12/14/2023 0 Comments Donate blood west nile virus![]() Therefore, the likelihood for ongoing disease transmission to occur is thought to correlate more with sufficient summer temperatures rather than minimum winter temperatures. Additionally, even small increases in temperature have been shown to result in significant increases in transmission potential for WNV in Culex pipiens mosquitoes. Overwintering of the virus in Culex mosquitoes and their eggs in Germany has been documented. German Culex pipiens have been shown to be highly susceptible for WNV, even at the relatively low temperature of 18☌. The principal vectors of WNV are ornithophilic Culex mosquitoes, especially Culex pipiens complex. Partnerships between public health experts, transfusion medicine specialists, veterinarians, and entomologists should be strengthened to ensure a One Health approach. In order to timely identify affected areas, combined results of human and veterinary surveillance are needed. As long as effective and affordable pathogen reduction is not available for all blood components, WNV testing or donor deferral will be essential. Altogether, 19 confirmed WNV infections were identified from 2020–2021. From 2020 onwards, roughly 80% of all blood establishments in Germany tested their donations for WNV using nucleic acid amplification techniques in the transmission season. WNV transmissions via blood products often result in WNND due to the predisposing underlying medical conditions of transfusion recipients. WNV is a transfusion-transmissible-infection, and donor deferral or testing of donations after a stay in an affected area are effective means to ensure transfusion safety. So far, no clear expansion of the affected areas is discernible but may develop. Autochthonous mosquito-borne WNV infections in humans were reported in all following years, indicating a continuous circulation in the affected areas of Central-East Germany. ![]() The widespread domestic Culex mosquitoes are efficient vectors for WNV. This changed when in the exceptionally warm summer of 2018, conditions for viral replication in mosquitoes were ideal, and the first WNV cases among birds and horses were identified. Human WNV cases have been identified in Southern and Eastern Europe for more than 20 years, but until 2018, Germany was considered to be a non-endemic country. In most individuals, WNV infection remains silent, while 20% develop mild symptoms of West Nile fever, and only 1% develop neuroinvasive disease (WNND). It circulates in an enzootic cycle between ornithophilic mosquitoes as vectors and reservoirs and avian host species for amplification, but humans can be infected as accidental hosts. While in-process testing identified approximately one ID-NAT-only detectable (antibody-negative) donation per year, reducing the geographic triggered area decreased its effectiveness.West Nile virus (WNV) is an arthropod-borne virus (arbovirus). WNV NAT's utility is between June-December however, abandoning testing outside of this time may increase risk. With reduced triggering geography, 12 of 19 (63%) were not identified (including 6/10 ID-NAT-only detectable, and 2/4 ID-NAT-only detectable/antibody negative). Ten of 19 (53%) identified in-process were ID-NAT-only detectable, including four antibody negatives, or approximately 1 per year (2.8% of ID-NAT-only detectable). Overall, 52% (358/684) required ID-NAT for detection, including 68 (19%) antibody negatives. ID-NAT included 3.2 million donations of more than 25 million tested year-round, resulting in 684 confirmed positives all confirmed-positive donations occurred from June to December (0.64/10,000). Reactive sample confirmation was performed by repeat NAT of an independent sample or antibody testing. During the MP- to ID-NAT transition, donation samples were retrieved and tested by ID-NAT for those with results not yet released (referred to as in-process testing). ID-NAT-triggered geographic areas included an entire state (2014-2017) or collections within a 50-mile radius of the triggering donor's residential zip code (2018). Mini-pool-NAT transitioned to ID-NAT following triggering based on one WNV NAT-reactive donation (having an elevated signal, repeat reactive, or in an area with WNV ongoing activity). Using data from 2014 to 2018, we investigated a strategy used to increase detection early in the triggering period and reviewed its yield as the individual donation (ID)-NAT geographic area was decreased. Rare transfusion-transmitted West Nile virus (WNV) cases usually occur due to gaps in testing involving converting to more sensitive nucleic acid testing (NAT) formats (referred to as triggering). ![]()
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