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

Abstract

Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3–August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts.

Evaluating Vaccination Strategies for Zika Virus in the Americas

“…Third, we determined the best fit parameter sets for the epidemiological variables using a least-squares approach. For Puerto Rico, we computed the human-to-mosquito transmission rate that produced a 23.5% attack rate, as observed during the Puerto Rico Chikungunya outbreak (27), and computed the mosquito seasonality parameters which best fit the observed Zika epidemic trajectory over the period January 17, 2016 through July 21, 2017 (28,29) (Figure S2). When not otherwise specified, we used the Puerto Rico best-fit attack rate as our base case.…”

Screening for Zika virus in deceased organ donors in Florida

“…13 ZIKV RNA persists significantly longer in whole blood than in plasma. 18,19 In June of 2016, as a result of the ZIKV epidemic affecting the Americas, our transplant center started screening all local deceased donors for ZIKV with ZIKV IGM and IGG and plasma and urine ZIKV PCR. 16 An investigation in Florida suggested that urine PCR might be the most sensitive test to diagnosis acute infection in symptomatic patients due to higher and more prolonged detection rates of ZIKV.…”

“…ZIKV screening for blood donors has been reported. 18,19 In June of 2016, as a result of the ZIKV epidemic affecting the Americas, our transplant center started screening all local deceased donors for ZIKV with ZIKV IGM and IGG and plasma and urine ZIKV PCR. The aim of this study was to evaluate the rates of positive ZIKV testing and risk factors for ZIKV among deceased donors in our transplant center located in an area of autochthonous ZIKV transmission.…”

Zika virus infection studies with CD34+ hematopoietic and megakaryocyte‐erythroid progenitors, red blood cells and platelets

“…Its occasionally severe pathogenicity in combination with the detection of asymptomatic but viremic blood donors in French Polynesia, Martinique, Puerto Rico and the US and three probable cases of ZIKV transfusion‐transmission in Brazil have made ZIKV a concern for blood safety. Guidelines and countermeasures have been published by the European Centre for Disease Prevention and Control (ECDC), the WHO, and the American Food and Drug Administration (FDA) to reduce the blood safety risk originating from ZIKV .…”

“…6,7 However, more severe complications such as Guillain-Barré syndrome in adults 8,9 and microcephaly and other congenital malformations in the developing fetus and newborns [10][11][12][13][14] have been associated with ZIKV infection and led to the declaration of ZIKV as a Public Health Emergency of International Concern by the World Health Organization (WHO) in 2016. 15 Its occasionally severe pathogenicity in combination with the detection of asymptomatic but viremic blood donors in French Polynesia, Martinique, Puerto Rico and the US [16][17][18][19][20][21][22] and three probable cases of ZIKV transfusion-transmission in Brazil 23,24 have made ZIKV a concern for blood safety. Guidelines and countermeasures have been published by the European Centre for Disease Prevention and Control (ECDC), the WHO, and the American Food and Drug Administration (FDA) to reduce the blood safety risk originating from ZIKV.…”