CONFERENCE REPORT: Transfusion-transmitted babesiosis in the United States: summary of a workshop (original) (raw)
Transfusion-transmitted Babesiosis in an Immunocompromised Patient: A Case Report and Review
American Journal of Medicine, 2011
Babesiosis is a tick- and transfusion-borne disease caused by intraerythrocytic Babesia parasites. In 2009, a 61-year-old Minnesota woman with chronic lymphocytic leukemia and a history of recent chemotherapy and numerous blood transfusions for gastrointestinal bleeding became febrile and anemic 12 days postsplenectomy. Babesia were visualized on blood smears, confirmed by polymerase chain reaction as B. microti. She developed respiratory failure
Human babesiosis": an emerging transfusion dilemma
International journal of hepatology, 2012
Babesiosis, a common disease of animals, can infect humans via vector "tick bite", particularly in endemic areas. The recent reports of fatal cases in Hepatitis C and postliver transplant patients resulting from transfusion of contaminated blood should alert the medical profession regarding this emerging dilemma in endemic as well as nonendemic areas and the need for accurate blood screening for transfusion. Here, we illustrate different stages of the parasite lifecycle, progression of babesiosis in animal model, some aspects of pathologic outcomes, ongoing therapeutic modalities, and a feasible Acridine Orange fluorescent methodology for the diagnostic evaluation of blood samples.
Transfusion, 2014
BACKGROUND: After malaria, babesiosis is the second most common transfusion-transmitted parasitic disease in the United States. In Europe, one reported transfusion case, concerning Babesia microti, occurred in Germany. STUDY DESIGN AND METHODS: Due to the fact that Babesia spp. are present in Tyrolean ticks, the aim of this study is to assess the occurrence of immunoglobulin (Ig)G antibodies against the Babesia divergens complex, including B. divergens and Babesia venatorum (EU1), as well as B. microti by screening a representative collective of 988 blood donors from North and East Tyrol (Austria) with indirect immunofluorescence antibody test. Additionally, we investigated 206 local ixodid ticks for the presence of babesial DNA by polymerase chain reaction. RESULTS: Seroprevalence data resulted in rates of 2.1% for IgG antibodies against the B. divergens complex and 0.6% against B. microti in Tyrolean blood donors. All sera could be confirmed by independent retesting. Our data indicate that cross-reactivity is high between B. divergens and B. venatorum and lower than 19.8% between B. divergens and B. microti. CONCLUSIONS: This study shows that Babesia spp. are present in the Tyrols, which blood donors come into serologic contact with, and that we have to consider how to sustain blood product safety concerning this new challenge. Additionally, it is the first description of B. venatorum in the Tyrols, found in one Ixodes ricinus at the Italian border. B abesia spp. are intraerythrocytic protozoan parasites transmitted primarily by ixodid ticks to their vertebrate hosts. Babesial parasites can infect many different vertebrates. Nevertheless, they are reliant on both a competent vertebrate and an invertebrate host for life cycle. 1,2 In 1957, the first European case of human babesiosis was documented in Croatia. 3 The first human babesiosis in the United States appeared in 1966 in California, but the species of Babesia was never definitely characterized. 4 These cases were followed by several hundred cases over a wide geographic range in the United States, Europe,
Characteristics of transfusion‐transmitted Babesia microti, American Red Cross 2010‐2017
Transfusion, 2019
BACKGROUNDBabesia microti, a red blood cell (RBC) parasite transmitted naturally to vertebrate hosts by ixodid ticks, is endemic to the northeastern and upper midwestern United States, with the geographic range of infected ticks expanding. B. microti is a blood safety issue with >200 transfusion‐transmissions reported.METHODSThe American Red Cross's Hemovigilance program investigated hospital‐reported transfusion‐transmitted babesiosis (TTB) cases. Follow‐up samples from involved donors were tested for B. microti antibodies and parasite DNA, the latter by real‐time polymerase chain reaction (PCR). Test‐positive donors were permanently deferred from future donations.RESULTSB. microti‐positive donors were implicated in 77 of 143 suspect TTB cases investigated from 2010 through 2017. In four cases, two positive donors were identified for a total of 81 positive donors. In three cases, a RBC unit was split and components transfused multiple times to the same pediatric recipient. R...
The third described case of transfusion-transmitted Babesia duncani
Transfusion, 2012
BACKGROUND: Almost all of the reported US tickborne and transfusion-associated Babesia cases have been caused by Babesia microti, which is endemic in the Northeast and upper Midwest. We investigated a case caused by B. duncani (formerly, the WA1-type parasite), in a 59-year-old California resident with sickle cell disease (HbSS) whose only risk factor for infection was receipt of red blood cell transfusions. CASE REPORT: The patient's case was diagnosed in September 2008: intraerythrocytic parasites were noted on a blood smear, after a several-month history of increasing transfusion requirements. Molecular and indirect fluorescent antibody (IFA) analyses were negative for B. microti but were positive for B. duncani (IFA titer, 1:1024). The complete 18S ribosomal RNA gene of the parasite was amplified from a blood specimen; the DNA sequence was identical to the sequence for the index WA1 parasite isolated in 1991. The patient's case prompted a transfusion investigation: 34 of 38 pertinent blood donors were evaluated, none of whom tested positive by B. microti IFA. The implicated donor-a 67-year-old California resident-had a B. duncani titer of 1:4096; B. duncani also was isolated by inoculating jirds (Mongolian gerbils) with a blood specimen from March 2009, more than 10 months after his index donation in April 2008. The patient's case was diagnosed more than 4 months after the implicated transfusion in May 2008. CONCLUSIONS: This patient had the third documented transfusion case caused by B. duncani. His case underscores the fact that babesiosis can be caused by agents not detected by molecular or serologic analyses for B. microti. B abesiosis is a tick-borne disease caused by intraerythrocytic parasites that also are transmissible by transfusion. 1-8 During the past three decades (1979-2009), more than 150 US cases of transfusion-associated babesiosis have been recognized, 2 most of which have been linked to red blood cell (RBC) components (liquid stored or frozen deglycerolized 9); whole blood-derived platelets (PLTs) also have been implicated, presumably because of residual RBCs or extracellular parasites in PLT concentrates. 2,8,10 No test has been approved by the Food and Drug Administration (FDA) for ABBREVIATIONS: ICU = intensive care unit; IFA = indirect fluorescent antibody.