{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:08:54Z","timestamp":1790878134038,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T00:00:00Z","timestamp":1576108800000},"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":[[2020,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Rare transfusion\u2010transmitted West Nile virus (WNV) cases usually occur due to gaps in testing involving converting to more sensitive nucleic acid testing (NAT) formats (referred to as triggering). Using data from 2014 to 2018, we investigated a strategy used to increase detection early in the triggering period and reviewed its yield as the individual donation (ID)\u2010NAT geographic area was decreased.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Mini\u2010pool\u2013NAT transitioned to ID\u2010NAT following triggering based on one WNV NAT\u2013reactive donation (having an elevated signal, repeat reactive, or in an area with WNV ongoing activity). ID\u2010NAT\u2013triggered geographic areas included an entire state (2014\u20102017) or collections within a 50\u2010mile radius of the triggering donor's residential zip code (2018). During the MP\u2010 to ID\u2010NAT transition, donation samples were retrieved and tested by ID\u2010NAT for those with results not yet released (referred to as in\u2010process testing). Reactive sample confirmation was performed by repeat NAT of an independent sample or antibody testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>ID\u2010NAT included 3.2 million donations of more than 25 million tested year\u2010round, resulting in 684 confirmed positives; all confirmed\u2010positive donations occurred from June to December (0.64\/10,000). Overall, 52% (358\/684) required ID\u2010NAT for detection, including 68 (19%) antibody negatives. Ten of 19 (53%) identified in\u2010process were ID\u2010NAT\u2013only detectable, including four antibody negatives, or approximately 1 per year (2.8% of ID\u2010NAT\u2013only detectable). With reduced triggering geography, 12 of 19 (63%) were not identified (including 6\/10 ID\u2010NAT\u2013only detectable, and 2\/4 ID\u2010NAT\u2013only detectable\/antibody negative).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>WNV NAT's utility is between June\u2013December; however, abandoning testing outside of this time may increase risk. While in\u2010process testing identified approximately one ID\u2010NAT\u2013only detectable (antibody\u2010negative) donation per year, reducing the geographic triggered area decreased its effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15620","type":"journal-article","created":{"date-parts":[[2019,12,12]],"date-time":"2019-12-12T11:06:22Z","timestamp":1576148782000},"page":"94-105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["West Nile virus activity in United States blood donors and optimizing detection strategies: 2014\u20102018"],"prefix":"10.1111","volume":"60","author":[{"given":"Jamel A.","family":"Groves","sequence":"first","affiliation":[{"name":"American Red Cross, Scientific Affairs  Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Foster","sequence":"additional","affiliation":[{"name":"American Red Cross, Scientific Affairs  Gaithersburg Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger Y.","family":"Dodd","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"}]}],"member":"311","published-online":{"date-parts":[[2019,12,12]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"845","article-title":"Outbreak of West Nile\u2013like viral encephalitis\u2013New York, 1999","volume":"48","author":"Centers for Disease Control and Prevention (CDC)","year":"1999","journal-title":"MMWR. Morb Mortal Wkly Rep"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/521911"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2302.161058"},{"key":"e_1_2_7_5_1","first-page":"1","article-title":"Surveillance for human West Nile virus disease\u2014United States, 1999\u20132008","volume":"59","author":"Lindsey NP","year":"2010","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6831a1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2015.03.001"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6602a3"},{"key":"e_1_2_7_9_1","first-page":"916","article-title":"Update: detection of West Nile virus in blood donations\u2013United States, 2003","volume":"52","author":"Centers for Disease Control and Prevention (CDC)","year":"2003","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_10_1","unstructured":"US Food and Drug Administration. Use of nucleic acid tests to reduce the risk of transmission of West Nile virus from donors of whole blood and blood components intended for transfusion. 2009 [cited 2019 September 05]. Available from:https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/use-nucleic-acid-tests-reduce-risk-transmission-west-nile-virus-donors-whole-blood-and-blood."},{"key":"e_1_2_7_11_1","unstructured":"ConnorJ LiptonK. Association Bulletin #08\u201003 West Nile Virus\u2014revised recommendations for triggering individual donation nucleic acid testing and use of communication plans. AABB; 2008 [cited 2019 June 9]. Available from:http:\/\/www.aabb.org\/programs\/publications\/bulletins\/DocsObsolete\/AB%2008-03%20OBSOLETE.pdf#search=Association%20Bulletin%202008%2E."},{"key":"e_1_2_7_12_1","unstructured":"StramerS MarkowitzM. Association Bulletin# 13\u201002\u2013West Ng\u2013revised recommendations. AABB; 2013 [cited 2019 June 9]. Available from:http:\/\/www.aabb.org\/programs\/publications\/bulletins\/Pages\/ab13-02.aspx."},{"key":"e_1_2_7_13_1","first-page":"30A","article-title":"Evaluation of the yield of triggering and detriggering criteria for West Nile virus (WNV) NAT","volume":"49","author":"Stramer S","year":"2009","journal-title":"Transfusion"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/656602"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.20930"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15022"},{"key":"e_1_2_7_17_1","unstructured":"Centers for Disease Control and Prevention (CDC). ArboNET Database: West Nile virus statistics and maps [cited 2019 Oct 8]. 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