{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:14:48Z","timestamp":1789398888528,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,7]],"date-time":"2015-09-07T00:00:00Z","timestamp":1441584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Novartis Vaccines and Diagnostics (now Grifols), Federal earmark","award":["1H75CK 000159-01"],"award-info":[{"award-number":["1H75CK 000159-01"]}]},{"name":"ARRA Grand Opportunity","award":["5RC2HL 101632-02"],"award-info":[{"award-number":["5RC2HL 101632-02"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>In the absence of active blood donation screening, dengue viruses (DENV) have been implicated in only a limited number of transfusion transmissions worldwide. This study attempted to identify if blood from donors testing negative by an NS1\u2010antigen (Ag) enzyme\u2010linked immunosorbent assay (ELISA) but confirmed positive for DENV RNA caused DENV\u2010related disease in recipients during the epidemic years of 2010 to 2012 in Puerto Rico.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Donation aliquots testing negative by an investigational NS1\u2010Ag ELISA were stored frozen and retested retrospectively using a research transcription\u2010mediated amplification assay (TMA) detecting DENV RNA. All RNA\u2010reactive donations were subject to confirmatory RNA and antibody testing. Recipient tracing was conducted for all components manufactured from TMA\u2010reactive components. Medical chart review, recipient interview, and follow\u2010up sampling occurred for 42 recipients transfused with TMA\u2010reactive components.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Six of 42 recipients developed new\u2010onset fever in the 2 weeks posttransfusion; three (50%) received RNA confirmed\u2010positive, NS1\u2010Ag\u2013negative red blood cell (RBC) units. One recipient of a high\u2010titer unit (7 \u00d7 10<jats:sup>7<\/jats:sup> DENV\u20104 RNA copies\/mL) developed severe dengue, and a second recipient had only fever recorded but had a negative sepsis work\u2010up. New fever attributable to DENV infection in a third recipient was confounded by fever potentially attributable to posttransfusion sepsis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>In our retrospective study, NS1\u2010Ag detected 20% of all RNA confirmed\u2010positive donations demonstrating limitations of NS1\u2010Ag ELISA for blood donation screening. We identified one recipient with a clinical syndrome compatible with severe dengue who had received an NS1\u2010Ag\u2013negative but RNA confirmed\u2010positive RBC unit. This investigation illustrates the difficulty in confirming transfusion transmission in dengue\u2010endemic areas among severely ill transfusion recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.13288","type":"journal-article","created":{"date-parts":[[2015,9,7]],"date-time":"2015-09-07T10:15:26Z","timestamp":1441620926000},"page":"215-222","source":"Crossref","is-referenced-by-count":41,"title":["Probable and possible transfusion\u2010transmitted dengue associated with NS1 antigen\u2013negative but RNA confirmed\u2010positive red blood cells"],"prefix":"10.1111","volume":"56","author":[{"given":"Desiree","family":"Matos","sequence":"first","affiliation":[{"name":"American Red Cross Blood Services Region and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay M.","family":"Tomashek","sequence":"additional","affiliation":[{"name":"Dengue Branch Centers for Disease Control and Prevention San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Perez\u2010Padilla","sequence":"additional","affiliation":[{"name":"Dengue Branch Centers for Disease Control and Prevention San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Mu\u00f1oz\u2010Jord\u00e1n","sequence":"additional","affiliation":[{"name":"Dengue Branch Centers for Disease Control and Prevention San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Hunsperger","sequence":"additional","affiliation":[{"name":"Dengue Branch Centers for Disease Control and Prevention San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalanthe","family":"Horiuchi","sequence":"additional","affiliation":[{"name":"Division of Vector\u2010Borne Disease Information Technology Support, Centers for Disease Control and Prevention Fort Collins, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Noyd","sequence":"additional","affiliation":[{"name":"Dengue Branch Centers for Disease Control and Prevention San Juan, Puerto Rico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Winton","sequence":"additional","affiliation":[{"name":"American Red Cross Scientific Support Office Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Foster","sequence":"additional","affiliation":[{"name":"American Red Cross Scientific Support Office Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Lanteri","sequence":"additional","affiliation":[{"name":"Blood Systems Research Institute San Francisco California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Linnen","sequence":"additional","affiliation":[{"name":"Hologic San Diego California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Stramer","sequence":"additional","affiliation":[{"name":"American Red Cross Scientific Support Office Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,9,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12060"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01771.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03566.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2008.01772.x"},{"key":"e_1_2_8_6_1","article-title":"Transfusion\u2010transmission of dengue virus and associated clinical symptomology during the 2012 epidemic in Brazil","author":"Sabino EC","year":"2015","journal-title":"J Infect Dis"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03729.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2011.03269.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01564-08"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002311"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.5.1823-1826.2000"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1386-6532(99)00059-1"},{"key":"e_1_2_8_13_1","unstructured":"Dengue: guidelines for diagnosis treatment prevention and control \u2010 new edition [Internet]. 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