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Peer-reviewedCC BYHematology, Transfusion and Cell Therapy

FREQUENCY OF ARBOVIRUS RNA AMONG BRAZILIAN BLOOD DONORS DURING THE EPIDEMIC PERIOD IN 2026

  1. 1GSH-LIAC Central Sorológica, Rio de Janeiro, Brazil
  2. 2Grifols Diagnostic Solutions, São Paulo, Brazil
  3. 3Grupo GSH, São Paulo, Brazil

Abstract

Introduction: Climatic changes are driving the expansion of arboviruses into new regions and fueling increasingly large outbreaks. In addition to clinical cases, arbovirus infections may remain completely asymptomatic. Individuals in the incubation period (pre symptomatic) or without symptoms may donate blood, posing no barrier to donation. Viremia generally lasts 1–2 weeks, during which arboviruses can be transmitted to recipients through transfusion. Objectives: To investigate the presence of Zika, Dengue, Chikungunya and West Nile viruses RNA on blood donations from several Brazilian states. Material and methods: A total of 15,180 blood donations collected across 12 Brazilian states and the Federal District between 23 March and 21 May 2026 were tested in minipools of eight plasma samples using the licensed Procleix ArboPlex® Assay. The assay’s LoD 95% is 7.7 IU/mL (CHKV), 11.7–17.5 IU/mL (DENV 1–4), 2.5 IU/mL (ZKV), and 3.8/2.2 IU/mL (WNV lineages 1/2), running on the fully automated Panther Platform. Results are reported in two channels: WNV separately, and ZKV/CHKV/DENV together. Reactive pools in the three virus channel are resolved by testing individual donations with the discriminatory assays included in the kit. Results: Donations from all 5 Brazilian regions were represented in this casuistic. Overall, there were 14 confirmed reactive donations, 12 for Dengue and 2 for Chikungunya. Dengue viremic donors were detected in the states of Piauí, Goiás and Rio Grande do Sul whereas Chikungunya was found in one donor from Goiás and another from Brasília. In Piauí, 1% of all donations analyzed were found viremic. WNV and ZKV were not detected in any minipool. As a comparison, in the same period, 64,609 donations were screened by the Procleix Ultrio Elite Assay® targeting HBV/HCV/HIV. Fourty-six donations were found viremic (n = 46), 23 for HIV-RNA, 12 for HCV-RNA and 11 for HBV-DNA. One window-period donation for HBV and another for HCV were observed among these reactives. All 23 HIV, 11 HCV and 10 HBV reactives were concordant with serology. No occult B infection (OBI, anti-HBc+/HBsAg-/HBV-DNA+) was verified among the HBV reactives. Discussion: It is quite clear that in an endemic country like Brazil, specially during the epidemic season (January – April), viremic donations are being transfused. The clinical impact of transfusion-transmitted Chikungunya (TT-CHKV) is unclear since it has not been described in the literature. However, there are several proven cases of TT-DENV leading to significant morbidity to recipients comprising a risk for blood safety. In concordance with the data from arbodiseases national surveillance, the Piauí state ranked third in DENV incidence in the same period, following the Tocantins state (no samples in this study) and Goiás which was the first. Piauí was the first state in Brazil to report a human WNV case but the fact that it was not encountered in these donors suggests that, so far, it has not become endemic. Zika absence also reflects the very small number of cases (n = 687) reported for the whole country in the same epidemiological weeks that our investigation was carried out. Conclusion: Finding of Dengue-viremic donations is not surprising since it is the most incident arbovirus disease in Brazil, affecting the whole country. NAT is an optimal strategy to prevent its TT in regions experiencing outbreaks with the additional benefit of providing epidemiological data that may be useful for Public Health.

