Awareness is Key to Countering Risk of Babesia
September 27, 2011 – Earlier in September, the Centers for Disease Control and Prevention (CDC) announced the results of a study that indicates that instances of transfusion-transmitted Babesia, a tickborne parasite that causes a disease known as babesiosis, have increased in recent years. Because any instances or risk of bloodborne infection are of potential concern to the thalassemia community, CAF is offering the following information.
1. Incidences have risen, but the risk is still very small.
Between 1979 and 2009, there were 159 reported transfusion-related babesiosis cases, 77% of which occurred between 2000 and 2009. However, approximately 5,000,000 people receive transfusions every year, so the risk of infection is still very slight.
2. Babesiosis is treatable.
Although babesiosis can be a serious or even fatal complication, it is treatable. And many people who become infected suffer no or only very slight ill effects. Those most at risk of severe consequences are the elderly, babies, people without a spleen and people with weak immune systems.
3. If you feel ill, let your doctor know.
People with thalassemia should always be careful about any potential infections, so if you develop any of the symptoms that may accompany babesiosis – fever, chills, fatigue, nausea, etc. – let your hematologist know immediately. It’s much better to be overly cautious.
4. There is no FDA-approved test for babesia in the blood, but several are being developed.
Beth Shaz, MD, Chief Medical Officer for New York Blood Center (NYBC), told CAF that at least two, and perhaps more, companies are actively developing a test; however, it is difficult to predict when a test will be approved and put in place. “So little is still known about the infection,” Dr. Shaz says. “We have to learn more about its window period, sensitivity, specificity, and so on.” Dr. Shaz mentioned that there are at least two platforms being explored – serology and nucleic acid test (NAT) – but that it’s too early to know from which platform the tests will ultimately derive. She also indicated that NYBC and other sources are working very diligently on pathogen inactivation, a method for treating blood products that inactivates pathogens such as babesia.
Although there is a clear need for a test, it also is important that the tests be developed in an appropriate space of time to ensure that they are as accurate as possible.
5. Potential donors are asked about babesia.
Potential blood donors are being asked if they have ever had babesia; those who have are permanently deferred. Of course, many people can carry the infection without knowing it; however, some of these people will be temporarily deferred if they have a fever or other signs of ill health at the time they wish to donate.
Dr. Shaz said that other questions to determine babesia infection are not currently employed. A question about having been bitten by a tick “is not highly correlated to infection,” Dr. Shaz explains. NYBC does avoid holding blood drives in areas in which tickborne babesia is endemic.
6. Awareness is your best weapon.
Although it may take some time, an appropriate test for babesia in the blood supply will be developed. In the meantime, people with thalassemia who are frequently transfused need to be aware that they should report anything that is out of the ordinary – a fever, unusual pains, chills, etc. – to their health treatment team. The chance that it is babesia or any other infection is small; but if it does turn out to be an infection, treating it early brings about the best result.
Dr. Ellis Neufeld, MD, PhD, Chair of CAF’s Medical Advisory Board, said, “Although hematologists and blood bank experts have known for some time about the risks of babesiosis in transfused patients, particularly patients with no spleen, we are happy to see this publicity from CDC about the problem. Awareness should help increase prompt recognition and allow immediate therapy.”