Transfusion-transmitted Babesia spp.: a changing landscape of epidemiology, regulation, and risk mitigation

Authors

Steven J. Drews, Microbiology, Donation Policy and Studies, Canadian Blood Services , Edmonton, Alberta, Canada.
Anne M. Kjemtrup, California Department of Public Health, Vector-Borne Disease Section , Sacramento, California, USA.
Peter J. Krause, Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine , New Haven, Connecticut, USA.
Grayson Lambert, Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine , New Haven, Connecticut, USA.
David A. Leiby, Department of Microbiology, Immunology, and Tropical Medicine, George Washington University , Washington, USA.
Antoine Lewin, Epidemiology, Surveillance and Biological Risk Assessment, Medical Affairs and Innovation, Héma-Québec , Montréal, Quebec, Canada.
Sheila F. O'Brien, Epidemiology and Surveillance, Canadian Blood Services, Donation Policy and Studies , Ottawa, Ontario, Canada.
Christian Renaud, Department of Microbiology, CHU Sainte-Justine, Université de Montréal , Montréal, Quebec, Canada.
Laura Tonnetti, American Red Cross, Scientific Affairs, Holland Laboratories for the Biomedical Sciences , Rockville, Maryland, USA.
Evan M. Bloch, Department of Pathology, Johns Hopkins University School of Medicine , Baltimore, Maryland, USA.

Document Type

Journal Article

Publication Date

9-26-2023

Journal

Journal of clinical microbiology

DOI

10.1128/jcm.01268-22

Keywords

Babesia; clinical diseases; risk mitigation; transfusion transmission; vectors

Abstract

spp. are tick-borne parasites with a global distribution and diversity of vertebrate hosts. Over the next several decades, climate change is expected to impact humans, vectors, and vertebrate hosts and change the epidemiology of . Although humans are dead-end hosts for tick-transmitted , human-to-human transmission of spp. from transfusion of red blood cells and whole blood-derived platelet concentrates has been reported. In most patients, transfusion-transmitted (TTB) results in a moderate-to-severe illness. Currently, in North America, most cases of TTB have been described in the United States. TTB cases outside North America are rare, but case numbers may change over time with increased recognition of babesiosis and as the epidemiology of is impacted by climate change. Therefore, TTB is a concern of microbiologists working in blood operator settings, as well as in clinical settings where transfusion occurs. Microbiologists play an important role in deploying blood donor screening assays in endemic regions, identifying changing risks for in non-endemic areas, investigating recipients of blood products for TTB, and drafting TTB policies and guidelines. In this review, we provide an overview of the clinical presentation and epidemiology of TTB. We identify approaches and technologies to reduce the risk of collecting blood products from -infected donors and describe how investigations of TTB are undertaken. We also describe how microbiologists in non-endemic regions can assess for changing risks of TTB and decide when to focus on laboratory-test-based approaches or pathogen reduction to reduce TTB risk.

APA Citation

Drews, Steven J.; Kjemtrup, Anne M.; Krause, Peter J.; Lambert, Grayson; Leiby, David A.; Lewin, Antoine; O'Brien, Sheila F.; Renaud, Christian; Tonnetti, Laura; and Bloch, Evan M., "Transfusion-transmitted Babesia spp.: a changing landscape of epidemiology, regulation, and risk mitigation" (2023). GW Authored Works. Paper 3348.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3348

Department

Microbiology, Immunology, and Tropical Medicine