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Investigation of a case of suspected transfusion‐transmitted malaria
Author(s) -
Anand Anjoli,
Mace Kimberly E.,
Townsend Rebecca L.,
MadisonAntenucci Susan,
Grimm Kacie E.,
Espioel,
Losco Paul,
Lucchi Naomi W.,
Rivera Hilda,
Breen Kathleen,
Tan Kathrine R.,
Arguin Paul M.,
White Jennifer L.,
Stramer Susan L.
Publication year - 2018
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14778
Subject(s) - malaria , parasitemia , asymptomatic , medicine , serology , immunology , plasmodium falciparum , disease , blood transfusion , sickle cell trait , antibody
BACKGROUND Transfusion‐transmitted malaria (TTM) is a rare occurrence with serious consequences for the recipient. A case study is presented as an example of best practices for conducting a TTM investigation. CASE REPORT A 15‐year‐old male with a history of sickle cell disease developed fever after a blood transfusion. He was diagnosed with Plasmodium falciparum malaria and was successfully treated. The American Red Cross, New York State Department of Health, and the Centers for Disease Control and Prevention investigated the eight donors who provided components to the transfusion. The investigation to identify a malaria‐positive donor included trace back of donors, serologic methods to identify donor(s) with a history of malaria exposure, polymerase chain reaction (PCR) testing, microsatellite analysis to identify the parasite in a donor and match its genotype to the parasite in the recipient, and reinterview of all donors to clarify malaria risk factors. RESULTS One donor had evidence of infection with P. falciparum by PCR, elevated antibody titers, and previously undisclosed malaria risk factors. Reinterview revealed that the donor immigrated to the United States from Togo just short of 3 years before the blood donation. The donor was treated for asymptomatic low parasitemia infection. CONCLUSION This investigation used standard procedures for investigating TTM but also demonstrated the importance of applying sensitive laboratory techniques to identify the infected donor, especially a donor with asymptomatic infection with low parasitemia. Repeat interview of all donors identified as having contributed to the transfused component provides complementary epidemiologic information to confirm the infected donor.