Occurrence ofLeishmania infantumParasitemia in Asymptomatic Blood Donors Living in an Area of Endemicity in Southern France

Abstract

Visceral leishmaniosis (VL) due to Leishmania infantum(L. chagasi) is a lethal disease if untreated, but asymptomatic L. infantum infections have been reported previously. A better understanding of parasite transmission, dissemination, and survival in the human host is needed. The purpose of this study was to assess whether L. infantum circulated in peripheral blood of subjects with no history of VL. Sera from 565 blood donors were screened by Western blotting to detectLeishmania-specific antibodies and identify individuals with probable past exposure to Leishmania. Seropositivity was found in 76 donors whose buffy coats were examined by PCR and direct culture. The parasite minicircle kinetoplast DNA was amplified from blood samples of nine donors. Promastigotes were detected by culture in blood samples from nine donors. Only two donors were PCR and culture positive. These results indicate that L. infantumcirculates intermittently and at low density in the blood of healthy seropositive individuals, who thus appear to be asymptomatic carriers. Implications for the safety of blood transfusion are discussed.

Is leishmaniasis an “unusual suspect” of infection in allogeneic transplantation?

“…Leishmania antibody detection has a 72% sensitivity and 94% specificity, while crossreactions have been observed with leprosy, Chagas disease, malaria, and schistosomiasis (27). PCR has been used for diagnosis of VL; many different primer sets, protocols, and visualization methods have been evaluated (37)(38)(39)(40)(41). Parasite DNA detection by PCR is more sensitive than detection in smears or culture, but it varies depending on the tissue used (42,43).…”

Other Viral, Bacterial, Parasitic and Prion-Based Infectious Complications

“…The patients had nonspecific clinical manifestations, including prolonged fever, malaise, abdominal pain, and intermittent diarrhea, which occurred up to 7 months after they returned to the United States. 121 L. tropica was found in the bone marrow of seven patients and in a lymph node in one patient. Intracellular amastigotes were seen in the peripheral blood of the one patient in whom this was studied.…”

“…However, at least eight soldiers returning from eastern Saudi Arabia after Operation Desert Storm developed visceral leishmaniasis that was attributed to L. tropica. 121,122 The leishmania organisms, transmitted primarily by bites from infected sand flies, are endemic in the tropical and subtropical regions of the Sudan, Eastern India, Bangladesh, Nepal, Brazil, and the Mediterranean. 123 After transmission by sand fly bite, parasites reside intracellularly in monocytes, which circulate before taking up residence in internal organs.…”

The Impact of Emerging Infectious Diseases on Chinese Blood Safety

“…It has been reported to cause cutaneous or visceral leishmaniasis in infants and immunocompromised patients [139][140][141][142]. Asymptomatic infections are usually found in healthy blood donors from endemic areas [144][145][146][147][148]. US military blood banks enforce permanent deferral for individuals with any history of leishmaniasis, but there is no existing regulation or standard for Leishmania testing in civilian donor screening [10].…”