The Centers for Disease Control and Prevention (CDC) is investigating a case of West Nile virus infection in a Mississippi resident diagnosed almost four weeks after receiving multiple units of blood during a surgical procedure. The patient reported having been bitten by mosquitoes several times before the procedure; however, as a precaution, remaining blood products from donors of blood to the patient voluntarily have been withdrawn from use.
Those donors are being contacted so they can be tested for the virus. Recipients of blood components from the donors also are being contacted and tested. In addition, the CDC has received reports from 10 states of 15 patients with confirmed West Nile infection diagnosed after receiving blood products within one month of the onset of illness.
"It is likely that not all of the 15 patients were infected via blood products; all lived in areas with active West Nile virus activity and thus may have been infected via mosquito bites," according to the CDC (web: www.cdc.gov/od/oc/media/pressrel/r021003.htm).
As of Nov. 20, 2002, the number of West Nile virus cases reported to the CDD had reached 3,698, with 212 deaths, in 40 states. And lest you think that you don’t have to worry about the virus during the winter, heed this warning: "In warmer climates, it’s a year-round concern," says Dorothy Fogg, RN, BSN, MA, senior perioperative nursing specialist in the Center for Nursing Practice, Health Policy, and Research, Association of periOperative Registered Nurses (AORN) in Denver. There are no approved tests that can be used to screen blood products or organs for the virus.
The CDC, Food and Drug Administration, and other groups are investigating possible cases of virus transmission through blood transfusion and organ transplantation. The CDC has asked that physicians notify public health authorities of any patients who develop symptoms of West Nile virus infection within four weeks of receiving a blood transfusion or organ transplantation. Also, physicians should report patients with West Nile virus infection whose symptoms begin in the weeks preceding blood or organ donation. Most people who have West Nile virus do not show symptoms, but some individuals develop fever and headache. [See Patient Information sheet www.same-daysurgery.com. Click on "toolbox." Your user name is your subscriber number. Your password is sds (lowercase) plus your subscriber number. The checklist is under "patient documentation/patient education."]
Universal precautions are sufficient to prevent transmission of the virus, according to AORN. However, there is a risk of transmitting the virus with needle sticks, according to AORN.
Take the usual needlestick precautions for disposables, such as no recapping and no bending, Fogg suggests. Comply with the Occupational Safety and Health Administration (OSHA) directive on needlestick precautions to the degree possible, she advises. (For more on the OSHA directive, see Same-Day Surgery, November 2001, p. 134. For more information in the virus impact, see SDS, November 2002, p. 143.)
Sources
For more information, contact:
• Dorothy Fogg, RN, BSN, MA, Senior Periopera-tive Nursing Specialist, Center for Nursing Prac-tice, Health Policy, and Research, Association of periOperative Registered Nurses, 2170 S. Parker Road, Denver, CO 80231. Telephone: (800) 755-2676. Fax: (303) 338-5165. E-mail: [email protected].
• Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Vector-Borne Infectious Diseases, P.O. Box 2087, Fort Collins, CO 80522. Fax: (970) 221-6476. Web: www.cdc.gov/ncidod/dvbid/westnile. E-mail: [email protected]. CDC Voice and Fax Information Service: (888) 232-3228.
The Centers for Disease Control and Prevention is investigating a case of West Nile virus infection in a Mississippi resident diagnosed almost four weeks after receiving multiple units of blood during a surgical procedure.
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