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Messy Spine 01-21-2009 02:09 PM

Blood Transfusion Risks
 
Transfusion-acquired parasite infection up in U.S.

Mon Jan 19, 2009 10:23am EST

NEW YORK (Reuters Health) - Since the end of 2005, the US Food and Drug Administration has received nine reports of deaths due to a parasitic infection called babesiosis transmitted by blood transfusions, following nearly a decade in which no cases were reported.

Babesiosis, caused by the parasite Babesia, is usually transmitted through the bite of a tick, the same tick responsible for Lyme disease, although transmission via blood transfusion has also been reported. The disease is hardest on the elderly and people with compromised immune systems.

Doctors should consider babesiosis in immunocompromised patients fever with a history of recent transfusion, Dr. Diane M. Gubernot at the FDA in Rockville, Maryland, and colleagues advise in a report in the medical journal Clinical Infectious Diseases.

Gubernot and colleagues queried FDA safety surveillance systems for trends in babesiosis reporting since 1997. Nine of 10 deaths they uncovered occurred between 2005 and 2008. The patient ages ranged from 43 to 88 years.

Most of the patients developed altered mental status, kidney failure, or respiratory distress, with symptoms appearing anywhere from 2.5 to 7 weeks following blood transfusion. Once symptoms developed, death followed within 5 to 17 days. Implicated blood donations were identified, and all donors tested positive for the infection.

In addition to the nine fatal cases, the number of reports of potential transfusion-transmitted Babesia infection and post-donation babesiosis rose from zero in 1999 to 25 in 2007.

Gubernot and her associates note that Babesia species can survive blood banking procedures, including freezing.

SOURCE: Clinical Infectious Diseases, January 1, 2009.

Harrison 01-22-2009 12:04 PM

Sad Development
 
Missy, thanks for posting this finding. I am sure that this will open a big can of worms for the FDA and the CDC!

I hope you and your sister and doing better these days.

Harrison 05-25-2010 09:20 PM

An update from WSJ on Blood Supply Risks
 
Public health officials are battling a host of new infectious threats to the nation's blood supply.

Blood centers, which have long tested for risks like hepatitis C and AIDS, have added a number of new tests on donated blood in recent years, including checks for West Nile virus and Chagas, a tropical parasitic disease.

But new screening tests are hard to develop and can take years to win government approval. Currently, for instance, there's no way to screen for newer threats like babesiosis, a parasitic infection that has been linked to 10 U.S. deaths through blood transfusions since 2006. And a dangerous virus known as Chikungunya has spread to the U.S. and Europe from Africa in the last several years.

Blood supply officials are urging the U.S. government to adopt so-called pathogen-reduction technology that can kill a wide range of contaminants in blood after it has been donated. One method already in use in about a dozen countries in Europe, Asia and elsewhere destroys most pathogens with a combination of chemicals and ultraviolet light. The Food and Drug Administration declined to approve the technology several years ago, citing possible side effects. But the agency is continuing to evaluate it.

Full story here at this link.

More info on Babesia, see here.

Harrison 06-25-2011 09:38 PM

I really don't like to be "right" for the sake of being correct about my assumptions (from years ago) based on "lack of clinical evidence," but after talking to many patients through the years, the patterns of sickness emerged.

Tick-born infections (one or more in a patient) are a big problem for many. That's why I posted this topic, and many others, through the years.

These infections are not treated easily. In most cases, the standard of care is inadequate in dealing with "early" infections. Use the search function above to find more info on this complicated and terrible topic.

As a footnote, several of the people I interviewed for the first film (Getting Back on Their Feet) had tick-born infections. One of them noted Babesia and Bartonella.

By the way, the article below has some misinformation -- Lyme disease often can present without a "telltale" rash. Also, most antibiotics are NOT adequate to eradicate Lyme and other infections. If that's not enough, MOST tick bites are accompanied by coinfections -- as noted below.
____________

June 20, 2011
Once Rare, Infection by Tick Bites Spreads
By LAURIE TARKAN
New York Times

A potentially devastating infection caused by tick bites has gained a foothold in the Lower Hudson Valley and in coastal areas of the Northeast, government researchers have found.

The condition, called babesiosis, is a malaria-like illness that results from infection with Babesia microti, a parasite that lives in red blood cells and is carried by deer ticks. Though far less common than Lyme disease, babesiosis can be fatal, particularly in people with compromised immune systems.

Because there is no widely used screening test for babesiosis, its spread poses a particular threat to the blood supply, scientists said. “We are very worried about it and are doing everything in our power to address this,” said Sanjai Kumar, chief of the laboratory of emerging pathogens at the Food and Drug Administration.

