Transfusion-transmitted Babesia spp.: a changing landscape of epidemiology, regulation, and risk mitigation

Abstract

Babesia spp. are tick-borne parasites with a global distribution and diversity of vertebrate hosts. Over the next several decades, climate change is expected to impact humans, vectors, and vertebrate hosts and change the epidemiology of Babesia . Although humans are dead-end hosts for tick-transmitted Babesia , human-to-human transmission of Babesia spp. from transfusion of red blood cells and whole blood-derived platelet concentrates has been reported. In most patients, transfusion-transmitted Babesia (TTB) results in a moderate-to-severe illness. Currently, in North America, most cases of TTB have been described in the United States. TTB cases outside North America are rare, but case numbers may change over time with increased recognition of babesiosis and as the epidemiology of Babesia is impacted by climate change. Therefore, TTB is a concern of microbiologists working in blood operator settings, as well as in clinical settings where transfusion occurs. Microbiologists play an important role in deploying blood donor screening assays in Babesia endemic regions, identifying changing risks for Babesia in non-endemic areas, investigating recipients of blood products for TTB, and drafting TTB policies and guidelines. In this review, we provide an overview of the clinical presentation and epidemiology of TTB. We identify approaches and technologies to reduce the risk of collecting blood products from Babesia -infected donors and describe how investigations of TTB are undertaken. We also describe how microbiologists in Babesia non-endemic regions can assess for changing risks of TTB and decide when to focus on laboratory-test-based approaches or pathogen reduction to reduce TTB risk.

Babesia duncani Pyruvate Kinase Inhibitor Screening and Identification of Key Active Amino Acid Residues

“…Babesiosis, an emerging tick-borne disease, is caused by intracellular protozoan parasites from the Babesia genus [ 1 ]. Various species capable of infecting humans have been identified, including Babesia microti , Babesia divergens , Babesia duncani , and Babesia bigemina [ 1 , 2 , 3 ]. The clinical spectrum of babesiosis varies widely, from mild symptoms such as fever and headache to severe complications like multi-organ failure, potentially leading to mortality [ 4 , 5 ].…”

“…The clinical spectrum of babesiosis varies widely, from mild symptoms such as fever and headache to severe complications like multi-organ failure, potentially leading to mortality [ 4 , 5 ]. These species exhibit diversity in transmission modes, clinical manifestations, and pathological characteristics, posing a significant threat to human health [ 3 , 6 ].…”

Efficacy and mechanism of actions of cipargamin as an antibabesial drug candidate

“…Babesia is a global pathogen that is more prevalent in certain regions such as Asia, Europe, and North America. However, as climate change brings with it higher temperatures and humidity, ticks and their reservoir hosts are anticipated to expand northward for survival and activity (Drews et al, 2023). The disease it causes is known as babesiosis, commonly characterized by fever and hemolytic anemia, but chronic infections are asymptomatic (Almazán et al, 2022).…”