(HealthDay News) — Screening blood donations for Zika virus (ZIKV) in the United States is costly with low yield, according to a study published in the New England Journal of Medicine.

Paula Saá, PhD from the American Red Cross in Gaithersburg, Md., and colleagues implemented investigational screening of donated blood for ZIKV RNA with transcription-mediated amplification (TMA). Repeat TMA, TMA testing in exploratory minipools, real-time reverse-transcriptase polymerase chain reaction, immunoglobulin M (IgM) serologic testing, and red-cell TMA were performed as confirmatory testing of reactive donations.

The researchers found that 9% of the 4,325,889 donations that were screened were initially tested in minipools, and there were no reactive donations. Overall, 160 of the 3,932,176 donations that were subsequently tested individually were initially reactive and 9 were confirmed positive. Six of the confirmed positive donations were reactive on repeat TMA; 4 of these were IgM negative and all 3 that could be tested were reactive on minipool TMA. Two of the confirmed positive donors had infections that were transmitted locally, 6 had travelled to ZIKV-active areas, and one had received an experimental ZIKV vaccine. The cost of identifying 8 mosquito-borne ZIKV infections through individual-unit nucleic acid testing was $5.3 million per ZIKV RNA-positive donation.

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“Screening of US blood donations for ZIKV by individual-donation TMA was costly and had a low yield,” the authors write.

The study was partially funded by Grifols Diagnostic Solutions.

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Saá P, Proctor M, Foster G, et al. Investigational Testing for Zika Virus among US Blood Donors. N Engl J Med 2018; 378:1778-1788. DOI:10.1056/NEJMoa1714977.

Bloch EM, Ness PM, Tobian AAR, and Sugarman J. Revisiting Blood Safety Practices Given Emerging Data about Zika Virus. New Engl J Med. DOI:10.1056/NEJMsb1704752.