Babesia blood testing: the first‐year experience

Background Babesia is an intraerythrocytic parasite responsible for hundreds of cases of transfusion‐transmitted babesiosis in the past 50 years. In May of 2020, blood testing for Babesia was implemented at the American Red Cross (ARC) for all donations in endemic areas of the northeastern and midwe...

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Bibliographic Details
Published in:Transfusion (Philadelphia, Pa.) Pa.), 2022-01, Vol.62 (1), p.135-142
Main Authors: Tonnetti, Laura, Dodd, Roger Y., Foster, Gregory, Stramer, Susan L.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Babesia
Babesia microti - genetics
Babesiosis
Babesiosis - diagnosis
Babesiosis - epidemiology
Blood
Blood & organ donations
blood donation screening
Blood Donors
Blood Group Antigens
Blood tests
Blood Transfusion
Humans
IgG antibody
Immunofluorescence
Immunoglobulin G
Lysates
Male
Middle Aged
Nucleic acids
Parasites
rRNA 18S
Screening
Serology
testing
Transfusion
United States
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Summary:Background Babesia is an intraerythrocytic parasite responsible for hundreds of cases of transfusion‐transmitted babesiosis in the past 50 years. In May of 2020, blood testing for Babesia was implemented at the American Red Cross (ARC) for all donations in endemic areas of the northeastern and midwestern regions of the United States. Methods Between May 2020 and May 2021, 1,816,669 donations from 13 states and DC were tested for Babesia by the ARC. Testing was performed in pools of 16 whole blood lysates using a licensed nucleic acid test (NAT) targeting Babesia 18S rRNA. Reactive donations were tested for B. microti antibody by immunoglobulin G immunofluorescence. Suspected cases of transfusion‐transmitted babesiosis (TTB) were investigated if reported. Results The first 13 months of Babesia screening identified 365 NAT‐reactive donations. Antibodies for B. microti were detected in 79% (287) of reactive donations; negative serology samples were prevalent between May and July. Follow‐up donations were collected from 142 donors, and 86% (122), collected up to 74 days after index, remained NAT reactive. Reactive donations were mainly collected in MA (77), CT (68), NY (49), NJ (47), and PA (44), but were identified in all states except Delaware. Most reactive blood donors were male (65%) aged between 40 and 80 years. Since the beginning of Babesia testing, no case of TTB was identified. Conclusions The absence of TTB cases since implementation of Babesia screening for blood donations collected in endemic areas suggests testing is an effective strategy to eliminate TTB.
ISSN:0041-1132
1537-2995
DOI:10.1111/trf.16718