West nile virus through blood transfusion

The patient was treated empirically with broad-spectrum antimicrobial and antifungal agents. Two days after readmission i. When the patient was discharged to a long-term--care facility 36 days after his transplant surgery , his fever had resolved, and his mental status had improved.

Because the patient had been hospitalized during the 2 weeks before onset of his WNV-related illness, WNV transmission by organ transplantation or blood transfusion was considered more likely than transmission by mosquito bite.

Traceback investigation revealed that the patient with WNND had received blood products from six different donors during the 8 weeks before symptom onset. No donor samples from the time of donation were available for testing. The implicated blood donor was a man from a rural area of South Dakota where substantial WNV activity in birds, mosquitoes, and humans occurred during the transmission season.

He had not traveled outside of South Dakota during the month before his last donation on August 4, He did not report any symptoms consistent with WNV disease during the 2 weeks before this donation or during the 3 subsequent months. Because the BCA that collected the donation did not conduct routine screening for WNV, a sample of the donor's blood was sent for screening at an out-of-state BCA, where the MP-NAT test result for six pooled samples, including his donation, was negative.

After identification of the IgM-positive donor, the platelet and fresh frozen plasma FFP co-components from his whole blood donation were traced. The platelet unit had been discarded without being transfused. The FFP unit had been transfused on August 10, , into a man aged 60 years who had received a kidney transplant in for end-stage renal disease attributed to insulin-dependent diabetes mellitus.

On the same day as the transfusion, he had undergone surgical repair of a spinal fracture caused by a fall. He received a transfusion of 15 blood products, including 6 units of FFP, one of which was from the blood donor described in this report. One week after surgery, he was discharged to a rehabilitation facility, where he continued to receive immunosuppressive therapy, including 4 mg tacrolimus twice daily and mg mycophenolate mofetil three times daily.

Eleven days after the surgery, he had onset of fever and was treated empirically with antimicrobial and antifungal agents.

This investigation also found that criteria used by the blood-screening laboratory to screen the implicated blood donation for WNV were less stringent than criteria used by other blood collection centers in the area. Use of the more stringent screening criteria might have detected the WNV and prevented the blood donation from being used. Asymptomatic WNV-infected persons with viremia likely represent the largest risk group of blood donors.

Because symptom screening at the time of blood donation will not identify most viremic donors, screening by NAT was implemented rapidly to identify potentially infectious blood donations by detecting WNV RNA.

Despite this enhanced safety, documentation of the six WNV TAT cases in indicates that blood components containing low levels of virus might escape detection and that at least some of these might be infectious. Virus loads in infectious donations were considerably lower in than in 1.

In , the estimated viremia levels in implicated donations were 0. The reasons for this lower range are unclear, and the lower limit of donor viremia that can lead to transfusion-associated infection is unknown. Data collected during will be considered by the blood supply community in collaboration with public health authorities when developing screening strategies for , when widespread seasonal transmission of WNV is expected to continue.

MP screening will continue to identify most persons who donate during the short viremic period, but prospective IDT might be implemented in regions with high WNV-infection rates i. However, the capacity of laboratory equipment and personnel for performing IDT and the availability of reagents are limited, and the higher false-positive rate of IDT compared with MP screening could have a negative short-term impact on the availability of blood in these regions.

Approximately 4. Although persons needing blood transfusions should be aware of the limited risk for WNV infection, the benefits of receiving needed transfusions outweigh the potential risk for WNV infection. In addition, blood donation poses no risk to the donor for acquiring WNV, and the U. Public Health Service encourages blood donation. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.

Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. This conversion may have resulted in character translation or format errors in the HTML version. A small number of West Nile virus infections have been reported from blood transfusions. However, blood collection agencies have been screening all donated blood for West Nile virus since to minimize this risk.

All donated blood is tested for West Nile virus. Any blood product found to be infected is removed from the blood supply. If you have been diagnosed with West Nile virus by your doctor, you should not donate blood for days. If you are diagnosed shortly after giving blood, you should tell your blood center. Donation centers try to ensure that donors who recently had West Nile virus do not give blood for days.

Let the center know if you have had a West Nile virus infection. They will help you decide if it is safe for you to donate. Top of Page. If you recently had a transfusion, you should be aware of the very small risk for West Nile virus infection. This risk may be higher during the summer when West Nile virus is most likely to infect blood donors. You should contact your doctor if you think you have symptoms caused by West Nile virus or other concerns.

There are no specific medicines that can treat West Nile virus infection.