title: Risk of transfusion-transmitted chikungunya infection and efficacy of blood safety implementation measures: experience from the 2009 epidemic in Songkhla Province, Thailand.
abstract: To date, neither is there a standard guideline for maintaining a safe blood supply during a chikungunya fever (CHIKF) outbreak nor has a study been performed on actual transfusion-transmitted CHIKF to recipients. This study estimated the potential incidence of transfusion-transmitted CHIKF and compared the efficacies of various blood safety intervention strategies to mitigate the transfusion-transmitted CHIKF risk.
  
  
  
  A Web-based tool named the European Up-Front Risk Assessment Tool (EUFRAT) was used to estimate the risk of transfusion-transmitted CHIKF using data inputs from the 2009 Songkhla epidemic in Thailand.
  
  
  
  The mean and maximal risks of viremic donations during the entire epidemic period were estimated to be 0.9 (95% confidence interval [CI], 0.0-2.7) and 4.8 (95% CI, 0.5-9.1), respectively. This meant that the potential risk of transfusion-transmitted CHIKF to recipients receiving all infective end products in the absence of blood safety measures was from 10.9 (95% CI, 1.8-20.4) to 57.6 (95% CI, 36.4-79.5). Based on experience from the 2009 Thai epidemic, the proportion of 10% asymptomatic cases, for instance, with predonation screening for CHIKF-related symptoms and follow-up observation in donors at risk was estimated to be 88.4% (95% CI, 69.9%-100.0%) to 99.1% (95% CI, 79.6%-100.0%) effective in reducing this transfusion risk compared to 83.7% (95% CI, 65.8%-100.0%) to 90.7% (95% CI, 72.1%-100.0%) by predonation screening for donors at risk of chikungunya virus infection alone.
  
  
  
  This study suggests that prompt blood screening measures can reduce the risk of transfusion-transmitted CHIKF and maintain a safe blood supply during an outbreak.
authors.affiliation: Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Hatsadee
authors.initials: H
authors.lastname: Appassakij
authors.affiliation: Sanpasitthiprasong Hospital, Ubon Ratchathani, Thailand.
authors.forename: Charuporn
authors.initials: C
authors.lastname: Promwong
authors.affiliation: Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Pairaya
authors.initials: P
authors.lastname: Rujirojindakul
authors.affiliation: Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Paiwon
authors.initials: P
authors.lastname: Khuntikij
authors.affiliation: Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Khachornsakdi
authors.initials: K
authors.lastname: Silpapojakul
mesh_terms: D001782:Blood Donors / Q000706:statistics & numerical data; D058731:Blood Safety / Q000706:statistics & numerical data; D065632:Chikungunya Fever / Q000453:epidemiology / Q000209:etiology* / Q000635:transmission; D002646:Chikungunya virus / Q000472:pathogenicity; D005260:Female; D006801:Humans; D008297:Male; D018570:Risk Assessment; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D065227:Transfusion Reaction