Dengue cases have surged worldwide during the 2023-24 outbreak season, with the WHO reporting close to a historic high of over five million cases and more than 5000 dengue-related deaths in over 80 countries. [1]
Dengue is capable of causing a transfusion-transmitted infection, with several case reports, including a case of severe dengue haemorrhagic fever. [2] In a study conducted in blood donors in Thailand and Vietnam, two countries endemic for dengue, the overall prevalence of dengue was 67 in 100000 donations, demonstrating the potential for transfusion-transmitted dengue in endemic regions of Asia-Pacific. [3] The risk of transfusion-transmitted dengue can be managed in different ways, including careful donor screening and deferral, and screening tests specific for dengue. Screening tests may be based on location-specific triggers, such as an outbreak in a non-endemic area, or specific factors in endemic areas. For example, during an autochthonous dengue outbreak in the Lazio region of Italy in August 2023, dengue screening by molecular testing was activated in all organ, tissue, haematopoietic stem cells and blood donors from the designated risk areas. [4]
With dengue infections currently soaring, and even with vector control, personal protection, and most recently a dengue vaccine, the possibility of transfusion transmission exists via asymptomatic donors. It is important to be aware of the possibility, and consider the right management strategy based on local factors.
References:
[1] World Health Organization (2023). Dengue – Global Situation. [online] www.who.int. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON498.
[2] Stramer, S.L. et al. (2012) ‘Dengue viremia in blood donors identified by RNA and detection of dengue transfusion transmission during the 2007 dengue outbreak in Puerto Rico’, Transfusion, 52(8), pp. 1657–1666. doi:10.1111/j.1537-2995.2012.03566.x.
[3] Stanley, J. et al. (2020) ‘Detection of dengue, chikungunya, and Zika RNA in blood donors from Southeast Asia’, Transfusion, 61(1), pp. 134–143. doi:10.1111/trf.16110.
[4] De Carli, G. et al. (2023) ‘Outbreaks of autochthonous dengue in Lazio region, Italy, August to September 2023: Preliminary investigation’, Eurosurveillance, 28(44). doi:10.2807/1560-7917.es.2023.28.44.2300552.
