On 2017 May 25, William McBride commented:

We have concerns that this paper overestimates the risk of dengue transmission through reliance on a test inadequately specific for blood donor screening. An earlier study of 100 donors from the same group Ashshi AM, 2015 acknowledged that the absence of molecular confirmation was a weakness of that study, but they utilised the same methods in this larger group. A similarly sized study conducted in Australia Rooks K, 2016 showed that of 973 donors tested, 3.3% were positive using the PanBio NS1 assay, but that no samples were positive using the BioRad NS1 assay. Further testing of over 6000 blood samples collected during 2 outbreaks were negative using a nucleic acid amplification assay. The question of the proportion of patients who remain asymptomatic during dengue infection is important, not just for assessing risk from blood donors, but for better understanding transmission of dengue more widely. A recent contribution in our understanding of the importance of asymptomatic dengue in transmission dynamics can be found at Duong V, 2015 which showed that around 7% of people infected with dengue remain asymptomatic. This rate may be even lower in an adult population.

On 2017 May 25, William McBride commented:

We have concerns that this paper overestimates the risk of dengue transmission through reliance on a test inadequately specific for blood donor screening. An earlier study of 100 donors from the same group Ashshi AM, 2015 acknowledged that the absence of molecular confirmation was a weakness of that study, but they utilised the same methods in this larger group. A similarly sized study conducted in Australia Rooks K, 2016 showed that of 973 donors tested, 3.3% were positive using the PanBio NS1 assay, but that no samples were positive using the BioRad NS1 assay. Further testing of over 6000 blood samples collected during 2 outbreaks were negative using a nucleic acid amplification assay. The question of the proportion of patients who remain asymptomatic during dengue infection is important, not just for assessing risk from blood donors, but for better understanding transmission of dengue more widely. A recent contribution in our understanding of the importance of asymptomatic dengue in transmission dynamics can be found at Duong V, 2015 which showed that around 7% of people infected with dengue remain asymptomatic. This rate may be even lower in an adult population.