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TRANSFUSION COMPLICATIONS: Transfusion-transmitted babesiosis in Rhode Island

Authors

  • Shadaba Asad,

    1. From the Division of Infectious Diseases, Department of Medicine, and Transfusion Medicine, Rhode Island Hospital; The Warren Alpert Medical School of Brown University; and Miriam Hospital, Providence, Rhode Island.
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  • Joseph Sweeney,

    1. From the Division of Infectious Diseases, Department of Medicine, and Transfusion Medicine, Rhode Island Hospital; The Warren Alpert Medical School of Brown University; and Miriam Hospital, Providence, Rhode Island.
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  • Leonard A. Mermel

    1. From the Division of Infectious Diseases, Department of Medicine, and Transfusion Medicine, Rhode Island Hospital; The Warren Alpert Medical School of Brown University; and Miriam Hospital, Providence, Rhode Island.
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  • LAM and SA developed the case report form, SA reviewed medical records, SA and JS obtained information pertaining to blood transfusions, all three authors analyzed the data, and all three authors contributed to writing the manuscript.

Dr Leonard Mermel, Division of Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903; e-mail: lmermel@lifespan.org.

Abstract

BACKGROUND: Babesiosis is caused by an intraerythrocytic protozoan transmitted by ticks. Blood transfusion is another mode of transmission.

STUDY DESIGN AND METHODS: This was a retrospective study based on babesiosis cases reported to the Rhode Island Department of Health between 1999 and 2007. Additional cases were also identified.

RESULTS: Twenty-one cases of transfusion-transmitted babesiosis (TTB) were identified from 1999 through 2007. From 2005 through 2007, the incidence approached one case per 9000 units of blood transfused. One of 21 (5%) TTB cases was diagnosed in July, in sharp contrast to 65 of 152 (43%) of the total babesiosis cases diagnosed during July in Rhode Island. Many cases were identified when a complete blood count with a differential was routinely requested and parasites were noted by laboratory technologists. Most patients with TTB had underlying conditions known to predispose to symptomatic infection.

CONCLUSION: Blood transfusion is an important mode of Babesia transmission. The current screening method of omitting donors with a history of babesiosis may be effective in preventing some, but not all, cases of TTB and current processing of blood products does not eradicate this parasite. Thus, a better screening test is needed. Alternatively, pathogen reduction technology could be utilized to prevent this mode of transmission.

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