Klevens R Monina, Cumming Melissa A, Caten Evan, Stramer Susan L, Townsend Rebecca L, Tonnetti Laura, Rios Jorge, Young Carolyn T, Soliva Susan, DeMaria Alfred
Massachusetts Department of Public Health, Bureau of Infectious Disease and Laboratory Sciences, Boston, Massachusetts.
Scientific Affairs Department, American Red Cross, Gaithersburg, Maryland.
Transfusion. 2018 Nov;58(11):2611-2616. doi: 10.1111/trf.14943. Epub 2018 Sep 27.
The risk for tickborne exposure to Babesia microti infection exists statewide in Massachusetts. Broad exposure complicates investigations of transfusion-transmitted babesiosis (TTB). We summarize 8 years of the epidemiology of TTB and highlight the role of public health in prevention and control.
Cases of babesiosis are routinely reported to the Massachusetts Department of Public Health. These are investigated to determine whether they meet the surveillance case definition and to identify whether they were potentially transfusion transmitted. Frequencies from 2009 to 2016 are described and incidence rates calculated using population denominators from the US census. Changes over time were analyzed using simple linear regression.
From 2009 to 2016, there were 2578 cases of babesiosis reported; of these, 45 (1.7%) were transfusion transmitted. Of the 45 cases of TTB, 15 (33%) received blood products from two or more suppliers. In 11 TTB cases, the Department of Public Health was notified first, who in turn notified the appropriate blood provider. In 2009, the crude rate of reported babesiosis was 1.2 per 100,000 population and increased significantly through 2016 to 7.8 per 100,000 population (p = 0.006). The number of blood donors reported with laboratory evidence of B. microti infection increased from 19 in 2012 to 78 in 2016; at the same time, the number of TTB cases decreased from six to three.
TTB remains a major challenge, and blood donor screening strategies are currently in the process of implementation. While population and environmental changes facilitate increases in babesiosis, donor screening has the potential to eliminate TTB.
在马萨诸塞州全境，通过蜱虫叮咬接触微小巴贝斯虫感染的风险均存在。广泛的接触使输血传播巴贝斯虫病（TTB）的调查变得复杂。我们总结了8年的TTB流行病学情况，并强调了公共卫生在预防和控制中的作用。
巴贝斯虫病病例会定期报告给马萨诸塞州公共卫生部。对这些病例进行调查，以确定它们是否符合监测病例定义，并确定它们是否可能是输血传播的。描述了2009年至2016年的发病频率，并使用美国人口普查的人口分母计算发病率。使用简单线性回归分析随时间的变化。
2009年至2016年，共报告了2578例巴贝斯虫病病例；其中，45例（1.7%）是输血传播的。在45例TTB病例中，15例（33%）接受了来自两个或更多供应商的血液制品。在11例TTB病例中，公共卫生部首先得到通知，随后公共卫生部通知了相应的血液供应商。2009年，报告的巴贝斯虫病粗发病率为每10万人1.2例，到2016年显著增加至每10万人7.8例（p = 0.006）。报告有微小巴贝斯虫感染实验室证据的献血者数量从2012年的19例增加到2016年的78例；与此同时，TTB病例数量从6例减少到3例。
TTB仍然是一个重大挑战，目前正在实施献血者筛查策略。虽然人口和环境变化促使巴贝斯虫病发病率上升，但献血者筛查有可能消除TTB。
