Dengue viremia in blood donors from Honduras, Brazil, and Australia

Authors

  • Jeffrey M. Linnen,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Elizabeth Vinelli,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Ester C. Sabino,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Leslie H. Tobler,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Catherine Hyland,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Tzong-Hae Lee,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Daniel P. Kolk,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Amy S. Broulik,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Cynthia S. Collins,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Robert S. Lanciotti,

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • Michael P. Busch

    1. From Gen-Probe, Inc., San Diego, California; the Honduras Red Cross National Blood Program, Tegucigalpa, Honduras; Fundaçao Pro Sangue/Hemocentro do São Paulo, São Paulo, Brazil; the Australian Red Cross Blood Service, Queensland, Australia; the Division of Vector-Borne Infectious Disease, Centers for Disease Control and Prevention, Fort Collins, Colorado; and Blood Systems Research Institute and the Department of Laboratory Medicine, University of California, San Francisco, California.
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  • DPK is currently at DermTech, La Jolla, CA. He was with Gen-Probe, Inc. during the study and preparation of the manuscript.

  • This study was supported in part by Blood Systems Foundation, by the Australian Red Cross Blood Services, and by blood banking organizations in Honduras and Brazil.

Michael P. Busch, MD, PhD, Blood Systems Research Institute, 270 Masonic Avenue, San Francisco, CA 94118; e-mail: mbusch@bloodsystems.org.

Abstract

BACKGROUND: Dengue fever and hemorrhagic disease are caused by four dengue virus (DENV) serotypes (DENV-1 to -4), mosquito-borne flaviviruses with increasing incidence, and expanding global distributions. Documented transfusion transmission of West Nile virus raised concern regarding transfusion-transmitted DENV.

METHODS: A DENV RNA assay was developed based on transcription-mediated amplification (TMA) blood screening assays routinely used by blood centers worldwide. Sensitivity was established by endpoint dilution analyses of DENV-1 RNA transcript and pedigreed tissue culture standards for all four DENV-serotypes. Frozen plasma samples were tested from 2994 donations from Honduras (September 2004-January 2005), 4858 donations from Brazil (February-April 2003), and 5879 donations from Australia (March-September 2003). Type-specific polymerase chain reaction (PCR) assays were used to quantify and genotype TMA repeat-reactive samples; viral cultures, type-specific antibody, and antigen assays were also performed.

RESULTS: The TMA assay detected 14.9 copies per mL DENV-1 transcript (95% detection limit), with comparable sensitivity for all four serotypes. Honduran donors yielded 9 TMA repeat-reactive samples (0.30%); 8 were confirmed by PCR, with 3 DENV serotypes detected and viral loads from fewer than 3 × 104 to 4.2 × 104 copies per mL; and 4 samples yielded infectious virus. Three (0.06%) Brazilian samples tested repeat-reactive; 2 (0.04%) were PCR-positive (serotypes DENV-1 and -3; 12 and 294 copies/mL). No Australian donor samples tested repeat-reactive.

CONCLUSION: Dengue viremia rates among asymptomatic blood donors ranged from 0.30 percent in Honduras to 0.04 percent in Brazil. Future studies are needed to establish rates of transfusion transmission by viremic donations and clinical consequences in recipients.

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