Canadian Blood Services, Microbiology, Donor and Clinical Services, Edmonton, AB, Canada.
Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada.
Vox Sang. 2021 Aug;116(7):741-754. doi: 10.1111/vox.13073. Epub 2021 Jan 25.
Filariae are parasitic worms that include the pathogens Loa loa, Onchocerca volvulus, Wuchereria bancrofti, Brugia spp. and Mansonella spp. which are endemic in parts of Africa, Asia, Asia-Pacific, South and Central America. Filariae have a wide clinical spectrum spanning asymptomatic infection to chronic debilitating disease including blindness and lymphedema. Despite successful eradication programmes, filarial infections remain an important -albeit neglected - source of morbidity. We sought to characterize the risk of transfusion transmission of microfilaria with a view to guide mitigation practices in both endemic and non-endemic countries.
A scoping review of scientific publications as well as grey literature was carried out by a group of domain experts in microbiology, transfusion medicine and infectious diseases, representing the parasite subgroup of the International Society of Blood Transfusion.
Cases of transfusion-transmitted filariasis are rare and confined to case reports of variable quality. Transfusion-associated adverse events related to microfilariae are confined to isolated reports of transfusion reactions. Serious outcomes have not been reported. No known strategies have been implemented, specifically, to mitigate transfusion-transmitted filariasis yet routine blood donor screening for other transfusion-transmissible infections (e.g. hepatitis B, malaria) may indirectly defer donors with microfilaremia in endemic areas.
Rare examples of transfusion-transmitted filariasis, without serious clinical effect, suggest that filariasis poses low transfusion risk. Dedicated mitigation strategies against filarial transfusion transmission are not recommended. Given endemicity in low-resource regions, priority should be on the control of filariasis with public health measures.
丝虫是寄生蠕虫，包括病原体罗阿罗阿、盘尾丝虫、班氏丝虫、布鲁线虫和曼森线虫，这些病原体在非洲、亚洲、亚太地区、南美和中美洲的部分地区流行。丝虫病的临床表现广泛，从无症状感染到慢性衰弱性疾病，包括失明和淋巴水肿。尽管根除计划取得了成功，但丝虫感染仍然是一个重要的——尽管被忽视的——发病源。我们旨在描述微丝蚴输血传播的风险，以期指导在流行地区和非流行地区采取缓解措施。
一组在微生物学、输血医学和传染病领域具有专业知识的专家对科学出版物和灰色文献进行了范围审查，代表国际输血协会寄生虫分组。
输血传播性丝虫病的病例罕见，仅限于各种质量的病例报告。与微丝蚴相关的输血相关不良事件仅限于孤立的输血反应报告。没有报告严重的后果。目前尚无已知的策略被实施，特别是为了减轻输血传播性丝虫病，但在流行地区，对其他可经输血传播的感染（如乙型肝炎、疟疾）进行常规献血者筛查可能会间接推迟微丝蚴血症的献血者。
罕见的输血传播性丝虫病的例子，没有严重的临床影响，表明丝虫病的输血风险较低。不建议针对丝虫输血传播采取专门的缓解策略。鉴于低资源地区的流行情况，应优先采取公共卫生措施来控制丝虫病。
