Zika Virus Spreads Through Organ Transplantation

Zika virus spread has caused international concern and transplant professionals are now warned about an emerging risk via transplantation.

Zika virus is a mosquito-borne virus that originated in Uganda in 1947
The spread of the Zika virus in America will continue to rise due to the prevalence of the Aedes mosquito
It is associated with Microcephaly and Guillain Barre disease
Recent studies have shown that there could be a possible transmission through organ transplantation
Transplant recipients and transplant professionals need to be aware of the risks of Zika virus spread

Zika virus has emerged as one of the major diseases that affects unborn children. It is transmitted by the Aedes mosquito, which is present in most parts of the world. This mosquito is active during the day and spreads more severe forms of flu-like Chikungunya and dengue.

Zika virus results in microcephaly (abnormal smallness of the head), Guillain-Barre and blindness among fetuses, which has been a major cause of worry. The known modes of transmission apart from mosquito-borne spread is through blood donation and sexual transmission. However, it is currently believed that organ transplantation can also increase the risk of Zika.

Zika Virus
Zika virus is closely related to the dengue virus. It leads to mild flu like symptoms in affected individuals. Fetal effects have led to maximum concern globally.

‘Precautions taken by prospective donors during travel to Zika prone areas will limit risk of Zika virus spread during organ donation.’

Facts About Zika Symptoms and Severity

Zika fever results in mild flu-like symptoms and is not usually fatal
1 in 5 infected people displays symptoms
Asymptomatic people continue to be carriers
The incubation period lasts between 3 to 10 days
The virus remains in the blood for a maximum of 10 days

Solid Organ Transplantation and Zika Virus Risk

Theoretically, Zika virus can spread through organ transplantation as there is confirmed transmission through blood. Certain precautions should be carried out if a person acting as a donor travels to a Zika-epidemic area.

1) Potential Donor has Visited Zika-Epidemic Area but Shows No Symptoms

Top 10 Facts on Zika Virus
Zika virus spreads through the bite of Aedes aegypti mosquito. It causes fever and a birth defect known as microcephaly. Here are top ten facts of Zika virus.

Blood tests to confirm the presence of the virus should be carried out, especially if the transplantation surgery is planned within 28 days of the travel. There should be recorded statements of symptoms noticed and the places visited, along with any history of mosquito bites during travel. Organ donation may be carried out after detailed analysis.

2) Potential Donor Tests Positive for Zika Virus and are Asymptomatic

Zika Virus – A New Mosquito-Borne Disease in the West
Zika virus infection represents another arbovirus or mosquito-borne viral disease to affect the Americas. Currently, there is no cure for Zika virus disease.

Organ donation from an individual who is asymptomatic, but tests positive for the presence of Zika virus in the blood should be delayed by 6 months, at the least.

3) Potential Donor Infected with Zika Virus and Showing Symptoms

Zika Fever - Causes, Symptoms, Diagnosis, Treatment and Prevention
Zika virus is transmitted to humans by infected mosquitoes which causes mild fever with maculopapular rash. No treatment or vaccine is currently available.

Organ donation from an infected and symptomatic donor should be avoided unless exceptional cases demand it.

Blood Donation: An individual who wishes to donate blood after returning from a Zika prone area can do so after 28 days.

Guidelines for Organ Transplant Personnel

The effect of Zika virus infection among immunocompromised patients is unknown, therefore, being cautious would be ideal. The following considerations should be borne in mind when selecting donors for transplantation.

Check the history of travel to Zika prone areas.
Organ donors for pregnant women or women of childbearing age should be screened well for the presence of Zika as the disease is particularly harmful to unborn babies.
Weigh the positives and negatives of organ transplantation from Zika infected person.

Travel Precautions for Prospective Donors

If travel to Zika prone areas cannot be avoided by individuals before organ donation, certain travel precautions need to be followed diligently.

Wear clothes that cover the body entirely, like full-length pants and full-sleeve shirts.
Spray mosquito repellents on exposed areas of the skin, clothes and footwear.
Use mosquito nets while sleeping, especially for children, pregnant mothers and prospective organ donors.
A good quality hotel should be selected for accommodation where sincere efforts are taken to keep mosquitoes away.

The spread of Zika virus has resulted in a global scare, but following guidelines laid down will aid in controlling the spread.

References:

1. http://www.ncbi.nlm.nih.gov/pubmed/24421913

2. https://optn.transplant.hrsa.gov/news/guidance-for-organ-donation-and-transplantation-professionals-regarding-the-zika-virus/

3. http://organdonationalliance.org/education-corner-zika-virus-donation-transplantation/

4. http://www.odt.nhs.uk/pdf/Zika_virus_and_Transplantation_of_Solid_Organs_from_Deceased_Donors.pdf

5. http://www.cst-transplant.ca/_Library/_documents/2016_0202_CST_Info_Sheet_Zika.pdf?platform=hootsuite

6. http://www.cdc.gov/zika/pdfs/fs-mosquito-bite-prevention-travelers.pdf

7. http://www.cntrp.ca/#!Important-information-on-the-Zika-Virus-and-the-risks-for-donation-and-transplantation-from-the-CST/cbmd/56b2247b0cf2dc1600e0fe8b

Source-Medindia