Intended for healthcare professionals


Organ transplants and blood transfusions may transmit West Nile virus

BMJ 2002; 325 doi: (Published 14 September 2002) Cite this as: BMJ 2002;325:566
  1. Fred Charatan
  1. Florida

    Four US recipients of organs from one donor have become infected with West Nile virus.

    Three of the transplant recipients, resident in Florida and Georgia, developed encephalitis. One has died, and the other two are recovering in hospital.

    The fourth, a Florida woman aged 71, underwent a liver transplantation at a Jacksonville hospital then developed mild symptoms of viral infection without encephalitis. She tested positive for the virus at the Florida Department of Health laboratory and is now recovering at home.

    The donor, who died in Georgia on 1 August, was injured in a car crash and had several blood transfusions before she died. She was not known to have been ill before the crash, and a sample of her blood taken before she had any transfusions showed no evidence of West Nile virus.

    Dr Julie Geberding, director of the Centers for Disease Control and Prevention (CDC) in Atlanta said on 30 August that “transmission of the West Nile virus through blood and organs is biologically plausible.”

    The CDC does not know whether the source of infection was mosquito bites or blood transfusions and is conducting further tests. It is also investigating a case diagnosed in a Mississippi resident nearly four weeks after the patient underwent a surgical procedure and received several units of blood.

    The patient reported having been bitten by mosquitoes on numerous occasions before being admitted to hospital. Donors of blood given to this patient are being contacted so they can be tested for the virus. Similarly, other recipients of blood components from these donors will also be contacted and tested.

    The West Nile virus has been spreading widely in the United States (31 August, p 460) since it was first reported in 1999(BMJ 1999;319:941). To date the CDC has reported 854 cases in people from 28 states, the District of Columbia, and New York city. Forty three people have died.

    Dr Lyle Petersen, deputy director of the Division of Vector-borne Infectious Diseases at the CDC, said at a press conference on 5 September: “There is a massive increase in West Nile virus activity this year compared to previous years, over a wider geographic area … It is not simply due to a reporting artefact.”

    But he added: “The medical need of getting blood or the medical benefit of getting blood or organs far outweighs any potential risk of getting [West Nile virus] transmission from blood or organs.”

    Embedded Image

    A Mississippi department of health employee holds one of the Culex mosquito species which has been identified as the primary carrier of West Nile virus in southern states


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