Brazil Identifies Two Cases of Zika Transmitted by Blood Transfusions Provincial health authorities say two people found to have been infected with mosquito-borne virus when they got transfusions in early 2015 By Reed Johnson and Luciana Magalhaes
http://www.wsj.com/articles/brazil-identifies-two-cases-of-zika-transmitted-by-blood-transfusions-1454544342
Both cases were reported by health officials in Campinas, a wealthy industrial city of about one million people an hour northwest of São Paulo, the country’s largest city.
A number of countries are tightening their rules on blood donations in response to the global Zika outbreak.
The American Red Cross said on Wednesday it is asking potential blood donors who have been in Mexico, the Caribbean or Central or South America to wait at least 28 days after their trip before donating.
Cármino Antonio de Souza, health secretary of Campinas, said on Wednesday that both transfusions occurred during the first four months of 2015, but the presence of Zika in the two transfusion recipients wasn’t confirmed until recently, in part because they were initially suspected of being infected with dengue, another mosquito-borne virus.
The first case involved a liver-transplant recipient who contracted Zika through blood donated in March 2015. The second was a gunshot victim who tested positive for Zika after receiving multiple blood transfusions; he later died of his wounds, not the Zika virus, Campinas health officials said.
In an email, Brazil’s federal Health Ministry stopped short of confirming the findings, but said it was investigating the two cases, the first reported in Brazil of Zika transmission through blood transfusions.
“The capacity of Zika to spread through blood transfusions needs to be evaluated, as well as the blood protection measures that should be adopted based on the new findings,” the ministry said.
A number of countries are tightening their rules on blood donations in response to the global Zika outbreak.
The American Red Cross said any donors who develop Zika symptoms within two weeks of giving blood should inform the Red Cross immediately so the donation can be quarantined.
“The concern is due to the large number of Zika virus infections outside the continental U.S., the possibility of a potential U.S. blood donor acquiring Zika infection while traveling to a Zika affected area, the potential severe outcomes of this infection, and the potential for transmission by transfusion,” said Magda Yang, a spokeswoman for Bethesda, Md.-based AABB, which develops safety standards for transfusions.
The Red Cross said it accepts blood donations only from healthy donors who are feeling good, adding that the lack of local mosquito transmission of the disease in the continental U.S. makes the risk of getting Zika from a transfusion “extremely low.”
Britain’s National Health Service and the Hong Kong Red Cross Blood Transfusion Service have implemented waiting periods for blood donors who have traveled to areas where Zika is prevalent. Canada has also implemented geographic restrictions.
An estimated 500,000 to 1.5 million Brazilians have been infected with the Zika virus, more than in any other country.
About one in five people infected with the virus develops symptoms, most commonly fever, rash, joint pain and conjunctivitis, or redness in the eyes. Other symptoms are muscle pain and headache. Only in rare cases does the disease cause serious neurological damage.
But many international medical authorities suspect Zika is linked to a surge in cases of infant microcephaly, a condition in which babies are born with undersized skulls and brains. On Monday, the World Health Organization declared Zika a global health emergency, citing its suspected connection to microcephaly and other neurological disorders.
The two Brazilian cases aren’t the first recorded instances of Zika being found in donated blood. Researchers in French Polynesia, where a Zika outbreak took place a few years ago, recorded multiple incidents of such cases in which donors were subsequently identified as positive for the Zika virus.
Marcelo Addas Carvalho, a director at the hematology center at the University of Campinas, said that while investigating Zika transmission through blood transfusion is important, the virus is far more likely to spread through mosquito bites. “Government and society actions need to focus on controlling the mosquito,” he said.
Peter Hotez, a tropical disease expert at Baylor College of Medicine in Houston, also said bites are the greatest threat in spreading Zika, but that it was important to protect the blood supply.
“This virus is rapidly marching through Brazil,” Dr. Hotez said. “We are going to need to have testing done. That is going to be a big issue.”
The new development in Brazil occurred barely a day after the Dallas County Health and Human Services Department reported that a person had been infected with the Zika virus after having sex with someone who had visited Venezuela, one of more than 20 countries in the Americas where the virus has been found.
Carlos Fortaleza, an infectious disease specialist at São Paulo state university, UNESP, said the reported blood-transfusion cases of Zika infection were a cause for precaution. He said the national Health Ministry should reinforce its processes for screening blood donors, “but there is no reason for panic.”
“We don’t even know how likely a Zika infection from a blood transfusion is, because we’d have to have a whole universe of research,” Mr. Fortaleza said.
—Rogerio Jelmayer, Kat Long and Jeffrey T. Lewis contributed to this article.
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