Transmission of Eastern Equine Encephalitis Virus From an Organ Donor to 3 Transplant Recipients.

Autor:	Pouch SM; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia., Katugaha SB; Infectious Diseases Physicians, Inc, Inova Fairfax Hospital Heart and Vascular Institute, Falls Church, Virginia., Shieh WJ; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Annambhotla P; Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Walker WL; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado.; Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, CDC, Atlanta, Georgia., Basavaraju SV; Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Jones J; Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Huynh T; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Reagan-Steiner S; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Bhatnagar J; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Grimm K; American Red Cross, Gaithersburg, Maryland, Emory University School of Medicine, Atlanta, Georgia., Stramer SL; American Red Cross, Gaithersburg, Maryland, Emory University School of Medicine, Atlanta, Georgia., Gabel J; Georgia Department of Public Health, Emory University School of Medicine, Atlanta, Georgia., Lyon GM; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia., Mehta AK; Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia., Kandiah P; Department of Neurology and Neurosurgery, Emory University School of Medicine, Atlanta, Georgia., Neujahr DC; Division of Pulmonary Allergy and Critical Care Medicine, Emory University School of Medicine, Atlanta, Georgia., Javidfar J; Department of Surgery, Emory University School of Medicine, Atlanta, Georgia., Subramanian RM; Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia., Parekh SM; Division of Digestive Diseases, Emory University School of Medicine, Atlanta, Georgia., Shah P; Department of Heart Failure and Transplantation, Inova Fairfax Hospital Heart and Vascular Institute, Falls Church, Virginia., Cooper L; Department of Heart Failure and Transplantation, Inova Fairfax Hospital Heart and Vascular Institute, Falls Church, Virginia., Psotka MA; Department of Heart Failure and Transplantation, Inova Fairfax Hospital Heart and Vascular Institute, Falls Church, Virginia., Radcliffe R; Division of Acute Disease Epidemiology, South Carolina Department of Health and Environmental Control, Columbia., Williams C; North Carolina Division of Public Health, Raleigh., Zaki SR; Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia., Staples JE; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Fischer M; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Panella AJ; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Lanciotti RS; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Laven JJ; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Kosoy O; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Rabe IB; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado., Gould CV; Division of Vector-Borne Diseases, NCEZID, CDC, Fort Collins, Colorado.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2019 Jul 18; Vol. 69 (3), pp. 450-458.
DOI:	10.1093/cid/ciy923
Abstrakt:	Background: In fall 2017, 3 solid organ transplant (SOT) recipients from a common donor developed encephalitis within 1 week of transplantation, prompting suspicion of transplant-transmitted infection. Eastern equine encephalitis virus (EEEV) infection was identified during testing of endomyocardial tissue from the heart recipient. Methods: We reviewed medical records of the organ donor and transplant recipients and tested serum, whole blood, cerebrospinal fluid, and tissue from the donor and recipients for evidence of EEEV infection by multiple assays. We investigated blood transfusion as a possible source of organ donor infection by testing remaining components and serum specimens from blood donors. We reviewed data from the pretransplant organ donor evaluation and local EEEV surveillance. Results: We found laboratory evidence of recent EEEV infection in all organ recipients and the common donor. Serum collected from the organ donor upon hospital admission tested negative, but subsequent samples obtained prior to organ recovery were positive for EEEV RNA. There was no evidence of EEEV infection among donors of the 8 blood products transfused into the organ donor or in products derived from these donations. Veterinary and mosquito surveillance showed recent EEEV activity in counties nearby the organ donor's county of residence. Neuroinvasive EEEV infection directly contributed to the death of 1 organ recipient and likely contributed to death in another. Conclusions: Our investigation demonstrated EEEV transmission through SOT. Mosquito-borne transmission of EEEV to the organ donor was the likely source of infection. Clinicians should be aware of EEEV as a cause of transplant-associated encephalitis. (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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