West Nile virus (WNV) is a single-stranded RNA virus of the Flaviviridae family and is the most recent emerging infectious disease threat to public health and, potentially, to the safety of our blood supply. In 2002, WNV was identified as transfusion transmissible. It is transmitted by mosquitoes to birds and other animals through a mosquito bite. The virus can infect people, horses, many types of birds, and some other animals. WNV was shown in 2002 to be transmissible by blood (Biggerstaff and Peterson, 2003), with an estimated mean risk of 2/10,000 to 5/10,000 in outbreak regions in the United States. The most common symptoms of transfusion-transmitted cases of WNV were fever and headache. Detection of WNV includes either a measurement of WNV antibodies or of WNV nucleic acid (detecting genetic material from the virus itself). There are two types of WNV antibody testing: IgM and IgG. In most individuals, IgM antibodies will be present within 8 days after the initial exposure to WNV, followed by IgG production several weeks later. But, the antibodies tested to detect WNV are not expedient for donor blood screening. Nucleic acid testing involves amplifying and measuring the West Nile virus's genetic material to detect the presence of the virus in blood or tissue. WNV NAT will be negative in the blood once clinical illness has occurred. In this situation, both NAT and IgM antibody testing may be needed. Nucleic acid tests to screen blood for WNV are commercially available and in current use. But, the viral yield for WNV infection is much lower than other viruses. Consequently, a more sensitive WNV NAT system for donor blood screening will be required, which could further reduce the risks of transfusion transmitted WNV.
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