According to a recent report by the Centers for Disease Control and Prevention, there were six cases of babesiosis in the Lower Hudson Valley in 2001 and 119 cases in 2008, a 20-fold increase. In areas where Lyme disease is endemic, like coastal Rhode Island, Massachusetts, Connecticut and Long Island, babesiosis also is becoming very common, said Dr. Peter Krause, senior research scientist at the Yale School of Public Health.

In one study of residents of Block Island, R.I., Dr. Krause found babesiosis to be just 25 percent less common than Lyme disease. Babesiosis also is spreading slowly into other regions where it did not exist before, like the Upper Midwest, said Dr. Krause.

Many people who are infected with the parasite have no symptoms at all, while others experience mild to moderate flu-like symptoms that may last for a few days or as long as six months. “But some people get so sick that they wind up hospitalized, put into an intensive care unit, or even dying,” said Dr. Gary Wormser, chief of infectious diseases at Westchester Medical Center in New York.

In states that track the disease, there are an estimated 1,000 reported cases a year, said Dr. Krause, but he and other experts believe this represents a fraction of the people who are infected. In the Block Island study, researchers tested about 70 percent of the islanders and found that about one quarter of adults and half of children who were infected had no symptoms and were therefore not reported. Even people with mild to moderate symptoms may never see a physician. Even if they do, the condition may not be accurately diagnosed.

Experts fear that many undiagnosed patients may be donating blood. Currently, blood banks do not screen for Babesia because the Food and Drug Administration has not licensed a test for this purpose. The only way to screen a patient is by using a questionnaire, which simply asks blood donors if they are infected.

Babesiosis already is the most frequently reported infection transmitted through transfusion in the United States, responsible for at least 12 deaths. In New York City, six transfusion-associated cases of babesiosis were reported in 2009. Infection by this route can be serious: One study found approximately 30 percent of people who were infected by a transfusion died.

Between 1999 and 2007, several infants in Rhode Island developed babesiosis following blood transfusions. The Rhode Island Blood Center has become the first in the country to use an experimental new test to screen blood for the parasite.

Experts urge blood transfusion patients and their doctors to be aware of symptoms of babesiosis, which can occur up to nine weeks after a transfusion.

The symptoms can be vague (there is no tell-tale rash as there may be with Lyme disease) and include fever, sweats, chills, headache, fatigue, and muscle aches and pains. In people who also have Lyme disease, doctors might suspect babesiosis if the symptoms are particularly severe or the antibiotics are not working, said Dr. Krause. A diagnosis can be confirmed through blood testing.

Infants and adults over age 50 are more likely to get moderate to severe symptoms if infected. People at increased risk of complications include patients with compromised immune systems (such as people receiving immunosuppressants), those who’ve had their spleens removed, and those with lymphoma or H.I.V. or who are being treated for cancer.

If not caught and treated early, babesiosis can lead to such complications as kidney, lung or heart failure. The infection can be treated with antimicrobial medications, but people with serious complications are less responsive to the drugs.

Why the parasite is spreading and why it’s spreading more slowly than Lyme disease are not well understood. One theory is that Babesia may be carried primarily in mice, which don’t tend to travel far afield. The bacterium causing Lyme disease, Borrelia burgdorferi, can be carried by birds.

Source: http://www.nytimes.com/2011/06/21/he...gewanted=print

Harrison 06-25-2011 09:45 PM

Continuing the topic, an excerpt from a veterinary article:

"...The bacteria that cause Lyme disease are particularly difficult to detect, according to Wagner, because after infection they tend to hide where they can't be found. They bury in the joints of dogs, causing arthritis or lameness. Serious kidney disease has also been associated with Lyme infections in dogs.
In humans and horses, they also burrow into the nervous system, in the spine or the brain, causing pain, paralysis, or behavioural changes..."
The article is about a new test for horses and other animals. Sourced here:

New test for Lyme disease in horses and dogs | Horsetalk.co.nz - International horse news

Harrison 08-24-2013 10:36 AM

Update on this topic
 
Tick-Borne Infections Infiltrate U.S. Blood Supply - Wired Science

Excerpt:

Allow me a tiny I Told You So. In February, I wrote a story for SELF Magazine about the rising incidence of diseases other than Lyme that are caused by tick bites. (And told you about it here, of course.) The story highlighted one particular tick-borne parasite, Babesia, and a serious problem with the infection it causes, babesiosis: that it was moving into the blood supply. We dug through FDA transcripts and CDC field reports in order to reveal that federal health authorities were very concerned about this prospect, and that more than 100 babesiosis infections caused by transfusions had already occurred — not just in the few states where the tick species carrying Babesia are found, but throughout the United States because blood products are shipped nationwide.

Ours was the first reporting we could find about babesiosis in the blood supply, and it didn’t get the attention it should have, probably because women’s magazines tend to be dismissed as not-serious — even though SELF’s health and medical reporting has won prizes and been turned into books. But based on research released this morning, our story at SELF wasn’t hyping the problem. If anything, we understated it.


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