1430. Possible Transmission of St. Louis Encephalitis Virus Through Blood Transfusion — Arizona, 2015
Session: Poster Abstract Session: Public Health
Friday, October 28, 2016
Room: Poster Hall
  • SLE Poster_ID Week_Venkat.png (261.1 kB)
  • Background: St. Louis encephalitis virus (SLEV) causes disease clinically similar to West Nile virus (WNV), a related flavivirus. In the United States, blood donors are screened for WNV; SLEV transmission through blood transfusion has not been reported. In September, SLEV infection was confirmed in an Arizona kidney transplant recipient. We investigated to determine the infection source.

    Methods: We interviewed the patient and reviewed medical records for transplant and transfusion history. Retained specimens before and after organ transplantation and blood transfusion were collected and tested by IgM microsphere immunoassay and plaque reduction neutralization testing. To determine the likelihood of mosquito-borne infection, we reviewed mosquito surveillance data (5-mile radius) surrounding the patient’s and blood donor’s residences 30 days prior to symptom onset.

    Results: Patient interview revealed neuroinvasive symptom onset compatible with a flavivirus infection 35 days posttransplant. Four organ recipients from the same donor, and 4 blood donors who provided packed red cells that were transfused to the patient ≤35 days before symptom onset were identified. One asymptomatic blood donor was positive for SLEV; the 3 blood donors, 3 organ recipients, and organ donor had no clinical or laboratory evidence of SLEV infection. One recipient of a blood component from the SLEV-infected blood donor died posttransfusion; no samples remained for testing. No blood components remained from the implicated donation. We identified 1 positive SLEV mosquito pool around the patient’s residence and 12 positive SLEV mosquito pools around the asymptomatic blood donor’s residence.

    Conclusion: This investigation provides evidence for the first reported possible case of SLEV transmission through blood product transfusion. Health care providers should consider SLEV in patients with compatible clinical symptoms who recently received blood products.

    Heather Venkat, DVM, MPH1,2,3, Rebecca Sunenshine, MD4, Craig Levy, MS3, Tammy Kafenbaum, BSN3, Tammy Sylvester, RN, BSN5, Laura Adams, DVM MPH2,6, Kirk Smith, PhD7, John Townsend, BS7, Melissa Dosmann, RN, CCTC8, Hany Kamel, MD9, Roberto Patron, MD10, Janna Huskey, MD11, Hasan Khamash, MD11, Elizabeth Krow-Lucal, PhD12 and Ingrid Rabe, MBChB, MMed13, (1)Centers for Disease Control and Prevention- Epidemic Intelligence Service, Atlanta, GA, (2)Arizona Department of Health Services, Phoenix, AZ, (3)Maricopa County Department of Public Health, Phoenix, AZ, (4)Ophpr, Centers for Disease Control and Prevention, Phoenix, AZ, (5)Epidemiology, Maricopa County Department of Public Health, Phoenix, AZ, (6)Centers for Disease Control and Prevention, Phoenix, AZ, (7)Vector Control Division, Maricopa County Environmental Services Department, Phoenix, AZ, (8)Arizona Mayo Clinic Hospital, Phoenix, AZ, (9)Blood Systems, Inc, Scottsdale, AZ, (10)Infectious Diseases Division, Mayo Clinic, Phoenix, AZ, (11)Mayo Clinic, Phoenix, AZ, (12)Arboviral Diseases Branch, Centers for Disease Control and Prevention- Epidemic Intelligence Service, Ft. Collins, CO, (13)Arboviral Diseases Branch, Centers for Disease Control and Prevention, Ft. Collins, CO


    H. Venkat, None

    R. Sunenshine, None

    C. Levy, None

    T. Kafenbaum, None

    T. Sylvester, None

    L. Adams, None

    K. Smith, None

    J. Townsend, None

    M. Dosmann, None

    H. Kamel, None

    R. Patron, None

    J. Huskey, None

    H. Khamash, None

    E. Krow-Lucal, None

    I. Rabe, None

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