Arboviral Threats: Safeguarding Blood Supply in an Evolving Global Landscape

The realm of transfusion medicine is ever-evolving, facing new challenges with each passing year. Among the most pressing concerns are the arboviral diseases. Arboviruses, like Dengue, Chikungunya, Usutu, West Nile virus, and Zika virus, not only pose a significant public health risk but also have the potential to compromise the safety and sufficiency of the blood supply. As blood banks strive to maintain the highest standards of care, they must remain vigilant and adapt to the dynamic landscape of emerging and re-emerging arboviral threats. 

Geographic Spread and Transmission

Arboviruses exhibit distinct geographical distributions, primarily concentrated in tropical and subtropical regions. However, their reach is not limited by borders, as globalization and climate change facilitate the spread of these pathogens to previously unaffected areas. 

A common characteristic among arboviral diseases is the potential for asymptomatic infections, which complicates diagnosis and control. Diagnosis of arboviral infections relies on serological and molecular assays, which can be complex and subject to cross-reactivity. While vaccines exist for certain arboviruses, such as dengue, their use remains controversial due to potential risks and limitations. In the absence of effective therapeutic interventions, prevention through vector control and personal protective measures becomes paramount. 

Impact on Blood Safety

Emerging arboviruses, such as Usutu and Chikungunya, are being detected more frequently in blood donors. While not every detected infection results in transmission through transfusion, the occurrence of arbovirus transmission via blood transfusion is well-established. West Nile virus, in particular, has the most documented cases and severe clinical outcomes. 

Blood banks face a delicate balance between ensuring blood safety and maintaining an adequate supply. When confronted with the risk of arboviral contamination, they must weigh the options of donor deferral or implementing screening measures. 

Deferring donors with a history of travel to endemic areas or potential exposure can effectively mitigate the risk of contamination. However, this approach may lead to a significant loss of donors, particularly first-time donors who are less likely to return after deferral. 

Addressing Challenges

In response to the multifaceted nature of the arboviral threat, the development of multiplex assays capable of detecting multiple arboviruses simultaneously has gained traction. By combining the detection of multiple arboviruses in a single test, multiplex assays offer a streamlined and cost-effective approach to blood screening. 

Conclusion

The threat posed by arboviruses to blood safety and sufficiency is a multifaceted challenge that demands a comprehensive and proactive approach. As these pathogens continue to emerge and re-emerge, blood banks must remain vigilant, adapting their strategies to the ever-changing landscape.