title: Mitigating the Risk of Transfusion-Transmitted Dengue in Australia.
abstract: Dengue viruses (DENV 1-4) are a risk to transfusion safety, with several transfusion-transmitted (TT) cases reported globally. DENV 1-4 are endemic in over 100 countries, with seasonal outbreaks occurring in northeastern Australia. To mitigate TT-DENV risk in Australia, fresh blood components are not manufactured from donors returning from any area (domestic/overseas) with known dengue transmission. Alternatively, TT-DENV risk may be mitigated using an appropriate blood donor screening assay. We aimed to determine the rate of dengue infection in donors during dengue outbreaks in Australia. Plasma samples were collected from blood donors during local dengue outbreaks. All samples were tested for the presence of DENV RNA and selected samples were tested for DENV antigen (nonstructural protein 1, NS1) with two assays. No donors residing in high risk areas had detectable levels of DENV RNA or NS1 and no cases of DENV viremia were detected in blood donors residing in areas of Australia experiencing DENV outbreaks. Definitive conclusions could not be drawn from this study; however, the lack of detection of DENV RNA or antigen in donations suggests that the current risk of TT-DENV is low and maintaining the fresh component restriction for "at-risk" donors is appropriate.
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Rooks
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Perth, WA, Australia.
authors.forename: Clive R
authors.initials: CR
authors.lastname: Seed
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Fryk
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Hyland
authors.affiliation: Medical Services, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Harley
authors.affiliation: Grifols Diagnostic Solutions, Inc., Emeryville, CA, USA.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Holmberg
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Sydney, NSW, Australia.
authors.forename: Denese C
authors.initials: DC
authors.lastname: Marks
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia.
authors.forename: Robert L P
authors.initials: RL
authors.lastname: Flower
authors.affiliation: Research and Development, Australian Red Cross Blood Service, Brisbane, QLD, Australia; School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Helen M
authors.identifier: 0000-0002-3446-8248
authors.initials: HM
authors.lastname: Faddy