Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Ann Intern Med. 2011 Oct 18;155(8):509-19. doi: 10.7326/0003-4819-155-8-201110180-00362. Epub 2011 Sep 5.
Babesiosis is a potentially life-threatening disease caused by intraerythrocytic parasites, which usually are tickborne but also are transmissible by transfusion. Tickborne transmission of Babesia microti mainly occurs in 7 states in the Northeast and the upper Midwest of the United States. No Babesia test for screening blood donors has been licensed.
To ascertain and summarize data on U.S. transfusion-associated Babesia cases identified since the first described case in 1979.
Case series.
United States.
Case patients were transfused during 1979-2009 and had posttransfusion Babesia infection diagnosed by 2010, without reported evidence that another transmission route was more likely than transfusion. Implicated donors had laboratory evidence of infection. Potential cases were excluded if all pertinent donors tested negative.
Distributions of ascertained cases according to Babesia species and period and state of transfusion.
159 transfusion-associated B. microti cases were included; donors were implicated for 136 (86%). The case patients' median age was 65 years (range, <1 to 94 years). Most cases were associated with red blood cell components; 4 were linked to whole blood-derived platelets. Cases occurred in all 4 seasons and in 22 (of 31) years, but 77% (122 cases) occurred during 2000-2009. Cases occurred in 19 states, but 87% (138 cases) were in the 7 main B. microti-endemic states. In addition, 3 B. duncani cases were documented in western states.
The extent to which cases were not diagnosed, investigated, reported, or ascertained is unknown.
Donor-screening strategies that mitigate the risk for transfusion transmission are needed. Babesiosis should be included in the differential diagnosis of unexplained posttransfusion hemolytic anemia or fever, regardless of the season or U.S. region.
None.
巴贝虫病是一种由红细胞内寄生虫引起的潜在致命疾病，这些寄生虫通常通过蜱传播，但也可以通过输血传播。在美国东北部和中西部的 7 个州，主要通过蜱传播巴贝虫病。目前尚无用于筛查献血者的巴贝虫检测获得许可。
确定并总结自 1979 年首例报告病例以来美国报告的与输血相关的巴贝虫病病例的数据。
病例系列。
美国。
病例患者于 1979 年至 2009 年期间接受输血，在 2010 年之前被诊断为输血后巴贝虫感染，且无证据表明其他传播途径比输血更有可能。受感染的供体有实验室感染证据。如果所有相关供体检测均为阴性，则排除潜在病例。
根据巴贝虫种类和输血时间及地点对已确定病例进行分布分析。
共纳入 159 例与输血相关的微小巴贝虫病病例；供体受到牵连的有 136 例（86%）。病例患者的中位年龄为 65 岁（范围，＜1~94 岁）。大多数病例与红细胞成分相关；4 例与全血来源的血小板相关。病例发生于四季和 31 年中的 22 年，但 77%（122 例）发生于 2000-2009 年。病例发生于 19 个州，但 87%（138 例）发生于 7 个主要的微小巴贝虫病流行州。此外，在西部的 3 个州也记录到 3 例巴贝虫病。
不知道有多少病例未被诊断、调查、报告或确定。
需要制定减轻输血传播风险的供体筛查策略。无论季节或美国地区如何，对于不明原因的输血后溶血性贫血或发热，都应将巴贝虫病纳入鉴别诊断。
无。
