2015年亚利桑那州，圣路易斯脑炎病毒可能通过输血传播。
St. Louis encephalitis virus possibly transmitted through blood transfusion-Arizona, 2015.
作者信息
Venkat Heather, Adams Laura, Sunenshine Rebecca, Krow-Lucal Elisabeth, Levy Craig, Kafenbaum Tammy, Sylvester Tammy, Smith Kirk, Townsend John, Dosmann Melissa, Kamel Hany, Patron Roberto, Kuehnert Matthew, Annambhotla Pallavi, Basavaraju Sridhar V, Rabe Ingrid B
机构信息
Epidemic Intelligence Service Program, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
Arizona Department of Health Services, Phoenix, Arizona.
出版信息
Transfusion. 2017 Dec;57(12):2987-2994. doi: 10.1111/trf.14314. Epub 2017 Sep 14.
BACKGROUND
St. Louis encephalitis virus is a mosquito-borne flavivirus that infrequently causes epidemic central nervous system infections. In the United States, blood donors are not screened for St. Louis encephalitis virus infection, and transmission through blood transfusion has not been reported. During September 2015, St. Louis encephalitis virus infection was confirmed in an Arizona kidney transplant recipient. An investigation was initiated to determine the infection source.
STUDY DESIGN AND METHODS
The patient was interviewed, and medical records were reviewed. To determine the likelihood of mosquito-borne infection, mosquito surveillance data collected at patient and blood donor residences in timeframes consistent with their possible exposure periods were reviewed. To investigate other routes of exposure, organ and blood donor and recipient specimens were obtained and tested for evidence of St. Louis encephalitis virus infection.
RESULTS
The patient presented with symptoms of central nervous system infection. Recent St. Louis encephalitis virus infection was serologically confirmed. The organ donor and three other organ recipients showed no laboratory or clinical evidence of St. Louis encephalitis virus infection. Among four donors of blood products received by the patient via transfusion, one donor had a serologically confirmed, recent St. Louis encephalitis virus infection. Exposure to an infected mosquito was unlikely based on the patient's minimal outdoor exposure. In addition, no St. Louis encephalitis virus-infected mosquito pools were identified around the patient's residence.
CONCLUSION
This investigation provides evidence of the first reported possible case of St. Louis encephalitis virus transmission through blood product transfusion. Health care providers and public health professionals should maintain heightened awareness for St. Louis encephalitis virus transmission through blood transfusion in settings where outbreaks are identified.
背景
圣路易斯脑炎病毒是一种通过蚊子传播的黄病毒，很少引起流行性中枢神经系统感染。在美国，献血者未接受圣路易斯脑炎病毒感染筛查，且尚未有通过输血传播该病毒的报道。2015年9月，一名亚利桑那州的肾移植受者被确诊感染圣路易斯脑炎病毒。随即展开调查以确定感染源。
研究设计与方法
对患者进行了访谈，并查阅了病历。为确定经蚊子传播感染的可能性，对在患者和献血者住所采集的、与他们可能的暴露期相符时间段内的蚊子监测数据进行了审查。为调查其他暴露途径，获取了器官及血液捐献者和受者的标本，并检测是否有圣路易斯脑炎病毒感染的证据。
结果
患者出现中枢神经系统感染症状。血清学确诊近期感染了圣路易斯脑炎病毒。器官捐献者和其他三名器官受者未显示出圣路易斯脑炎病毒感染的实验室或临床证据。在患者通过输血接受的四份血液制品的捐献者中，有一名捐献者血清学确诊近期感染了圣路易斯脑炎病毒。鉴于患者户外暴露极少，感染受感染蚊子的可能性不大。此外，在患者住所周围未发现感染圣路易斯脑炎病毒的蚊子群落。
结论
本次调查提供了首例有报道的可能通过血液制品输血传播圣路易斯脑炎病毒病例的证据。在已发现疫情的地区，医护人员和公共卫生专业人员应提高对通过输血传播圣路易斯脑炎病毒的警惕性。
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