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BibTeX
@article{benati2026frequency,
  title = {{FREQUENCY OF ARBOVIRUS RNA AMONG BRAZILIAN BLOOD DONORS DURING THE EPIDEMIC PERIOD IN 2026}},
  author = {Fabricio José BENATI and Isabel Ferreira La Rocque FREITAS and Ana Carolina Resende BARRETO and José Eduardo LEVI and Leandro Felipe Figueiredo DALMAZZO},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.107149},
  url = {https://doi.org/10.1016/j.htct.2026.107149},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - FREQUENCY OF ARBOVIRUS RNA AMONG BRAZILIAN BLOOD DONORS DURING THE EPIDEMIC PERIOD IN 2026
AU  - Fabricio José BENATI
AU  - Isabel Ferreira La Rocque FREITAS
AU  - Ana Carolina Resende BARRETO
AU  - José Eduardo LEVI
AU  - Leandro Felipe Figueiredo DALMAZZO
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.107149
UR  - https://doi.org/10.1016/j.htct.2026.107149
AB  - Introduction: Climatic changes are driving the expansion of arboviruses into new regions and fueling increasingly large outbreaks. In addition to clinical cases, arbovirus infections may remain completely asymptomatic. Individuals in the incubation period (pre symptomatic) or without symptoms may donate blood, posing no barrier to donation. Viremia generally lasts 1–2 weeks, during which arboviruses can be transmitted to recipients through transfusion. Objectives: To investigate the presence of Zika, Dengue, Chikungunya and West Nile viruses RNA on blood donations from several Brazilian states. Material and methods: A total of 15,180 blood donations collected across 12 Brazilian states and the Federal District between 23 March and 21 May 2026 were tested in minipools of eight plasma samples using the licensed Procleix ArboPlex® Assay. The assay’s LoD 95% is 7.7 IU/mL (CHKV), 11.7–17.5 IU/mL (DENV 1–4), 2.5 IU/mL (ZKV), and 3.8/2.2 IU/mL (WNV lineages 1/2), running on the fully automated Panther Platform. Results are reported in two channels: WNV separately, and ZKV/CHKV/DENV together. Reactive pools in the three virus channel are resolved by testing individual donations with the discriminatory assays included in the kit. Results: Donations from all 5 Brazilian regions were represented in this casuistic. Overall, there were 14 confirmed reactive donations, 12 for Dengue and 2 for Chikungunya. Dengue viremic donors were detected in the states of Piauí, Goiás and Rio Grande do Sul whereas Chikungunya was found in one donor from Goiás and another from Brasília. In Piauí, 1% of all donations analyzed were found viremic. WNV and ZKV were not detected in any minipool. As a comparison, in the same period, 64,609 donations were screened by the Procleix Ultrio Elite Assay® targeting HBV/HCV/HIV. Fourty-six donations were found viremic (n = 46), 23 for HIV-RNA, 12 for HCV-RNA and 11 for HBV-DNA. One window-period donation for HBV and another for HCV were observed among these reactives. All 23 HIV, 11 HCV and 10 HBV reactives were concordant with serology. No occult B infection (OBI, anti-HBc+/HBsAg-/HBV-DNA+) was verified among the HBV reactives. Discussion: It is quite clear that in an endemic country like Brazil, specially during the epidemic season (January – April), viremic donations are being transfused. The clinical impact of transfusion-transmitted Chikungunya (TT-CHKV) is unclear since it has not been described in the literature. However, there are several proven cases of TT-DENV leading to significant morbidity to recipients comprising a risk for blood safety. In concordance with the data from arbodiseases national surveillance, the Piauí state ranked third in DENV incidence in the same period, following the Tocantins state (no samples in this study) and Goiás which was the first. Piauí was the first state in Brazil to report a human WNV case but the fact that it was not encountered in these donors suggests that, so far, it has not become endemic. Zika absence also reflects the very small number of cases (n = 687) reported for the whole country in the same epidemiological weeks that our investigation was carried out. Conclusion: Finding of Dengue-viremic donations is not surprising since it is the most incident arbovirus disease in Brazil, affecting the whole country. NAT is an optimal strategy to prevent its TT in regions experiencing outbreaks with the additional benefit of providing epidemiological data that may be useful for Public Health.
SN  - 2531-1379
SN  - 2531-1387
ER  -