Comment; Sad that there were complications from iatrogenic Babesiosis in sick transfusion recipients–reinforces the concept that something as relatively commonplace as a blood transfusion needs to be considered essentially as an organ transplant–not to be taken lightly! Good to know that expanded testing is now in place to resolve this problem.
Laura TonnettiRebecca L. TownsendRoger Y. DoddSusan L. StramerFirst published: 27 June 2019 https://doi.org/10.1111/trf.15425Read the full textPDFTOOLSSHARE
Abstract
BACKGROUND
Babesia 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.
METHODS
The 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.
RESULTS
B. 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. RBCs were the transmitting product in all cases. At follow‐up, all involved donors were antibody positive; 25 donors were also PCR positive. Positive donations were collected throughout the year, peaking in the summer. Most donors (78) were resident of, or traveled to (2), an endemic state. One donor resided in a non‐endemic state without relevant travel history. One fatality listed babesia as a contributing factor. No implicated donation was screened by an investigational protocol.
CONCLUSIONS
Babesiosis remains a blood safety issue. Prior to FDA‐licensed screening test availability and final FDA Guidance, blood collectors in endemic states investigationally tested none, a portion, or all collections. Future expanded testing will reduce the frequency of TTB cases.
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