Busch Michael P, Wright David J, Custer Brian, Tobler Leslie H, Stramer Susan L, Kleinman Steven H, Prince Harry E, Bianco Celso, Foster Gregory, Petersen Lyle R, Nemo George, Glynn Simone A
Blood Systems Research Institute, San Francisco, California 94118, USA.
Emerg Infect Dis. 2006 Mar;12(3):395-402. doi: 10.3201/eid1205.051287.
National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV donor screening yielded 944 confirmed viremic donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0-10.7). An estimated 735,000 (95% CI 322,000-1,147,000) infections occurred in 2003, with 256 (95% CI 112-401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, donor screening can serve as a tool to monitor seasonal incidence in the general population.
2003年7月，美国开始采用小池核酸扩增检测（MP-NAT）对献血者进行西尼罗河病毒（WNV）RNA的全国性筛查。我们汇总了全国核酸检测阳性率数据，并在一个西尼罗河病毒流行地区（北达科他州）进行了WNV免疫球蛋白M（IgM）检测。利用各州的MP-NAT阳性率、抗体血清阳性率以及MP-NAT可检测到RNA的平均时间来估算2003年的新发感染情况。WNV献血者筛查发现了944例确诊病毒血症献血者。MP-NAT阳性率在8月达到峰值，4个州超过0.5%的献血样本WNV RNA呈阳性。北达科他州9月下旬的IgM血清阳性率峰值为5.2%。MP-NAT可检测到病毒血症的平均时间为6.9天（95%置信区间[CI] 3.0 - 10.7）。2003年估计发生了73.5万例（95% CI 32.2万 - 114.7万）感染，每例神经侵袭性病例有256例（95% CI 112 - 401）感染。除了预防输血传播的WNV感染外，献血者筛查还可作为监测普通人群季节性发病率的工具。
