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

Tropical Viruses

Definition

Tropical Virus endemic areas are shown in the Geographical Disease Risk Index (GDRI) as a Tropical Virus Risk.

Obligatory

Must not donate if:
a) A mother has been diagnosed with Chikungunya, Dengue, Yellow Fever or Zika virus infection whilst in an endemic area or following her return to the UK during this pregnancy.

b) A mother has either had a history of symptoms suggestive of Chikungunya, Dengue, Yellow Fever or zika virus infection whilst in an endemic area or following her return to the UK during this pregnancy.

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

See if Relevant

Geographical Disease Risk Index
Malaria
South American Trypanosomiasis Risk
Infection - Tropical

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.

Yellow Fever Virus is a Flavivirus. Symptoms of Yellow Fever include high temperature, headache, nausea and vomiting, muscle pains and backache. One in four individuals may suffer from jaundice and bleeding from the gastrointestinal tract and other sites.

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 cocirculate.

The main vector for these viruses 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 these viruses. The main geographical areas affected by these 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 Australia and  there have been outbreaks of Dengue and Chikungunya in Europe.

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

The scope of this entry has been extended to include Yellow Fever.

Update Information

This entry was last updated in:
TDSG-CB Edition 203, Release 44.