Transfusion medicine

• Zika virus (ZIKV) is a mosquito borne virus that is transmissible via blood transfusion (U.S. Food and Drug Administration: Information for Blood Establishments Regarding FDA’s Determination that Zika Virus is no Longer a Relevant Transfusion-Transmitted Infection [Accessed 12 August 2021])
• Although most patients are asymptomatic, the disease causes severe fetal malformations (microcephaly)
• Testing and deferral periods are required by the Food and Drug Administration

Postinfectious disease screening is positive for a 42 year old male blood donor who donated 2 days ago. The testing is positive for Zika virus by individual donor nucleic acid testing. You call the donor to inform him that he is now deferred. Because the donor is male, it is important to inform him of which of the following?

1. Zika virus can be sexually transmitted for 6 months in semen
2. Zika virus can be transmitted through urine, so he should not use a public restroom for 10 days
3. Zika virus is latent and he will never clear the infection
4. Zika virus is not contagious outside of blood transfusion and mosquito bites

A. Zika virus is sexually transmitted and can cause fetal malformations in pregnancy. It is detectable in semen for 6 months.

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Reference: Zika virus

You receive a letter from your blood provider, stating that a donor who last donated 8 weeks ago returned and the donor is now positive for Zika virus by individual donor nucleic acid testing. The donor was negative at the time of the transfusion. The blood donor is asymptomatic. A review of records reveals this unit was transfused to a 22 year old female postdelivery of a full term male infant. When you call the recipient to inform her of the exposure, she asks you what main risk of the disease is. You tell her

1. She is at an increased risk of developing Guillain-Barré disease
2. She may have a flu-like illness with fever, conjunctivitis, rash and headache
3. There is no risk to her since the donor was negative for Zika at the time of donation
4. This virus causes birth defects, so she should avoid pregnancy for at least 8 weeks
5. This virus is transmissible through breast milk, so she should talk to her pediatrician

E. This virus is transmissible through breast milk, so she should talk to her pediatrician. The mother already delivered at the time of transfusion, so it should not have been transmitted to her infant perinatally. It is transmissible through breast milk, though in general, the benefits of breastfeeding are thought to outweigh the risk of Zika transmission in an otherwise healthy infant. She should discuss this with her pediatrician.

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Reference: Zika virus