title: High Incidence of Chikungunya Virus and Frequency of Viremic Blood Donations during Epidemic, Puerto Rico, USA, 2014.
abstract: Chikungunya virus (CHIKV) caused large epidemics throughout the Caribbean in 2014. We conducted nucleic acid amplification testing (NAAT) for CHIKV RNA (n = 29,695) and serologic testing for IgG against CHIKV (n = 1,232) in archived blood donor samples collected during and after an epidemic in Puerto Rico in 2014. NAAT yields peaked in October with 2.1% of donations positive for CHIKV RNA. A total of 14% of NAAT-reactive donations posed a high risk for virus transmission by transfusion because of high virus RNA copy numbers (10 (4) -10 (9) RNA copies/mL) and a lack of specific IgM and IgG responses. Testing of minipools of 16 donations would not have detected 62.5% of RNA-positive donations detectable by individual donor testing, including individual donations without IgM and IgG. Serosurveys before and after the epidemic demonstrated that nearly 25% of blood donors in Puerto Rico acquired CHIKV infections and seroconverted during the epidemic.
authors.forename: Graham
authors.initials: G
authors.lastname: Simmons
authors.forename: Vanessa
authors.initials: V
authors.lastname: Brès
authors.forename: Kai
authors.initials: K
authors.lastname: Lu
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Liss
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Brambilla
authors.forename: Kyle R
authors.initials: KR
authors.lastname: Ryff
authors.forename: Roberta
authors.initials: R
authors.lastname: Bruhn
authors.forename: Edwin
authors.initials: E
authors.lastname: Velez
authors.forename: Derrek
authors.initials: D
authors.lastname: Ocampo
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Linnen
authors.forename: Gerardo
authors.initials: G
authors.lastname: Latoni
authors.forename: Lyle R
authors.initials: LR
authors.lastname: Petersen
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Williamson
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
mesh_terms: D001782:Blood Donors; D065632:Chikungunya Fever / Q000453:epidemiology* / Q000821:virology*; D002646:Chikungunya virus / Q000302:isolation & purification*; D058872:Epidemics; D006801:Humans; D015994:Incidence; D021141:Nucleic Acid Amplification Techniques; D011647:Puerto Rico; D012698:Serologic Tests; D014766:Viremia / Q000453:epidemiology*
keywords: Puerto Rico; blood donors; chikungunya virus; epidemic; minipools; nucleic acid amplification test; seroprevalence; viremia; viruses