JPAC Joint United Kingdom (UK) Blood Transfusion and Tissue Transplantation Services Professional Advisory Committee

Tropical Viruses

Definition

To include Dengue Virus, Dengue Fever and Chikungunya Virus, also known as CHIKV, Zika Virus and Zika Virus Fever.

Tropical Virus Endemic Areas: are shown in the 'Geographical Disease Risk Index' (GDRI) as a Tropical Virus Risk.

 

Obligatory

Must not donate if:
a) It is less than six months from a donor's return from a Tropical Virus Risk endemic area and the donor has been diagnosed with chikungunya. dengue or zika virus infection whilst there or following their return to the UK.

b) It is less than six months from a donor's return from a Tropical Virus Risk endemic area and the donor has either had a history of symptoms suggestive of chikungunya, dengue or zika virus infection whilst there or following their return to the UK.

c) In other cases it is less than four weeks from a donor's return from a Tropical Virus Risk endemic area.

d) The donor has had sex in the last 28 days with someone who has had a confirmed Zika Virus infection in the 6 months preceding the sexual contact.

Discretionary

All donors may be accepted six months after their return from an affected area or resolution of symptoms. This may be reduced to four weeks, if they have had neither symptoms nor evidence of infection.


 

See if Relevant

Infection - General
Malaria
South American Trypanosomiasis
The 'Geographical Disease Risk Index'

Additional Information

Chikungunya is an alpha virus that can cause a wide spectrum of disease. This may range from no or minimal symptoms to death. Most commonly it causes arthritis (typically in the knee, ankle and small joints of the extremities), high fever and a maculopapular rash.

It is geographically widespread but since 2005 it has reached epidemic proportions in parts of India and islands in the Indian Ocean. It is known to be spread by blood in symptomatic cases and on theoretical grounds could be spread by transfusion and transplantation of tissues and organs from people with pre-symptomatic or asymptomatic disease. A number of visitors returning from endemic areas to the UK have been diagnosed with this infection.

Dengue Virus is a flavivirus that typically gives rise to abrupt high fever with a range of accompanying symptoms. Dengue fever (DF) is the most common arthropod borne disease worldwide.  Dengue is currently considered endemic in approximately 128 countries.

Overall, 15-90% of cases may have an asymptomatic course of infection, but clinical presentation varies with age group. However there is a risk of change in disease presentation and potential for increased incidence of more severe disease in older age groups due to co-circulation of different dengue types and emergence of new types in endemic areas patterns.

Zika virus is a flavivirus that is transmitted to humans through the bite of a carrier mosquito. Zika Virus can also be transmitted human to human through sexual contact.  Zika infection is a rapid acute infection that in the majority of cases is asymptomatic or has very mild general symptoms. A small number of cases may have more apparent symptoms but hospitalisation is rare. Zika infection may be mistaken for Chikungunya or Dengue infections as the virus often co-circulate.

The main vector for chikungunya virus, dengue virus and zika virus is Aedes aegypti (Aedes albopictus is another emerging vector), which is found worldwide between latitudes 35ºN and 35ºS. There is no epidemiologically important animal reservoir for Chikungunya, Dengue or Zika viruses.  The main areas affected by all 3 viruses include the Caribbean, South and Central America, Mexico, Africa, the Pacific Islands, SE Asia, Indian sub-continent, Hawaii. Additionally Dengue fever has been reported in Japan and Australia.

As the problem can vary both in relation to geography and time of the year it is not possible to state areas from which donors need to be deferred or dates of disease activity. These are provided in the Geographical Disease Risk Index.

Position statements are available in the JPAC Document Library.

 

Information

This entry is compliant with the Blood Safety and Quality Regulations 2005.

 

Reason for change

Information about Zika virus transmission has been updated and deferral of donors with a history of sexual contact with someone known to have had a confirmed Zika virus infection in the 6 months prior to the sexual contact has been added.

Update Information

This entry was last updated in:
DSG-WB Edition 203, Release 34