title: First cases of Zika virus-infected US blood donors outside states with areas of active transmission.
abstract: Zika virus (ZIKV) is transmitted by Aedes mosquitos and can result in severe congenital and adult neurologic abnormalities. ZIKV has rapidly spread northward through Central America and the Caribbean and autochthonous cases have been identified in the continental United States. High rates of ZIKA RNA positivity were detected in blood donors during previous epidemics. ZIKV transmission by transfused blood from healthy donor components has been a growing concern.
  
  
  
  Individual-donation aliquots of plasma from volunteer blood donors were tested individually with an investigational Procleix ZIKV assay. Initially reactive samples were tested for ZIKV RNA in plasma and red blood cells (RBCs) and for ZIKV-specific antibodies in serum. A confirmed positive classification required confirmation of RNA and/or detection of ZIKV antibodies in index and/or follow-up samples.
  
  
  
  Between September 19 and November 30, 2016, a total of 466,834 donations were screened for ZIKV RNA. Five donors (one in approx. 93,000) were reactive for ZIKV RNA by both the Procleix ZIKV assay and supplemental testing. The donations were collected outside areas considered as having active transmission, and all five donors had travel exposures. A lookback case demonstrated no infection despite transfusion of a Zika IgG-positive platelet (PLT) component with probable low levels of ZIKV RNA.
  
  
  
  This report describes the first ZIKV-positive donors detected outside areas with active transmission. These donors most likely represent travel-acquired "tail-end infections" with prolonged RBC-associated ZIKV RNA. The lack of transmission to the recipient of an apheresis PLT may suggest that these units are not infectious.
authors.affiliation: Creative Testing Solutions, Tempe, Arizona.
authors.forename: Phillip C
authors.initials: PC
authors.lastname: Williamson
authors.affiliation: Hologic, Inc, San Diego, California.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Linnen
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Kessler
authors.affiliation: New York Blood Center, New York, New York.
authors.forename: Beth H
authors.initials: BH
authors.lastname: Shaz
authors.affiliation: Blood Systems, Inc, Scottsdale, Arizona.
authors.forename: Hany
authors.initials: H
authors.lastname: Kamel
authors.affiliation: Blood Systems, Inc, Scottsdale, Arizona.
authors.forename: Ralph R
authors.initials: RR
authors.lastname: Vassallo
authors.affiliation: Creative Testing Solutions, Tempe, Arizona.
authors.forename: Valerie
authors.initials: V
authors.lastname: Winkelman
authors.affiliation: Hologic, Inc, San Diego, California.
authors.forename: Kui
authors.initials: K
authors.lastname: Gao
authors.affiliation: Hologic, Inc, San Diego, California.
authors.forename: Rainer
authors.initials: R
authors.lastname: Ziermann
authors.affiliation: Hologic, Inc, San Diego, California.
authors.forename: Juscilene
authors.initials: J
authors.lastname: Menezes
authors.affiliation: Hologic, Inc, San Diego, California.
authors.forename: Stephen
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Grifols Diagnostic Solutions, Inc, Emeryville, California.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Holmberg
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Sonia
authors.initials: S
authors.lastname: Bakkour
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Mars
authors.initials: M
authors.lastname: Stone
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Kai
authors.initials: K
authors.lastname: Lu
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Graham
authors.initials: G
authors.lastname: Simmons
authors.affiliation: Blood Systems Research Institute, San Francisco, California.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
mesh_terms: D000328:Adult; D001782:Blood Donors; D017691:Caribbean Region / Q000453:epidemiology; D002489:Central America / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012367:RNA, Viral / Q000097:blood*; D000071244:Zika Virus; D000071243:Zika Virus Infection / Q000097:blood / Q000208:ethnology / Q000635:transmission
chemical_list: D012367:RNA, Viral