Two people in southeastern Brazil contracted the Zika virus through blood transfusions, a municipal health official said on Thursday, presenting a fresh challenge to efforts to contain the virus on top of the disclosure of a case of sexual transmission in the US.
The two unrelated cases in Brazil might be the first of people contracting Zika via blood transfusions in the current outbreak, though the US Centers for Disease Control and Prevention, along with other health bodies, have said that Zika could be spread via blood transfusions.
That concern led the US Red Cross to announce that it is asking travelers to Zika outbreak nations to wait at least 28 days before donating blood. Canadian officials said that people who have traveled outside of Canada, the continental US and Europe would not be able to give blood for 21 days after their return.
Brigina Kemp, a top health official in the Brazilian city of Campinas, said that a gunshot victim and a transplant patient each tested positive for Zika after receiving blood transfusions from different donors.
Kemp said staff at the University of Campinas’ hospital first noticed something was wrong in the middle of last year, when Brazil’s first cases of Zika were beginning to be reported. Generally so mild that it only causes symptoms in about one out of five cases, Zika began to raise alarm bells after doctors here started to notice a possible link between the virus — spread by the Aedes aegypti mosquito — and the birth defect microcephaly.
The hospital staff noticed abnormal blood work on a young gunshot wound victim who had spent months at the facility. The patient received dozens of blood transfusions from 18 donors between February and May last year, when he died.
Because the region was in the throes of a dengue outbreak at the time, the staff suspected that disease, which is closely related to Zika, and tested him for it, Kemp said. However, the tests came back negative and the blood sample was shelved, but when an organ transplant patient tested positive for Zika after developing a fever, the hospital’s blood bank staff started looking for other possible Zika cases and tests on the gunshot victim’s blood samples came back positive.
Transfusions in the two cases were traced to separate donors who had Zika, both of whom reported having suffered symptoms days after they gave blood.
The blood bank then informed Sao Paulo’s Adolfo Lutz Institute, which also tested the samples and informed Campinas’ health department of the results last month.
The Brazilian Ministry of Health said in an e-mail that while the case of the gunshot victim was not yet part of a scientific study, “the case is among multiple investigations under way into the behavior of the virus.”
Brazilian Association of Hematology and Hemotherapy president Dante Langhi said that an academic paper about the transplant case was slated to be published shortly in a specialized medical journal.
Langhi said he had been told that researchers investigating the transplant case had determined that the patient contracted Zika through the transfusion and not through a bite by the Aedes mosquito that is the virus’ main vector.
“The situation must be evaluated and discussed by technical and government authorities,” Langhi said.
The Zika virus was first identified in Uganda in 1947 and subsequently spread to parts of Asia. Brazil’s first case was recorded in the middle of last year and the disease quickly spread across nation and to more than 20 nations in the region, the Caribbean and beyond, leading the WHO this week to declare an international emergency.
Meanwhile, the South Pacific island nation of Tonga has declared an outbreak of the Zika virus after five cases of the mosquito-borne illness were confirmed and another 259 suspected, the nation’s chief medical officer said yesterday.
Chief Medical Officer Reynold Ofanoa said that officials became suspicious after a sharp rise in the number of patients suffering acute fever and rashes since the beginning of the year.
“We were suspecting a probable outbreak of either Zika, dengue or chikungunya,” he said, referring to two other mosquito-borne viruses. “So we sent the blood specimens for testing overseas and when we obtained the results it showed that we’ve got confirmed positive blood tests for Zika.”
The tropical archipelago had never previously had any confirmed cases of the Zika virus, Ofanoa said, so it was likely brought into the nation by an infected person and then spread by mosquitoes.
“I think this is the first time it happened in Tonga, so surely the disease came from overseas,” Ofanoa said.
There were no immediate plans to introduce travel restrictions into or out of the nation, he said.
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