Abstract
National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV donor screening yielded 944 confirmed viremic donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0-10.7). An estimated 735,000 (95% CI 322,000-1,147,000) infections occurred in 2003, with 256 (95% CI 112-401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, donor screening can serve as a tool to monitor seasonal incidence in the general population.
Highlights
National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003
We report the combined results of WNV donor screening during the summer and fall of 2003 by America’s Blood Centers (ABC) and the American Red Cross (ARC), which together collect and test ≈95% of US donations
Of the 191 viremic donations detected in July, only 2 were detected in the first week of July, and only 4 confirmed viremic donations were reported by ABC or ARC after October 31; the July–October period composes virtually the entire 2003 epidemic
Summary
National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. RESEARCH to determine the proportion of donors with measurable antibody responses to WNV during 2003 We used this proportion, along with the minipool-NAT data from that region, to determine the average time during which WNV RNA was detectable by minipool-NAT. Along with the minipool-NAT data from that region, to determine the average time during which WNV RNA was detectable by minipool-NAT This time was combined with the minipool-NAT donor screening data for each state and US Census data to estimate the proportion of WNV-infected persons (seasonal incidence) in each state and the total number of incident infections nationwide in 2003
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