The Risk of Acquiring Lyme Disease or Babesiosis from a Blood Transfusion

Gerber, Michael A.; Shapiro, Eugene D.; Krause, Peter J.; Cable, Ritchard G.; Badon, Stanley J.; Ryan, Raymond

doi:10.1093/infdis/170.1.231

Cited by 92 publications

(69 citation statements)

References 8 publications

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“…A recent report from Rhode Island suggested the mean rate of TTB to be approximately 1 case per 15,000 units of RBCs transfused (4). Estimates from Connecticut ranged from earlier estimates of 1 case per 601 units of transfused RBCs (36) to later estimates of 1 case per 1,800 to 1 case per 100,000 red cell units transfused (5,14). In most instances, the rate of transmission is likely underestimated due to an ongoing failure to recognize true cases of transmission.…”

Section: Case Characteristicsmentioning

confidence: 99%

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

2011

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SUMMARY Babesia spp. are intraerythrocytic protozoan parasites of animals and humans that cause babesiosis, a zoonotic disease transmitted primarily by tick vectors. Although a variety of species or types of Babesia have been described in the literature as causing infection in humans, the rodent parasite Babesia microti has emerged as the focal point of human disease, especially in the United States. Not only has B. microti become established as a public health concern, this agent is increasingly being transmitted by blood transfusion: estimates suggest that between 70 and 100 cases of transfusion-transmitted Babesia (TTB) have occurred over the last 30 years. A recent upsurge in TTB cases attributable to B. microti , coupled with at least 12 fatalities in transfusion recipients diagnosed with babesiosis, has elevated TTB to a key policy issue in transfusion medicine. Despite clarity on a need to mitigate transmission risk, few options are currently available to prevent the transmission of B. microti by blood transfusion. Future mitigation efforts may stress serological screening of blood donors in regionalized areas of endemicity, with adjunct nucleic acid testing during the summer months, when acute infections are prevalent. However, several hurdles remain, including the absence of a licensed blood screening assay and a thorough cost-benefit analysis of proposed interventions. Despite current obstacles, continued discussion of TTB without proactive intervention is no longer a viable alternative.

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Section: Case Characteristicsmentioning

confidence: 99%

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

2011

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“…Gerber et al (11), in a study of patients having undergone cardiothoracic surgery with multiple blood transfusions, noted that the risk of acquiring babesiosis from packed erythrocytes was 0.17%, making it a potential but minor threat to the blood supply. Nevertheless, transmissions are now well-documented in the literature (7,11,17,28,47,55).…”

Section: Babesia and The Blood Supplymentioning

confidence: 99%

Cultivation ofBabesiaandBabesia-Like Blood Parasites: Agents of an Emerging Zoonotic Disease

Schuster

2002

Clin Microbiol Rev

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Babesia and its close relatives are members of a group of organisms called piroplasms, a name which comes from their pear-shaped outlines. Long associated with blood diseases of cattle and other mammals, members of the genus Babesia have been recognized since the 1950s as infectious agents in humans. Species of this protozoan blood parasite that have routinely been isolated from mice (B. microti) or cattle (B. divergens) have also been isolated from humans. In addition to these familiar species, new isolates that resist being placed in existing taxonomic categories are the basis for rethinking their phylogenetic relationships based on sequencing data. The parasite represents a threat to the safety of the blood supply in that blood from asymptomatic humans can transmit Babesia to blood recipients. Such transmissions have occurred. The development of methods for cultivation of these organisms represents a significant opportunity to study their biology and disease potential. In addition, in vitro cultivation has provided a basis for studying immune responses of mammals to these infectious agents, with the hope of ultimately producing attenuated strains that could be used for immunizing of cattle and, perhaps, humans who live in areas of endemicity. The microaerophilous stationary phase culture technique, which uses a tissue culture medium base supplemented with appropriate serum and erythrocytes, has made it possible to obtain large numbers of parasitized erythrocytes for studying the biology of this parasite

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“…The first human infections were identified among asplenic patients in Europe (1957) and among normosplenic residents of Nantucket Island, MA, in the United States (1970) (11,16,51,55). More recently, blood transfusions from otherwise healthy donors who harbor occult infections have been recognized as an important potential risk factor in disease transmission (1,12,19,23,32,53).…”

mentioning

confidence: 99%

Multiplex Assay Detection of Immunoglobulin G Antibodies That Recognize Babesia microti Antigens

Priest

Moss

Won

et al. 2012

Clin Vaccine Immunol

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Human babesiosis, a blood-borne infection caused by several species of Babesia, including B. microti, is an emerging disease that is endemic in the Northeast, upper Midwest, and Pacific Northwest regions of the United States. Risk factors for babesiosis include exposure to the infected tick vector and blood transfusions from infected donors. In this work, we cloned and expressed two of the immunodominant antigens from B. microti and used them in a multiplex bead format assay (MBA) to detect parasitespecific IgG responses in human sera. The MBA using recombinant B. microti secreted antigen 1 (BmSA1) protein was more specific (100%) and slightly more sensitive (98.7%) than the assay using a truncated recombinant BMN1-17 construct (97.6% and 97.4%, respectively). Although some antibody reactivity was observed among sera from confirmed-malaria patients, only one Plasmodium falciparum sample was simultaneously positive for IgG antibodies to both antigens. Neither antigen reacted with sera from babesiosis patients who were infected with Babesia species other than B. microti. Both positive and negative MBA results were reproducible between assays and between instruments. Additional studies of these recombinant antigens and of the multiplex bead assay using blood samples from clinically defined babesiosis patients and from blood donors are needed to more clearly define their usefulness as a blood screening assay.

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The Risk of Acquiring Lyme Disease or Babesiosis from a Blood Transfusion

Cited by 92 publications

References 8 publications

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

Cultivation ofBabesiaandBabesia-Like Blood Parasites: Agents of an Emerging Zoonotic Disease

Multiplex Assay Detection of Immunoglobulin G Antibodies That Recognize Babesia microti Antigens

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