Premium
St. Louis encephalitis virus possibly transmitted through blood transfusion—Arizona, 2015
Author(s) -
Venkat Heather,
Adams Laura,
Sunenshine Rebecca,
KrowLucal Elisabeth,
Levy Craig,
Kafenbaum Tammy,
Sylvester Tammy,
Smith Kirk,
Townsend John,
Dosmann Melissa,
Kamel Hany,
Patron Roberto,
Kuehnert Matthew,
Annambhotla Pallavi,
Basavaraju Sridhar V.,
Rabe Ingrid B.
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14314
Subject(s) - encephalitis , medicine , virus , virology , transmission (telecommunications) , japanese encephalitis , flavivirus , blood transfusion , immunology , electrical engineering , engineering
BACKGROUND St. Louis encephalitis virus is a mosquito‐borne flavivirus that infrequently causes epidemic central nervous system infections. In the United States, blood donors are not screened for St. Louis encephalitis virus infection, and transmission through blood transfusion has not been reported. During September 2015, St. Louis encephalitis virus infection was confirmed in an Arizona kidney transplant recipient. An investigation was initiated to determine the infection source. STUDY DESIGN AND METHODS The patient was interviewed, and medical records were reviewed. To determine the likelihood of mosquito‐borne infection, mosquito surveillance data collected at patient and blood donor residences in timeframes consistent with their possible exposure periods were reviewed. To investigate other routes of exposure, organ and blood donor and recipient specimens were obtained and tested for evidence of St. Louis encephalitis virus infection. RESULTS The patient presented with symptoms of central nervous system infection. Recent St. Louis encephalitis virus infection was serologically confirmed. The organ donor and three other organ recipients showed no laboratory or clinical evidence of St. Louis encephalitis virus infection. Among four donors of blood products received by the patient via transfusion, one donor had a serologically confirmed, recent St. Louis encephalitis virus infection. Exposure to an infected mosquito was unlikely based on the patient's minimal outdoor exposure. In addition, no St. Louis encephalitis virus‐infected mosquito pools were identified around the patient's residence. CONCLUSION This investigation provides evidence of the first reported possible case of St. Louis encephalitis virus transmission through blood product transfusion. Health care providers and public health professionals should maintain heightened awareness for St. Louis encephalitis virus transmission through blood transfusion in settings where outbreaks are identified.