Mitigating the Risk of Transfusion-Transmitted Dengue in Australia.

Kelly Rooks,Robert L P Flower,Robert J Harley,Catherine A Hyland,Jesse J Fryk,Denese C Marks,Clive R Seed,Helen M Faddy,Jerry A Holmberg

doi:10.1155/2016/3059848

Abstract

Dengue viruses (DENV 1–4) are a risk to transfusion safety, with several transfusion-transmitted (TT) cases reported globally. DENV 1–4 are endemic in over 100 countries, with seasonal outbreaks occurring in northeastern Australia. To mitigate TT-DENV risk in Australia, fresh blood components are not manufactured from donors returning from any area (domestic/overseas) with known dengue transmission. Alternatively, TT-DENV risk may be mitigated using an appropriate blood donor screening assay. We aimed to determine the rate of dengue infection in donors during dengue outbreaks in Australia. Plasma samples were collected from blood donors during local dengue outbreaks. All samples were tested for the presence of DENV RNA and selected samples were tested for DENV antigen (nonstructural protein 1, NS1) with two assays. No donors residing in high risk areas had detectable levels of DENV RNA or NS1 and no cases of DENV viremia were detected in blood donors residing in areas of Australia experiencing DENV outbreaks. Definitive conclusions could not be drawn from this study; however, the lack of detection of DENV RNA or antigen in donations suggests that the current risk of TT-DENV is low and maintaining the fresh component restriction for “at-risk” donors is appropriate.

Highlights

Dengue is one of the most important arboviral pathogens worldwide, with an estimated 390 million infections per year [1]
None of the samples collected during local dengue outbreaks were positive for dengue virus (DENV) RNA, despite a subset being collected from “higher-risk” areas (Table 2)
All of the control samples were negative for DENV RNA

Summary

Introduction

Dengue is one of the most important arboviral pathogens worldwide, with an estimated 390 million infections per year [1]. Of these estimated dengue infections, only 96 million manifest clinically, with the majority of infections asymptomatic [2]. DENV are mosquitoborne, with the primary vector being Aedes aegypti. This urban-adapted mosquito is distributed throughout tropical and subtropical climates, giving rise to endemic and epidemic DENV transmission in both developing and developed nations [4]. A secondary vector capable of transmitting DENV, Aedes albopictus, has increased in geographic range in recent years, which may contribute to the increasing number of dengue infections [4]

Objectives

Methods

Results

Discussion

Conclusion