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Previous Volume 348:2196-2203 May 29, 2003 Number 22 Next

	Full Text PDF PDA Full Text Perspective by Morse, D. L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background In August 2002, fever and mental-status changes developed in recipients of organs from a common donor. Transmission of West Nile virus through organ transplantation was suspected.

Methods We reviewed medical records, conducted interviews, and collected blood and tissue samples for testing with a variety of assays. Persons who donated blood to the organ donor and associated blood components were identified and tested for West Nile virus.

Results We identified West Nile virus infection in the organ donor and in all four organ recipients. Encephalitis developed in three of the organ recipients, and febrile illness developed in one. Three recipients became seropositive for West Nile virus IgM antibody; the fourth recipient had brain tissue that was positive for West Nile virus by isolation and nucleic acid and antigen assays. Serum specimens obtained from the organ donor before and immediately after blood transfusions showed no evidence of West Nile virus; however, serum and plasma samples obtained at the time of organ recovery were positive on viral nucleic acid testing and viral culture. The organ donor had received blood transfusions from 63 donors. A review of blood donors and follow-up testing identified one donor who had viremia at the time of donation and who became seropositive for West Nile virus IgM antibodies during the next two months.

Conclusions Our investigation of this cluster documents the transmission of West Nile virus by organ transplantation. Organ recipients receiving immunosuppressive drugs may be at high risk for severe disease after West Nile virus infection. Blood transfusion was the probable source of the West Nile virus viremia in the organ donor.

Source Information

From the Epidemic Intelligence Service (M.I.), Division of Applied Public Health Training (A.G.W.), Epidemiology Program Office, and the Divisions of Healthcare Quality Promotion (D.B.J.), Viral and Rickettsial Diseases (S.Z., M.E.C.), and Vector-Borne Infectious Diseases (R.S.L., A.A.M., L.R.P.), National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta and Fort Collins, Colo.; Emory University School of Medicine, Atlanta (A.G., C.A.D., C.A.P.); the Florida Department of Health, Tallahassee (M.J.T., C.G.B., S.W.); the Mayo Clinic, Jacksonville, Fla. (W.C.H.); the University of Miami, Miami (S.M.P.); the Georgia Department of Human Resources, Division of Public Health, Atlanta (M.I., S.E.L.-P.); American Red Cross Blood Services, Southern Region, Atlanta (K.L.H.); and the Food and Drug Administration, Rockville, Md. (J.L.G.).

Address reprint requests to Dr. Iwamoto at the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A35, Atlanta, GA 30333.

Full Text of this Article

Related Letters:

West Nile Virus
Katz L. M., Bianco C., Morse D. L.
Extract | Full Text | PDF  
N Engl J Med 2003; 349:1873-1874, Nov 6, 2003. Correspondence

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