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[Syphilis and blood transfusion]
1Departamento de Hematología y Hemoterapia, Fundación Jiménez Díaz (Universidad Autónoma), Madrid.
Abstract:
Along 17 years (1973-1989), syphilis screening has been performed on 146,355 blood units in the author's blood bank. A total number of 143 positive results (confirmed by MHA-TP) was registered, which means an incidence of 0.097%. Of the total number of blood units, 31,529 came from professional donors, 51 of them (0.16%) being positive, while of the 114,826 blood units from voluntary donors 92 were positive (0.08%). With respect to voluntary donations, the highest incidence of positive reactions was found between 1980 and 1982, but this period registered also the highest number of blood units studied. Along this 17 year period 8 patients have received blood products with positive syphilis test. They were transfused on urgent request with fresh blood or platelet concentrates, the transfusion being performed before knowing the results of the screening for syphilis. No special measures were taken in 2 such cases, who died shortly after the transfusion on account of their disease. Two other were treated with penicillin at the time of transfusion. The remaining four patients received preventive penicillin. Even taking into account that positive screening tests are uncommon amongst blood donors, and that only under special circumstances the patients receiving contaminated blood may develop the illness, it seems advisable for every blood bank to perform the screening for syphilis on every blood donation.
Insights
Syphilis screening of blood donations identified a 0.097% incidence rate. While rare, screening all blood units for syphilis is crucial to prevent transfusion-transmitted infections.
Area of Science:
- Transfusion Medicine
- Infectious Disease Epidemiology
- Public Health
Background:
- Syphilis remains a potential threat in transfusion medicine.
- Effective screening protocols are vital for blood safety.
Purpose of the Study:
- To evaluate the incidence of syphilis among blood donors.
- To assess the risk of transfusion-transmitted syphilis.
Main Methods:
- Retrospective analysis of 146,355 blood units screened for syphilis between 1973-1989.
- Confirmation of positive results using the Microhemagglutination-Treponema pallidum (MHA-TP) test.
- Documentation of cases where patients received contaminated blood products.
Main Results:
- An overall syphilis incidence of 0.097% was observed.
- Professional donors had a higher positive rate (0.16%) than voluntary donors (0.08%).
- Eight patients received blood products with positive syphilis tests, with varying clinical outcomes and interventions.
Conclusions:
- Despite low incidence, syphilis screening in blood donations is essential.
- Proactive screening minimizes the risk of transfusion-transmitted syphilis.
- Universal syphilis screening ensures blood product safety and public health.