{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:19:06Z","timestamp":1788347946543,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Despite West Nile virus (WNV) blood donation screening using nucleic acid testing (NAT), donors with low viral loads not detected by mini\u2010pool\u2010NAT have led to transfusion transmitted (TT)\u2010WNV infection. We describe a probable case of fatal TT\u2010WNV infection from an individual donor (ID)\u2010NAT non\u2010reactive apheresis platelet donation.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>An apheresis platelet donation was WNV ID\u2010NAT reactive and prior donations from the same donor were investigated. A WNV ID\u2010NAT non\u2010reactive apheresis platelet unit collected 26\u2009days earlier was transfused during heart transplantation to a patient who subsequently developed WNV neuroinvasive disease and expired. The source of the recipient's WNV infection was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Twenty\u2010six days after collection of the suspect platelet unit, a donation from the same donor was WNV ID\u2010NAT reactive and WNV IgM and IgG positive. In addition to the suspect platelet unit, the heart transplant recipient who developed WNV infection received 17 blood components from 24 donors. Serologic testing performed on 11 of the remaining 24 donors (46%) was WNV IgM negative. Pre\u2010transplant recipient and heart donor samples tested WNV RNA and IgM negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>A probable case of fatal neuroinvasive TT\u2010WNV was linked to an infectious apheresis platelet unit undetected by WNV ID\u2010NAT. It is hypothesized that the suspect unit was collected early in the viremic period when viral RNA was below the limit\u2010of\u2010detection of the ID\u2010NAT assay. Implementation of ID\u2010NAT screening of blood donors has not entirely eliminated the risk of TT\u2010WNV infections, which may best be addressed by pathogen inactivation technologies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15568","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T14:36:54Z","timestamp":1571668614000},"page":"424-429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Probable transfusion transmission of West Nile virus from an apheresis platelet that screened non\u2010reactive by individual donor\u2010nucleic acid testing"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9307-8795","authenticated-orcid":false,"given":"Chelsea","family":"Hayes","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Arizona College of Medicine  Tucson Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy L.","family":"Fridey","sequence":"additional","affiliation":[{"name":"American Red Cross Blood Services  Pomona California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Snyder","sequence":"additional","affiliation":[{"name":"California Department of Public Health  Sacramento California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamel A.","family":"Groves","sequence":"additional","affiliation":[{"name":"American Red Cross Scientific Affairs  Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5865-6366","authenticated-orcid":false,"given":"Susan L.","family":"Stramer","sequence":"additional","affiliation":[{"name":"American Red Cross Scientific Affairs  Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Klapper","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200106143442401"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1108.050289a"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/656602"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1108.050289b"},{"key":"e_1_2_7_6_1","unstructured":"West Nile virus disease cases and deaths reported to CDC by year and clinical presentation 1999\u20102017 [monograph on the internet]. 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Grifols Diagnostic Solutions Inc. Available from:https:\/\/www.mycts.org\/Portals\/0\/Assay_PI\/WholeBlood\/Procleix%20WNV_TIG.pdf"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1954.3.19"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.0030106"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00316-07"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21393"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/591467"},{"key":"e_1_2_7_23_1","unstructured":"Guidance for Industry: Assessing Donor Suitability and Blood and Blood Product Safety in Cases of Known or Suspected West Nile Virus Infection [monograph on the internet]. Food and Drug Administration; 2005. 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