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Relationship between tick bites and the seroprevalence of Babesia microti and Anaplasma phagocytophila (previously Ehrlichia sp.) in blood donors

Authors

  • David A. Leiby,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Amy P.S. Chung,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Ritchard G. Cable,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Jonathan Trouern-Trend,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Jeffrey McCullough,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Mary J. Homer,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Lisa D. Reynolds,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Raymond L. Houghton,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • Michael J. Lodes,

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • David H. Persing

    1. From the Transmissible Diseases Department, American Red Cross, Rockville, Maryland;
    2. Connecticut Region, American Red Cross, Farmington, Connecticut;
    3. North Central Region, American Red Cross, St. Paul, Minnesota;
    4. Corixa Corporation, Seattle, Washington;
    5. Divisions of Clinical Microbiology
      and Experimental Pathology, Mayo Clinic and Foundation, Rochester, Minnesota.
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  • ABBREVIATIONS:

    ARC = American Red Cross; HGE = human granulocytic ehrlichiosis; IFA = immunofluorescent antibody; PBST = PBS containing 0.01-percent Tween 20.

  • Supported in part by the American Red Cross, Biomedical Services, and by NIH grants AI 36810 and AI 41103.

Address reprint requests to: David A. Leiby, PhD, Transmissible Diseases Department, American Red Cross, 15601 Crabbs Branch Way, Rockville, MD 20855; e-mail: leibyd@usa.redcross.org .

Abstract

BACKGROUND : Tick-borne diseases, particularly babesiosis and ehrlichiosis, represent recently emerging infections. Despite an increased recognition of the threat tick-borne agents pose to blood safety, our understanding of the prevalence and transmissibility of these agents in blood donors is limited.

STUDY DESIGN AND METHODS : Babesia microti and Anaplasma phagocytophila (previously Ehrlichia sp.) seroprevalence was determined in random Connecticut and Wisconsin donors, and subsequently in Connecticut donors reporting tick bites. In the interim, a postcard survey regarding tick bites during the previous 6 months was sent to 6000 random donors in six geographically distinct collection regions.

RESULTS : In total, 3 of 999 Wisconsin donors (0.3%) and 6 of 1007 Connecticut donors (0.6%) had antibodies to B. microti. Of 992 donors tested for A. phagocytophila, 5 Wisconsin donors (0.5%) and 35 Connecticut donors (3.5%) were seropositive. A total of 2482 donors (41.4%) completed the survey; 103 (4.1%) reported a tick bite. Of 848 Connecticut donors (0.4%) reporting tick bites, 3 had B. microti antibodies, while 8 (0.9%) had A. phagocytophila antibodies. These rates were not significantly different from control donors.

CONCLUSION : Blood donors seropositive for B. microti and A. phagocytophila are present in Connecticut and Wisconsin. Donors readily recall previous tick bites, but self-reported bites are not reliable indicators of serologic status. The exposure of blood donors to tick-borne pathogens does suggest a need to better understand the transfusion transmission potential of these agents.

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