Transfusion-Transmitted Dengue and Associated Clinical Symptoms During the 2012 Epidemic in Brazil

J Infect Dis. 2016 Mar 1;213(5):694-702. doi: 10.1093/infdis/jiv326. Epub 2015 Jun 8.


Background: A linked donor-recipient study was conducted during epidemics in 2 cities in Brazil to investigate transfusion-transmitted (TT) dengue virus (DENV) by DENV RNA-positive donations.

Methods: During February-June 2012, samples were collected from donors and recipients and retrospectively tested for DENV RNA by transcription-mediated amplification. Recipient chart review, using a case (DENV positive)-control (DENV negative and not known to be exposed) design, was conducted to assess symptoms.

Results: Of 39 134 recruited blood donors, DENV-4 viremia was confirmed in 0.51% of donations from subjects in Rio de Janeiro and 0.80% of subjects in Recife. Overall, 42 DENV RNA-positive units were transfused into 35 recipients. Of these, 16 RNA-positive units transfused into 16 susceptible recipients were identified as informative: 5 cases were considered probable TT cases, 1 possible TT case, and 10 nontransmissions. The TT rate was 37.5% (95% confidence interval [CI], 15.2%-64.6%), significantly higher than the viremia rate of 0.93% (95% CI, .11%-3.34%) in nonexposed recipients (P < .0001). Chart review did not find significant differences between cases and controls in symptoms or mortality.

Conclusions: During a large epidemic of DENV-4 infection in Brazil, >0.5% of donations were RNA positive, and approximately one third of components resulted in TT. However, no significant clinical differences were evident between RNA-positive and RNA-negative recipients.

Keywords: NAT; clinical symptoms; dengue; transfusion-transmission.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Donors
  • Brazil / epidemiology
  • Dengue / epidemiology*
  • Dengue / transmission*
  • Dengue Virus / isolation & purification*
  • Epidemics*
  • Humans
  • RNA, Viral / blood
  • RNA, Viral / isolation & purification
  • Transfusion Reaction*


  • RNA, Viral