The impact of Babesia microti blood donation screening.
Journal
Transfusion
ISSN: 1537-2995
Titre abrégé: Transfusion
Pays: United States
ID NLM: 0417360
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
received:
29
08
2018
revised:
03
10
2018
accepted:
03
10
2018
pubmed:
1
12
2018
medline:
30
7
2019
entrez:
1
12
2018
Statut:
ppublish
Résumé
Babesia microti, an intraerythrocytic parasite endemic in the Northeast and upper Midwest United States, is responsible for over 200 reported cases of transfusion-transmitted babesiosis (TTB). The American Red Cross has prospectively screened donations in endemic areas for B. microti since 2012. Blood donation samples from Massachusetts, Connecticut, Minnesota, and Wisconsin were tested by arrayed fluorescence immunoassay and real-time polymerase chain reaction. Donors with reactive results by any test were deferred and invited to participate in a follow-up study. Screening of 506,540 donations (June 2012-May 2018) yielded 1299 reactives, 177 of which were DNA and antibody positive and 25 DNA positive only. During the same time, 23 unscreened RBC units collected in Connecticut and Massachusetts were involved in TTB cases, making the risk of transmitting the infection from an unscreened donation in these two states 15.6-times greater than from a Babesia-negative unit. B. microti screening in Connecticut and Massachusetts has been associated with a reduction in TTB cases; none reported from blood donors residing in Connecticut since 2016. The positive donor rate has also decreased in Connecticut from 0.67% in 2013 to 0.23% in 2017. Ongoing follow-up testing has shown that only 10% of antibody-positive donors serorevert within 1 year, while 94% of polymerase chain reacton-positive donors become negative within 12 months. Blood donation screening for B. microti in endemic areas effectively mitigates TTB risk. Screening should be considered for all areas demonstrating ongoing risk defined as clinical cases or positive blood donors including those associated with TTB cases.
Sections du résumé
BACKGROUND
Babesia microti, an intraerythrocytic parasite endemic in the Northeast and upper Midwest United States, is responsible for over 200 reported cases of transfusion-transmitted babesiosis (TTB). The American Red Cross has prospectively screened donations in endemic areas for B. microti since 2012.
METHODS
Blood donation samples from Massachusetts, Connecticut, Minnesota, and Wisconsin were tested by arrayed fluorescence immunoassay and real-time polymerase chain reaction. Donors with reactive results by any test were deferred and invited to participate in a follow-up study.
RESULTS
Screening of 506,540 donations (June 2012-May 2018) yielded 1299 reactives, 177 of which were DNA and antibody positive and 25 DNA positive only. During the same time, 23 unscreened RBC units collected in Connecticut and Massachusetts were involved in TTB cases, making the risk of transmitting the infection from an unscreened donation in these two states 15.6-times greater than from a Babesia-negative unit. B. microti screening in Connecticut and Massachusetts has been associated with a reduction in TTB cases; none reported from blood donors residing in Connecticut since 2016. The positive donor rate has also decreased in Connecticut from 0.67% in 2013 to 0.23% in 2017. Ongoing follow-up testing has shown that only 10% of antibody-positive donors serorevert within 1 year, while 94% of polymerase chain reacton-positive donors become negative within 12 months.
CONCLUSIONS
Blood donation screening for B. microti in endemic areas effectively mitigates TTB risk. Screening should be considered for all areas demonstrating ongoing risk defined as clinical cases or positive blood donors including those associated with TTB cases.
Types de publication
Clinical Trial
Journal Article
Langues
eng
Pagination
593-600Informations de copyright
© 2018 AABB.