West Nile and Usutu Virus Infections and Challenges to Blood Safety in the European Union

Emerg Infect Dis. 2019 Jun;25(6):1050-1057. doi: 10.3201/eid2506.181755.


West Nile virus (WNV) and Usutu virus (USUV) circulate in several European Union (EU) countries. The risk of transfusion-transmitted West Nile virus (TT-WNV) has been recognized, and preventive blood safety measures have been implemented. We summarized the applied interventions in the EU countries and assessed the safety of the blood supply by compiling data on WNV positivity among blood donors and on reported TT-WNV cases. The paucity of reported TT-WNV infections and the screening results suggest that blood safety interventions are effective. However, limited circulation of WNV in the EU and presumed underrecognition or underreporting of TT-WNV cases contribute to the present situation. Because of cross-reactivity between genetically related flaviviruses in the automated nucleic acid test systems, USUV-positive blood donations are found during routine WNV screening. The clinical relevance of USUV infection in humans and the risk of USUV to blood safety are unknown.

Keywords: European Union; Usutu virus; West Nile virus; blood safety; measures; surveillance systems; viruses.

MeSH terms

  • Blood Donors*
  • Blood Safety*
  • Blood Transfusion
  • Communicable Diseases, Emerging / epidemiology
  • Europe / epidemiology
  • European Union*
  • Flavivirus Infections / epidemiology*
  • Flavivirus Infections / prevention & control
  • Flavivirus Infections / transmission
  • Flavivirus Infections / virology
  • Flavivirus*
  • Humans
  • Incidence
  • Public Health Surveillance
  • West Nile Fever / epidemiology*
  • West Nile Fever / prevention & control
  • West Nile Fever / transmission
  • West Nile Fever / virology
  • West Nile virus*

Supplementary concepts

  • Usutu virus