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Information Regarding West Nile Virus Transmission Through Blood Transfusion
Primary Care Center - West Nile VirusBackground:
West Nile Virus (WNV) is an arthropod-borne virus that is primarily transmitted in birds through mosquito bites while humans are incidental hosts. The disease was first identified in the US in 1999 in the New York City area. The largest human WNV meningoencephalitis outbreak ever documented as well as the largest outbreak of meningoencelphalitis from any cause in North America occurred in 2002, with 4,161 human cases and 277 deaths reported as of March 12, 2003. This epidemic included the first documented cases of WNV transmission through organ transplantation and blood transfusion.

The incubation period for WNV is thought to be between 2-14 days with viremia lasting from 1-11 days and sometimes longer. Of those infected, 80% remain asymptomatic. The other 20% experience mild symptoms which may include fever, headache, body aches, gastrointestinal complaints, eye pain and occasionally a rash. It is estimated that 1 in 150-200 persons develops a more severe form of a disease which may culminate in fatal encelphalitis in 1 in 1,000 infections.

Transmission by Blood Transfusion:
Between August 28, 2002 and March 1, 2003, the CDC received reports of 61 cases of possible transfusion transmitted WNV infection. After testing retained donor blood samples, the investigation demonstrated that transfusion transmission was the likely source of WNV infection in 21 of the cases.

Since 80% of those infected with WNV are asymptomatic, donor exclusions based on health screening will have limited effectiveness. Laboratory screening tests to detect donor infections with WNV will be needed if the epidemic persists. A memo received from the American Red Cross indicates plans to begin testing for WNV genetic material in blood donations under an Investigational New Drug (IND) application beginning on or about July 1, 2003. Blood donations accepted between July 1st and October 31st are at the greatest risk, as this corresponds to the time when 99% of human cases occurred.