Herwaldt Barbara L, Neitzel David F, Gorlin Jed B, Jensen Kathryn A, Perry Elizabeth H, Peglow William R, Slemenda Susan B, Won Kimberly Y, Nace Eva K, Pieniazek Norman J, Wilson Marianna
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Transfusion. 2002 Sep;42(9):1154-8. doi: 10.1046/j.1537-2995.2002.00189.x.
Babesiosis is a tick-borne zoonosis caused by intraerythrocytic protozoa. More than 40 US cases of Babesia microti infection acquired by blood transfusion have been reported. This report describes the identification of a transfusion-associated case of babesiosis and the subsequent identification of the infected blood donor and three other infected recipients of cellular blood components from three other donations by this donor.
Serum specimens from the donors of blood that had been made into cellular components received by the index recipient and from other recipients of such components from the implicated donor were tested by the indirect fluorescent antibody (IFA) assay for antibodies to B. microti. Whole blood from IFA-positive persons was tested by PCR for B. microti DNA.
IFA testing of serum from 31 of 36 donors implicated a 45-year-old man (titer, 1 in 256), whose donation had been used for RBCs. He likely became infected when bitten by ticks while camping in Minnesota in June 1999 and had donated blood four times thereafter. As demonstrated by PCR, he remained parasitemic for at least 10 months. Of the five other surviving recipients of cellular blood components from the implicated donor, three recipients (one for each of the three other donations) had become infected through either RBC or platelet transfusions.
Babesiosis should be included in the differential diagnosis of posttransfusion febrile illness, and effective means for preventing transmission by blood transfusion are needed.
巴贝斯虫病是一种由红细胞内原生动物引起的蜱传人畜共患病。美国已报告了40多例因输血感染微小巴贝斯虫的病例。本报告描述了一例输血相关巴贝斯虫病病例的鉴定，以及随后对受感染献血者的鉴定，以及该献血者另外三次献血的其他三名接受细胞血液成分的受感染接受者。
对索引受血者接受的制成细胞成分的血液的献血者以及来自相关献血者的此类成分的其他受血者的血清标本进行间接荧光抗体（IFA）检测，以检测抗微小巴贝斯虫抗体。对IFA阳性者的全血进行PCR检测微小巴贝斯虫DNA。
对36名献血者中的31名的血清进行IFA检测，发现一名45岁男子（滴度为1:256），其献血用于红细胞。他可能在1999年6月在明尼苏达州露营时被蜱叮咬而感染，此后献血四次。PCR检测表明，他至少10个月内一直存在寄生虫血症。在相关献血者的其他五名存活的细胞血液成分接受者中，三名接受者（另外三次献血各一名）通过红细胞或血小板输血感染。
巴贝斯虫病应纳入输血后发热性疾病的鉴别诊断，需要有效的预防输血传播的方法。
