West nile virus infection screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.
Overview
Universal screening for WNV is not recommended. As blood and transplant-related transmissions of the virus have been reported, nucleic acid tests (NAT) may be used to screen for WNV among potential blood and solid organ donors. In blood donation, individual screening is not recommended either. Instead, a "minipool" nucleic acid testing program (MP NAT) is implemented. Positive pools warrant further investigation for individuals. Patients with positive NAT may not donate blood or solid organs for at least 120 days. Re-testing after 120 days is indicated.
Screening
Universal screening for WNV is not recommended. Screening is only recommended for blood and solid organ transplant donors.
Screening donor blood products
Following the discovery of WNV transmission by blood transfusions, WNV blood donor screening is performed using nucleic acid testing (NAT). A "minipool" nucleic acid testing program (MP NAT) is currently implemented to detect WNV viremia among donors. In contrast, serological testing is not feasible for screening purposes because IgM seroconversion may be detectable approximately 5 months following infection.[1] Pools with positive NAT results warrant further investigation for individual screening. Individual patients with positive NAT may not donate blood for at least 120 days.[2][3][4][1]
Screening solid organ transplant donors
Although the only data on human-to-human transmission by organ transplantation is derived from reports that included deceased donors, transmission to recipients may still occur if donors have NAT-negative IgM-positive results. These findings suggest that clearance of the WNV from solid organs may be delayed compared to its clearance from plasma. Accordingly, screening for WNV among transplant donors is recommended using NAT. There is no evidence to demonstrate the optimal time for solid organ donation in cases of positive NAT, but re-testing after 120 days to confirm negative NAT has become common practice. Patients with negative results after 120 days may donate solid organs.[1]
References
- ↑ 1.0 1.1 1.2 "Identifying risk factors for West Nile virus (WNV) during evaluation of potential living donors" (PDF). United Network for Organ Sharing. The Organ Procurement and Transplantation Network. 2013. Retrieved 09/11/2014. Check date values in:
|accessdate=(help) - ↑ Stramer SL, Fang CT, Foster GA, Wagner AG, Brodsky JP, Dodd RY (2005). "West Nile virus among blood donors in the United States, 2003 and 2004". N Engl J Med. 353 (5): 451–9. doi:10.1056/NEJMoa044333. PMID 16079368.
- ↑ Busch MP, Caglioti S, Robertson EF, McAuley JD, Tobler LH, Kamel H; et al. (2005). "Screening the blood supply for West Nile virus RNA by nucleic acid amplification testing". N Engl J Med. 353 (5): 460–7. doi:10.1056/NEJMoa044029. PMID 16079369.
- ↑ Kleinman S, Glynn SA, Busch M, Todd D, Powell L, Pietrelli L; et al. (2005). "The 2003 West Nile virus United States epidemic: the America's Blood Centers experience". Transfusion. 45 (4): 469–79. doi:10.1111/j.0041-1132.2005.04315.x. PMID 15819665.