Transfusion-Associated Babesiosis in the United States: A Description of Cases

Herwaldt, Barbara L.; Linden, Jeanne V.; Bosserman, Elizabeth; Young, Carolyn; Olkowská, D; Wilson, Marianna

doi:10.7326/0003-4819-155-8-201110180-00362

Cited by 279 publications

(391 citation statements)

References 42 publications

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“…Because babesiosis may be asymptomatic, blood donors may not realize that they are infected, which poses a risk to the blood supply in areas of high endemicity. Between 1979 and 2009 over 159 transfusion-related cases of Babesia infection, including nine deaths, have been documented (4,5,8). The Centers for Disease Control and Prevention (CDC) responded to the increased public health threat by making babesiosis a nationally notifiable disease as of January 2011.…”

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confidence: 99%

A New Real-Time PCR Assay for Improved Detection of the Parasite Babesia microti

et al. 2012

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Babesiosis is an emerging zoonosis with important public health implications, as the incidence of the disease has risen dramatically over the past decade. Because the current gold standard for detection of Babesia is microscopic examination of blood smears, accurate identification requires trained personnel. Species in the genus cannot be distinguished microscopically, and Babesia can also be confused with the early trophozoite stage (ring forms) of Plasmodium parasites. To allow more accurate diagnosis in a format that is accessible to a wider variety of laboratories, we developed a real-time PCR assay targeting the 18S rRNA gene of Babesia microti, the dominant babesiosis pathogen in the United States. The real-time PCR is performed on DNA extracted from whole-blood specimens and detects Babesia microti with a limit of detection of ϳ100 gene copies in 5 l of blood. The real-time PCR assay was shown to be 100% specific when tested against a panel of 24 organisms consisting of Babesia microti, other Babesia species, Plasmodium species, tick-borne and other pathogenic bacteria, and other blood-borne parasites. The results using clinical specimens show that the assay can detect infections of lower parasitemia than can be detected by microscopic examination. This method is therefore a rapid, sensitive, and accurate method for detection of Babesia microti in patient specimens.

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confidence: 99%

A New Real-Time PCR Assay for Improved Detection of the Parasite Babesia microti

et al. 2012

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“…Screening for Babesia infection is performed only by questioning potential donors about a history of babesiosis and their current health status and a predonation evaluation for anemia. In a comprehensive review of 159 transfusiontransmitted babesiosis cases, most transmissions occurred in states where babesiosis is endemic but without a seasonal pattern (5). In addition, the time from symptom onset to diagnosis was a median of 6 days (range, 0 to 54 days), reflecting the fact that babesiosis is not likely to be considered in the differential due to a presumed lack of risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…Transfusion-transmitted babesiosis (TTB) is a well-described phenomenon that has increased in frequency over the last 2 decades (2,5). While babesiosis is the leading cause of transfusiontransmitted infection and transfusion-transmitted infection-related death (2), it is not currently screened for by laboratory testing of the U.S. blood supply.…”

Section: Discussionmentioning

confidence: 99%

The Brief Case: Probable Transfusion-Transmitted Babesiosis in a Transplant Recipient

2016

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A 3-year-old immunocompromised male who had been hospitalized for 7 months in the cardiac intensive care unit developed fever and tachycardia in December. He was prenatally diagnosed with hypoplastic left heart syndrome and received right ventricle to pulmonary artery conduit surgery days after delivery. Due to worsening right ventricular function, after a hemi-Fontan procedure, he received an orthotopic heart transplant at the beginning of his 3rd year of life. His posttransplant course was complicated by multiple episodes of rejection, cytomegalovirus (CMV) pneumonitis, and several central-line-associated bloodstream infections. As a result of the rejection, necessitating plasmapheresis as well as frequent blood draws for management, which led to anemia, he received 36 packed red blood cell transfusions over the course of 7 months posttransplantation. These transfusions were evenly spaced, and he remained hospitalized during the 7 months. At the time of the febrile episode, he was on caspofungin, trimethoprim-sulfamethoxazole, and ganciclovir. The subsequent diagnostic workup included multiple sets of blood cultures, a urine culture, and a CMV viral load analysis. He was started on vancomycin and cefepime while awaiting microbiologic results. Other pertinent test results included a complete blood count (CBC) with differential showing pancytopenia and an aspartate transaminase (AST) level of 200 U/liter (reference range, 20 to 60 U/liter), an alanine aminotransferase (ALT) level of 84 U/liter (reference range, 5 to 45 U/liter), and a C-reactive protein level of 3.1 mg/dl (reference range, 0 to 0.9 mg/dl), which increased to 7

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“…The incubation period for babesiosis is somewhere between 5 to 30 days [7]. Moreover, the disease has been increasingly acquired over the past decade by blood transfusions; the incubation period in such cases has been reported to be as long as 63 days, and in one case, up to 6 months [7,8]. The incidence of transfusion-transmitted Babesia has been reported to be about 1.1 cases per million packed RBCs across the USA [9].…”

Section: Introductionmentioning

confidence: 99%

Hematologic Manifestations of Babesiosis

Akel

Mobarakai

2018

Ann Clin Lab Res

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Background: Babesiosis, a zoonotic parasitic infection transmitted by the Ixodes tick, has become an emerging health problem in the human host that is attracting attention worldwide. Most cases of human babesiosis are reported in the United States and Europe. The disease is caused by the protozoa of the genus Babesia, which invade human erythrocytes and lyse them causing a febrile hemolytic anemia. The infection is usually asymptomatic or self-limited in the immunocompetent host, or follows a persistent, relapsing, and/or life threatening course with multi-organ failure, mainly in the splenectomized or immunosuppressed patients. Hematologic manifestations of the disease are common. They can range from mild anemia, to severe pancytopenia, splenic ruture, disseminated intravascular coagulopathy (DIC), or even hemophagocytic lymphohistiocytosis (HLH).

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Transfusion-Associated Babesiosis in the United States: A Description of Cases

Cited by 279 publications

References 42 publications

A New Real-Time PCR Assay for Improved Detection of the Parasite Babesia microti

A New Real-Time PCR Assay for Improved Detection of the Parasite Babesia microti

The Brief Case: Probable Transfusion-Transmitted Babesiosis in a Transplant Recipient

Hematologic Manifestations of Babesiosis

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