Paty M-C
Unité des maladies entériques, alimentaires et zoonoses, département maladies infectieuses, Institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice cedex, France.
Transfus Clin Biol. 2013 May;20(2):165-73. doi: 10.1016/j.tracli.2013.03.008. Epub 2013 Apr 25.
Arbovirus infections are increasing in prevalence worldwide. This presents new risks for blood transfusion. This article describes the epidemiology and surveillance of West Nile Virus, dengue and chikungunya and their role in the risk management of transfusions. Arboviruses are RNA viruses and very adaptable by nature. The majority of arbovirus infections are zoonoses. The risk of transmission is multifactorial and concerns the virus, vectors, animal reservoirs, the environment and human behaviour. In recent years, West Nile Virus has become established and widespread in North America, the number of cases of dengue worldwide has increased dramatically, and major epidemics of chikungunya have occurred in the Indian Ocean and Asia. The transmission of dengue and chikungunya is demonstrated in temperate zones. All arboviruses are potentially transmissible by transfusion due to their capacity to induce an asymptomatic viremic phase. The risk of West Nile Virus transmission via transfusion is recognised and prevention measures are well established. The risk of transmission via transfusion of dengue and chikungunya is real but difficult to quantify and the optimum prevention strategy is currently the subject of research. Access to up-to-date epidemiological data is an essential aid to decision-making, especially for donors returning from endemic areas to Europe. The challenge is to define and implement appropriate measures in unpredictable situations.
虫媒病毒感染在全球范围内的流行率正在上升。这给输血带来了新的风险。本文描述了西尼罗河病毒、登革热和基孔肯雅热的流行病学和监测情况，以及它们在输血风险管理中的作用。虫媒病毒是RNA病毒，天生具有很强的适应性。大多数虫媒病毒感染为人畜共患病。传播风险是多因素的，涉及病毒、媒介、动物宿主、环境和人类行为。近年来，西尼罗河病毒已在北美站稳脚跟并广泛传播，全球登革热病例数急剧增加，基孔肯雅热在印度洋和亚洲发生了大规模流行。登革热和基孔肯雅热在温带地区也有传播。由于所有虫媒病毒都有能力诱导无症状病毒血症期，因此都有可能通过输血传播。西尼罗河病毒通过输血传播的风险已得到认可，预防措施也已完善。登革热和基孔肯雅热通过输血传播的风险是真实存在的，但难以量化，目前最佳预防策略仍是研究课题。获取最新的流行病学数据对于决策至关重要，特别是对于从流行地区返回欧洲的献血者而言。面临的挑战是在不可预测的情况下定义并实施适当的措施。
