West Nile virus transmission through organ transplantation in north-eastern Italy: a case report and implications for pre-procurement screening

Inojosa, Walter O; Scotton, Pier Giorgio; Fuser, Rodolfo; Giobbia, Mario; Paolin, Adolfo; Maresca, M. C.; Brunello, Anna; Nascimben, Ennio; Sorbara, Carlo; Rigoli, Roberto; Berti, Rossana; Gajo, Giovanni Battista; Giometto, Bruno

doi:10.1007/s15010-012-0263-4

Cited by 31 publications

(21 citation statements)

References 17 publications

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“…Testing for WNV infection before organ donation was done in only one of the eight donors. Because of a high level of WNV infection in northeastern Italy, the Italian National Transplant Network instituted a surveillance program in 2008 to detect WNV in organ donors in northeastern Italy (24, 25). However, the blood of this tested organ donor was negative for WNV by nucleic acid amplification (NAT).…”

Section: Review Of Clinical Diagnostic and Therapeutic Features Of mentioning

confidence: 99%

Donor-Derived West Nile Virus Infection in Solid Organ Transplant Recipients

et al. 2014

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We describe four solid-organ transplant recipients with donor-derived West Nile virus (WNV) infection (encephalitis 3, asymptomatic 1) from a common donor residing in a region of increased WNV activity. All four transplant recipients had molecular evidence of WNV infection in their serum and/or cerebrospinal fluid (CSF) by reverse transcription polymerase chain reaction (RT-PCR) testing. Serum from the organ donor was positive for WNV IgM but negative for WNV RNA, whereas his lymph node and spleen tissues tested positive for WNV by RT-PCR. Combination therapy included intravenous immunoglobulin (4 cases), interferon (3 cases), fresh frozen plasma with WNV IgG (2 cases), and ribavirin (1 case). Two of the four transplant recipients survived. Review of the 20 published cases of organ-derived WNV infection found that this infection is associated with a high incidence of neuroinvasive disease (70%) and severe morbidity and mortality (30%). Median time to onset of symptomatic WNV infection was 13 days after transplantation (range 5–37 days). Initial unexplained fever unresponsive to antibiotic therapy followed by rapid onset of neurologic deficits was the most common clinical presentation. Confirmation of infection was made by testing serum and CSF for both WNV RNA by RT-PCR and WNV IgM by serological assays. Treatment usually included supportive care, reduction of immunosuppression, and frequent intravenous immunoglobulin. The often negative results for WNV by current RT-PCR and serological assays and the absence of clinical signs of acute infection in donors contribute to the sporadic occurrence of donor-derived WNV infection. Potential organ donors should be assessed for unexplained fever and neurological symptoms, particularly if they reside in areas of increased WNV activity.

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Section: Review Of Clinical Diagnostic and Therapeutic Features Of mentioning

confidence: 99%

Donor-Derived West Nile Virus Infection in Solid Organ Transplant Recipients

et al. 2014

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“…Transmission of WNV between humans during blood transfusion and tissue and or organ transplantation has been recorded in the USA [22] and recently in Europe [23,24,25,26]. In order to increase the biological safety of blood and organ donations, a screening policy has been implemented [27,28] in areas where human cases of WNV related diseases are known to be present, since it is believed that at least 80% of the WNV infected population remains asymptomatic during the phase in which viral RNA is actually detectable in blood [3].…”

Section: Virus Detectionmentioning

confidence: 99%

Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies

Sambri

Capobianchi²,

Cavrini

et al. 2013

Viruses

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West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD).

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“…It is worth mentioning that the investigation that followed the infection of four organ recipients from an infected donor, demonstrated that the donor had been probably infected through blood transfusion [140]. Currently, there is not any national policy that requires organ donors screening, but serious cases of neuroinvasive disease in recipients implies a need for ELISA and NAT testing of donors during transmission season [143]. In 2002; a 20-year-old WNV infected woman delivered at term a live infant with chorioretinits and severe cerebral abnormalities (white matter loss, focal cerebral destruction) that was positive for WNV-specific IgM and neutralizing antibodies [144].…”

Section: Wnv In Humansmentioning

confidence: 99%

West Nile Virus State of the Art Report of MALWEST Project

Marka

Diamantidis

Papa

et al. 2013

IJERPH

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During the last three years Greece is experiencing the emergence of West Nile virus (WNV) epidemics. Within this framework, an integrated surveillance and control programme (MALWEST project) with thirteen associate partners was launched aiming to investigate the disease and suggest appropriate interventions. One out of seven work packages of the project is dedicated to the State of the Art report for WNV. Three expert working groups on humans, animals and mosquitoes were established. Medical databases (PubMed, Scopus) were searched together with websites: e.g., WHO, CDC, ECDC. In total, 1,092 relevant articles were initially identified and 258 of them were finally included as references regarding the current knowledge about WNV, along with 36 additional sources (conference papers, reports, book chapters). The review is divided in three sections according to the fields of interest: (1) WNV in humans (epidemiology, molecular characteristics, transmission, diagnosis, treatment, prevention, surveillance); (2) WNV in animals (epidemiological and transmission characteristics concerning birds, horses, reptiles and other animal species) and (3) WNV in mosquitoes (control, surveillance). Finally, some examples of integrated surveillance programmes are presented. The introduction and establishment of the disease in Greece and other European countries further emphasizes the need for thorough research and broadening of our knowledge on this viral pathogen.

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West Nile virus transmission through organ transplantation in north-eastern Italy: a case report and implications for pre-procurement screening

Cited by 31 publications

References 17 publications

Donor-Derived West Nile Virus Infection in Solid Organ Transplant Recipients

Donor-Derived West Nile Virus Infection in Solid Organ Transplant Recipients

Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies

West Nile Virus State of the Art Report of MALWEST Project

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