Tropical Viruses

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Definition

Dengue Virus

Chikungunya Virus

Zika Virus

Acceptability at Recruitment

QUALIFIED - see below

Acceptability at CT / Work-Up

QUALIFIED - see below

Individual at Risk

Recipient

Explanation of Condition

Chikungunya Virus

Chikungunya is an alpha virus that can cause a wide spectrum of disease. This may range from no or minimal symptoms to death. Most commonly it causes arthritis (typically in the knee, ankle and small joints of the extremities), high fever and a maculopapular rash. It is geographically widespread but since 2005 it has reached epidemic proportions in parts of India and islands in the Indian Ocean. It is known to be spread by blood in symptomatic cases and on theoretical grounds could be spread by transfusion and transplantation of tissues and organs from people with pre-symptomatic or asymptomatic disease. A number of visitors returning from endemic areas to the UK have been diagnosed with this infection.

Dengue Virus

Dengue Virus is a flavivirus that typically gives rise to abrupt high fever with a range of accompanying symptoms. Dengue fever (DF) is the most common arthropod borne disease worldwide. Dengue is currently considered endemic in approximately 128 countries. Overall, 15-90% of cases may have an asymptomatic course of infection, but clinical presentation varies with age group. However there is a risk of change in disease presentation and potential for increased incidence of more severe disease in older age groups due to cocirculation of different dengue types and emergence of new types in endemic areas patterns.

Zika virus

Zika virus is a flavivirus that is transmitted to humans through the bite of a carrier mosquito. Zika infection is a rapid acute infection that in the majority of cases is asymptomatic or has very mild general symptoms. A small number of cases may have more apparent symptoms but hospitalisation is rare. Zika infection may be mistaken for Chikungunya or Dengue infections as the virus often co-circulate.

Guidance

See www.transfusionguidelines.org for up-to-date guidance

The following applies to all tropical viruses

RECRUITMENT

ACCEPT - if more than 4 weeks from a donor's return from a Tropical Virus Risk area, and the donor has had neither symptoms nor evidence of infection

DEFER - for 6 months IF it is less than six months from a donor's return from a Tropical Virus endemic area and the donor has been diagnosed or has a history of symptoms suggestive of infection whilst there or following their return to the UK.


VT/WORK-UP

ACCEPTABLE - May donate if more than 4 weeks from a donor's return from a Tropical Virus Risk area, and the donor has had neither symptoms nor evidence of infection

DEFER - If it is less than six months from a donor's return from a Tropical Virus Risk endemic area and the donor has been diagnosed or has a history of symptoms suggestive of a tropical virus infection whilst there or following their return to the UK. This period may be shortened at the discretion of the transplant centre following discussion.

Where NAT testing is available this can be undertaken in discussion with MO and TC if it is i) less than 4 weeks from a donor's return from a tropical virus endemic area ii) less than 6 months from a donors return and they have a history of symptoms suggestive of a tropical virus.

Version

Version 1.0

9 June 2016