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Abstract

Background

The first autochthonous human West Nile virus (WNV)-positive cases in Germany were confirmed in 2019. Risk minimisation measures (RMM) were introduced in 2020; no WNV transfusion-transmitted infections have been reported to date.

Aim

To analyse German suspected WNV-positive blood donations during annual seasons 2020–23 to review donor testing requirements.

Methods

WNV look-back procedures were initiated as per German regulations and additional donor data were collected. Blood samples were analysed by metagenomic next-generation sequencing (mNGS), individual donor nucleic acid amplification technique (ID-NAT)-based testing and antibody (Ab) testing.

Results

Seventy-four cases were followed up after WNV-positive donor mini-pool screening. Forty-five (83%) of 54 samples tested with the cobas WNV assay and 14 (29%) of 49 samples tested with the RealStar WNV assay showed a reactive ID-NAT-based result; the viral load ranged between 70,251 IU/mL and values below quantification limits. Fifteen (23%) of 64 samples serologically tested were reactive with at least one of the three Ab tests performed; the previous WNV-negative donation was nearly always documented > 28 days before. Of 73 samples sequenced, mNGS detected WNV in 26 (36%) and other flaviviruses in 14 (19%) cases.

Conclusion

In some suspected cases where a WNV infection was not confirmed, mNGS demonstrated a cross-reaction with other flaviviruses. Ab testing could only detect WNV in late stages of infection. A NAT-based WNV donor screening with a detection limit of at least 120 IU/mL seems to be a sufficiently effective RMM at present. However, a continuous re-evaluation of test strategy is always required.

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2025-02-27
2025-02-27
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Assessment of the effectiveness of West Nile virus screening by analysing suspected positive donations among blood donors, Germany, 2020 to 2023
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Stefano+Orru%26apos%3B&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Orru&apos; Stefano</a>, <a href="/search?value1=Annette+Reissinger&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Reissinger Annette</a>, <a href="/search?value1=Angela+Filomena&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Filomena Angela</a>, <a href="/search?value1=Anna+Heitmann&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Heitmann Anna</a>, <a href="/search?value1=Markus+Benedikt+Funk&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Funk Markus Benedikt</a>, <a href="/search?value1=Jonas+Schmidt-Chanasit&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Schmidt-Chanasit Jonas</a>, <a href="/search?value1=Julia+Kre%C3%9F&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kreß Julia</a>, <a href="/search?value1=Heinrich+Scheiblauer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Scheiblauer Heinrich</a>, <a href="/search?value1=D%C3%A1niel+Cadar&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cadar Dániel</a>, <a href="/search?value1=Sarah+Anna+Fiedler&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fiedler Sarah Anna</a></span>. Assessment of the effectiveness of West Nile virus screening by analysing suspected positive donations among blood donors, Germany, 2020 to 2023. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(8):pii=2400373. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.8.2400373" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.8.2400373</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 11 Jun 2024;&nbsp;&nbsp; <span class="generated">Accepted</span>: 19 Sept 2024 </span> </p>
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