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Published on: September 6, 2017
A cluster of transfusion-associated babesiosis cases traced to a single asymptomatic donor
J Dobroszycki1, B L Herwaldt, F Boctor
1Department of Pediatrics, Bronx-Lebanon Hospital Center, NY, USA.
Context:
The risk of acquiring babesiosis by blood transfusion is largely unknown since in areas where it is endemic it is often an asymptomatic infection.
Objective:
To investigate and treat a cluster of blood transfusion-associated babesiosis cases.
Design:
Case series and epidemiologic investigation.
Setting:
Urban inner-city hospital.
Patients:
Six persons who received Babesia microti-infected blood components from a donor.
Main Outcome Measure:
Diagnosis and successful therapy of babesiosis following transfusion.
Results:
Six individuals (1 adult, 1 child, and 4 neonates) were exposed to products from a single blood donation by an asymptomatic Babesia-infected donor. Three of the 6 exposed patients became parasitemic. Polymerase chain reaction testing, animal inoculation studies, and indirect immunofluorescent antibody testing were used to confirm the presence of Babesia microti in the donor's blood and to establish the presence of infection in 3 of the 6 recipients. The 3 infected recipients and 1 additional recipient were treated without incident.
Conclusion:
Physicians should consider babesiosis in the differential diagnosis of a febrile hemolytic disorder after blood transfusion. Prompt diagnosis is important since babesiosis is responsive to antibiotic therapy and, untreated, can be a fatal disease in certain risk groups.
Insights
Blood transfusions can transmit babesiosis from asymptomatic donors. Three of six recipients of infected blood components developed babesiosis, highlighting the need for diagnostic vigilance.
Area of Science:
- Infectious Diseases
- Transfusion Medicine
- Parasitology
Background:
- Babesiosis transmission risk via blood transfusion is poorly understood, especially in endemic regions with asymptomatic infections.
- Asymptomatic carriers pose a significant risk for transfusion-transmitted babesiosis.
Observation:
- A case series investigated transfusion-associated babesiosis in an urban hospital.
- Six individuals received blood products from a single donor infected with Babesia microti.
Findings:
- Three out of six recipients developed parasitemia, confirmed by PCR, animal inoculation, and immunofluorescence.
- The infected donor was asymptomatic, underscoring the challenge of identifying infected blood products.
- Affected recipients and one additional patient received prompt and successful treatment.
Implications:
- Babesiosis should be considered in febrile hemolytic disorders post-transfusion.
- Early diagnosis and treatment are crucial as babesiosis can be fatal in at-risk populations.
- This study emphasizes the importance of screening blood donations for Babesia in endemic areas.
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