Possible Transfusion-Transmitted Babesia divergens–like/MO-1 Infection in an Arkansas Patient

Abstract

A patient with asplenia and multiple red blood cell transfusions acquired babesiosis infection with Babesia divergens-like/MO-1 organisms and not Babesia microti, the common United States species. He had no known tick exposure. This is believed to be the first transfusion-transmitted case and the fifth documented case of B. divergens-like/MO-1 infection.

Analysis of antigen‐antibody cross‐reactivity among lineages and sublineages of Babesia microti parasites using human babesiosis specimens

“…Moreover, the findings of this study might be valuable to develop tests to detect B. microti antibodies in each babesiosis‐endemic region. In addition to B. microti , human babesiosis and/or TTB caused by B. duncani , B. divergens , B. divergens –like (MO‐1), and B. venatorum have been detected worldwide . Similar to the B. microti group, it is possible that antibody cross‐reactivity to different lineages and sublineages within the same Babesia species may be low or absent.…”

“…In addition to B. microti, human babesiosis and/or TTB caused by B. duncani, B. divergens, B. divergens-like (MO-1), and B. venatorum have been detected worldwide. [36][37][38][39] Similar to the B. microti group, it is possible that antibody cross-reactivity to different lineages and sublineages within the same Babesia species may be low or absent. Further study is needed to develop effective serologic detection methods for human babesiosis through the evaluation of specificity using humans infected with the B. microti group or other Babesia species, such as B. duncani or B. divergence.…”

Blood Transfusion-Associated Infections in the Twenty-First Century: New Challenges

“…TT-babesiosis was first described in 1979 in the USA and since then there have been over 200 cases related to transfusion described with mortality of about 18-19% [109][110][111]. Over 95% of the cases were due to B. microti but at least 3 cases were from Babesia duncani [109] and recently a case from Arkansas secondary to Babesia divergens from multiple RBC transfusion was described [112]. Babesiosis has been transmitted by RBC stored for up to 35 days and by previous frozen RBC and rarely by platelets [113].…”

Risk‐based decision making: a good start to aiding US blood policy decisions?

“…Furthermore, Grifols and Roche each have IND applications for NAT assays sensitive for four Babesia species ( B. microti, B. duncani, B. divergens, and B. venatorum ) using their automated blood screening platforms that are already installed in US blood screening laboratories. Cases of transfusion‐transmitted B. duncani have been reported in the United States in nonendemic states such as Washington and California, and possible B. divergens ‐like/MO‐1 has been reported in Arkansas . The Babesia Report recommends NAT‐only testing, while the recently released FDA draft guidance recommends NAT and antibody screening .…”

“…Cases of transfusion-transmitted B. duncani have been reported in the United States in nonendemic states such as Washington and California, and possible B. divergens-like/MO-1 has been reported in Arkansas. 6,7 The Babesia Report 1 recommends NAT-only testing, while the recently released FDA draft guidance recommends NAT and antibody screening. 8 As more data become available and additional assays are FDA approved, the recommended testing algorithms will change.…”