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From Medscape
Tick-Borne Disease Transmission by Blood Donation Prevalent in
Endemic Areas
Mary Beth Nierengarten
Oct. 11, 2005 (San Francisco) - The need to develop strategies to
prevent transmission of tick-borne disease via blood transfusion is
increasing as new reports continue to surface. Although not as much
in the popular press as Lyme disease, Babesia microti is creating its
own quieter havoc.
In a study presented here at the Infectious Diseases Society of
America 43rd annual meeting, Megan Nguyen, BS, from the American Red
Cross in Rockville, Maryland, presented data from a six-year study
that showed the prevalence of B microti transmission via blood
transfusion in areas where the tick is commonly found.
Examination of 13,573 samples from blood donors from 1999 to 2004 in
endemic regions of Connecticut showed that 175 samples (1.3%) tested
positive for B microti infection based on indirect fluorescent
antibody testing.
Of these 175, 129 donors consented to participate in a three-year
follow-up study in which they were tested by IFA for the presence of
antibodies to B microti as well as receiving nested polymerase chain
reaction (PCR) testing for parasitemia on a regular basis. Overall,
27 donors (21%) were found to have parasitemia as indicated by a
positive PCR test, suggesting that some patients have persistent,
ongoing infection.
In addition, parasitemia rates decreased from 55% in the first two
years of the follow-up study to 3% in the third and final year. Ms.
Nguyen said the study did not show a clear reason for this, adding
that many factors could account for it.
Ms. Nguyen emphasized that "anybody who has had B microti is
permanently prohibited from donating blood" and is registered in the
blood bank system of the Red Cross nationwide. However, it is
important to identify those people infected with B microti prior to
blood donation. According to Ms. Nguyen, most of the transfusion-
related transmission occurs through people who are infected with the
tick-borne disease but who are asymptomatic.
Identifying infected people before they donate blood is therefore an
important goal in reducing the risk of transfusion-related B microti
transmission, but the best way to do this is not yet clear, she said.
Richard Whitley, MD, a professor of pediatrics at the University of
Alabama in Birmingham who moderated the session, told Medscape that
prospective blood donors are not currently screened routinely for
tick-borne diseases, an issue that needs to be addressed by local
blood banks.
However, Ms. Nguyen told Medscape she is hopeful "that there will be
screening" or a U.S. Food and Drug Administration (FDA) approval for
testing before donation. Unfortunately, she added, she does not know
of any test under investigation for FDA approval.
IDSA 43rd Annual Meeting: Abstract LB-3. Presented Oct. 7, 2005.
Reviewed by Gary D. Vogin, MD
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