Zika virus in asymptomatic blood donors in Martinique

Gallian, Pierre; Cabie, André; Richard, Pascale; Paturel, Laure; Charrel, Rémi N.; Pastorino, Boris; Leparc-Goffart, Isabelle; Tiberghien, Pierre; Lamballerie, Xavier de

doi:10.1182/blood-2016-09-737981

Cited by 113 publications

(116 citation statements)

References 16 publications

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“…40,41 The measured mean genomic titers of inactivated ZIKV in this study were higher than the RNA loads found in ZIKV RNA-reactive, asymptomatic blood donors in French Polynesia during 2013 through 2014 (mean, 4.85 log 10 GEq/mL; range, 3.4-6.9 log 10 GEq/mL), as determined using the same PCR methodology, 28 and in Martinique in 2016 (range, 2.09-6.50 log 10 GEq/mL) using a comparable methodology. 42 This indicates that, if the amotosalen/UVA method had been in routine use, it may…”

Section: Discussionmentioning

confidence: 99%

Inactivation of Zika virus in platelet components using amotosalen and ultraviolet A illumination

et al. 2017

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BACKGROUND Concerned over the risk of Zika virus (ZIKV) transfusion transmission, public health agencies recommended the implementation of mitigation strategies for its prevention. Those strategies included the use of pathogen inactivation for the treatment of plasma and platelets. The efficacy of amotosalen/ultraviolet A to inactivate ZIKV in plasma had been previously demonstrated, and the efficacy of inactivation in platelets with the same technology was assumed. These studies quantify ZIKV inactivation in platelet components using amotosalen/ultraviolet A. STUDY DESIGN AND METHODS Platelet components were spiked with ZIKV, and ZIKV infectious titers and RNA loads were measured by cell culture‐based assays and real‐time polymerase chain reaction in spiked platelet components before and after photochemical treatment using amotosalen/ultraviolet A. RESULTS The mean ZIKV infectivity titers and RNA loads in platelet components before inactivation were either 4.9 log10 plaque forming units per milliliter, or 4.4 log10 50% tissue culture infective dose per milliliter and 7.5 log10 genome equivalents per milliliter, respectively. No infectivity was detected immediately after amotosalen/ultraviolet A treatment. No replicative virus remained after treatment, as demonstrated by multiple passages on Vero cell cultures; and ZIKV RNA was not detected from the first passage after inactivation. Additional experiments in this study demonstrated efficient inactivation to the limit of detection in platelets manufactured in 65% platelet additive solution, 35% plasma, or 100% plasma. CONCLUSION As previously demonstrated for plasma, robust levels of ZIKV inactivation were achieved in platelet components. With inactivation of higher levels of ZIKV than those reported in asymptomatic, RNA‐reactive blood donors, the pathogen‐inactivation system using amotosalen/ultraviolet A offers the potential to mitigate the risk of ZIKV transmission by plasma and platelet transfusion.

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Section: Discussionmentioning

confidence: 99%

Inactivation of Zika virus in platelet components using amotosalen and ultraviolet A illumination

et al. 2017

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“…The reduction of ZIKV transmission was implemented probabilistically for each mosquito bite when the infectious case was symptomatic. Recent evaluation suggests that symptomatic cases reached levels of molecular viral load that were significantly higher than asymptomatic cases 37 . Although this level depends on the time of sampling, it may be an indication of lower transmissibility of asymptomatic infection.…”

Section: Methodsmentioning

confidence: 99%

Asymptomatic Transmission and the Dynamics of Zika Infection

Moghadas

Shoukat

Espíndola

et al. 2017

Sci Rep

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Following the 2013–14 outbreak in French Polynesia, the Zika virus (ZIKV) epidemic spread widely to many countries where Aedes Aegypti as the main transmitting vector is endemic. The lack of a second wave of ZIKV infection in most affected regions may suggest that a sufficiently high level of herd immunity was reached during the first wave. We developed an agent-based transmission model to investigate the role of asymptomatic infection on the likelihood of observing a second wave, while accounting for its relative transmissibility. We found that, as the relative transmissibility of asymptomatic infection increases, a second wave is more likely to occur, despite an increase in the attack rate during the first wave. When the reproduction number varies between 1.9 and 2.8 based on estimates for Antioquia, Colombia, the attack rate varies between 4% and 26% for a low (below 10%) effectiveness of interventions in blunting the ZIKV transmission from symptomatic cases to mosquitoes. Moreover, the fraction of cases due to sexual transmission is estimated below 4% of the cumulative incidence. Our analyses underscore the need to quantify the transmissibility of asymptomatic infections, without which the overall attack rates and the level of herd immunity cannot be accurately estimated.

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“…Secondly, an estimated 80% of ZIKV infections do not develop symptoms and symptomatic infection includes a pre-symptomatic viraemic period [102,105,[156][157][158][159][160], although the viraemic period appears to be typically brief with relatively low levels of virus [102,105,161,162]. In addition, ZIKV RNA has been detected in asymptomatic blood donors during outbreaks in French Polynesian (2013-14) [105,163], Puerto Rico (April 3-June 11, 2016) [164], Martinique (January to June 2016) [165] and the continental US (May to October, 2016) [166]. Thirdly, there is a general consensus that ZIKV is the causative agent of severe neurological disorders [43,[167][168][169][170][171] including microcephaly in newborns [95,96,[172][173][174][175] and Guillain-Barré syndrome (GBS) in the wider population [109,[176][177][178][179].…”

Section: Why Zikv Represents a Potential Threat To Blood Safetymentioning

confidence: 99%

Emerging Infectious Diseases and Blood Safety: Modeling the Transfusion-Transmission Risk

Kiely

Gambhir

Cheng

et al. 2017

Transfusion Medicine Reviews

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While the transfusion-transmission (TT) risk associated with the major transfusion-relevant viruses such as HIV is now very low, during the last 20 years there has been a growing awareness of the threat to blood safety from emerging infectious diseases, a number of which are known to be, or are potentially, transfusion transmissible. Two published models for estimating the transfusion-transmission risk from EIDs, referred to as the Biggerstaff-Petersen model and the European Upfront Risk Assessment Tool (EUFRAT), respectively, have been applied to several EIDs in outbreak situations. We describe and compare the methodological principles of both models, highlighting their similarities and differences. We also discuss the appropriateness of comparing results from the two models. Quantitating the TT risk of EIDs can inform decisions about risk mitigation strategies and their cost-effectiveness. Finally, we present a qualitative risk assessment for Zika virus (ZIKV), an EID agent that has caused several outbreaks since 2007. In the latest and largest ever outbreak, several probable cases of transfusion-transmission ZIKV have been reported, indicating that it is transfusion-transmissible and therefore a risk to blood safety. We discuss why quantitative modeling the TT risk of ZIKV is currently problematic.

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Zika virus in asymptomatic blood donors in Martinique

Cited by 113 publications

References 16 publications

Inactivation of Zika virus in platelet components using amotosalen and ultraviolet A illumination

Inactivation of Zika virus in platelet components using amotosalen and ultraviolet A illumination

Asymptomatic Transmission and the Dynamics of Zika Infection

Emerging Infectious Diseases and Blood Safety: Modeling the Transfusion-Transmission Risk

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