengue Virus Infection among Voluntary Blood Donors in Osogbo, Southwestern Nigeria

“…Transmission of dengue virus through blood transfusion becomes a blood safety issue because, possibility of contracting the virus through exposure to blood from non-vector sources was proven [4,5] . More so, the Aedes vector usually transmits this infection through blood meal too [2] .…”

“…Cases of percutaneous transmission via needle stick injuries, mucocutaneous transmission through a blood splash to the face, vertical transmission and transmission via bone marrow transplant were reported [3] . Transmission through mucocutaneous exposure was previously incriminated as the source of DENV infection in a health worker in the United State [4] . Recent report had shown that exposure during a laboratory-based mosquito infection and transmission experiments resulted in an acute DENV infection of the laboratory scientist [5] .…”

Zika virus disease: a current review of the literature

“…Transmission of ZIKV via breastfeeding has not yet been observed [8], although the transmission of other flaviviruses via this route has been described previously [54,55]. The other suspected routes of ZIKV transmission include monkey bite, mucocutaneous exposure, organ transplantation or hemodialysis [56,57]. The risk of ZIKV infection among kidney recipients should also be considered if the donors are either residing in or returning from endemic regions, because the virus may be shed in the urine of the infected person for more than 30 days [31,32,58].…”

Threat of Dengue to Blood Safety in Dengue-Endemic Countries

“…Routes of transmission include percutaneous, mucous membrane, bone marrow transplant, organ transplant, hemodialysis, and transfusion of blood products (6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) (Table) However, despite good evidence for its transmission in healthcare settings, dengue is currently not considered a risk to blood safety.…”