title: Transfusion-Transmitted Dengue and Associated Clinical Symptoms During the 2012 Epidemic in Brazil.
abstract: BACKGROUND
  A linked donor-recipient study was conducted during epidemics in 2 cities in Brazil to investigate transfusion-transmitted (TT) dengue virus (DENV) by DENV RNA-positive donations.
  
  
  METHODS
  During February-June 2012, samples were collected from donors and recipients and retrospectively tested for DENV RNA by transcription-mediated amplification. Recipient chart review, using a case (DENV positive)-control (DENV negative and not known to be exposed) design, was conducted to assess symptoms.
  
  
  RESULTS
  Of 39 134 recruited blood donors, DENV-4 viremia was confirmed in 0.51% of donations from subjects in Rio de Janeiro and 0.80% of subjects in Recife. Overall, 42 DENV RNA-positive units were transfused into 35 recipients. Of these, 16 RNA-positive units transfused into 16 susceptible recipients were identified as informative: 5 cases were considered probable TT cases, 1 possible TT case, and 10 nontransmissions. The TT rate was 37.5% (95% confidence interval [CI], 15.2%-64.6%), significantly higher than the viremia rate of 0.93% (95% CI, .11%-3.34%) in nonexposed recipients (P < .0001). Chart review did not find significant differences between cases and controls in symptoms or mortality.
  
  
  CONCLUSIONS
  During a large epidemic of DENV-4 infection in Brazil, >0.5% of donations were RNA positive, and approximately one third of components resulted in TT. However, no significant clinical differences were evident between RNA-positive and RNA-negative recipients.
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo.
authors.forename: Ester C
authors.initials: EC
authors.lastname: Sabino
authors.affiliation: Faculdade de Ciências Médicas-UPE/Fundação Hemope, Recife.
authors.forename: Paula
authors.initials: P
authors.lastname: Loureiro
authors.affiliation: Fundação Hemorio, Rio de Janeiro, Brazil.
authors.forename: Maria Esther
authors.initials: ME
authors.lastname: Lopes
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo.
authors.forename: Ligia
authors.initials: L
authors.lastname: Capuani
authors.affiliation: RTI International, Rockville, Maryland.
authors.forename: Christopher
authors.initials: C
authors.lastname: McClure
authors.affiliation: RTI International, Rockville, Maryland.
authors.forename: Dhuly
authors.initials: D
authors.lastname: Chowdhury
authors.affiliation: Universidade Federal de São Joao del Rey, Divinopolis, Brazil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Di-Lorenzo-Oliveira
authors.affiliation: Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical, Universidade de São Paulo.
authors.forename: Lea C
authors.initials: LC
authors.lastname: Oliveira
authors.affiliation: Hologic, San Diego.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Linnen
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Tzong-Hae
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Thelma
authors.initials: T
authors.lastname: Gonçalez
authors.affiliation: RTI International, Rockville, Maryland.
authors.forename: Donald
authors.initials: D
authors.lastname: Brambilla
authors.affiliation: Blood Systems Research Institute, San Francisco, California University of British Columbia, Vancouver, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Kleinman
authors.affiliation: Blood Systems Research Institute, San Francisco, California Department of Laboratory Medicine, University of California-San Francisco.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
authors.affiliation: Blood Systems Research Institute, San Francisco, California Department of Laboratory Medicine, University of California-San Francisco.
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
mesh_terms: D001782:Blood Donors; D001938:Brazil / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology* / Q000635:transmission*; D003716:Dengue Virus / Q000302:isolation & purification*; D058872:Epidemics; D006801:Humans; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D065227:Transfusion Reaction
chemical_list: D012367:RNA, Viral
keywords: NAT; clinical symptoms; dengue; transfusion-transmission