Molecular Screening of Blood Donors for Babesia in Tyrol, Austria

Human babesiosis in Europe has been attributed to infection with Babesia divergens and, to a lesser extent, with Babesia venatorum and Babesia microti, which are all transmitted to humans through a bite of Ixodes ricinus. These Babesia species circulate in the Netherlands, but autochthonous human babesiosis cases have not been reported so far. To gain more insight into the natural sources of these Babesia species, their presence in reservoir hosts and in I. ricinus was examined. Moreover, part of the ticks were tested for co-infections with other tick borne pathogens. In a cross-sectional study, qPCR-detection was used to determine the presence of Babesia species in 4611 tissue samples from 27 mammalian species and 13 bird species. Reverse line blotting (RLB) and qPCR detection of Babesia species were used to test 25,849 questing I. ricinus. Fragments of the 18S rDNA and cytochrome c oxidase subunit I (COI) gene from PCR-positive isolates were sequenced for confirmation and species identification and species-specific PCR reactions were performed on samples with suspected mixed infections. Babesia microti was found in two widespread rodent species: Myodes glareolus and Apodemus sylvaticus, whereas B. divergens was detected in the geographically restricted Cervus elaphus and Bison bonasus, and occasionally in free-ranging Ovis aries. B. venatorum was detected in the ubiquitous Capreolus capreolus, and occasionally in free-ranging O. aries. Species-specific PCR revealed co-infections in C. capreolus and C. elaphus, resulting in higher prevalence of B. venatorum and B. divergens than disclosed by qPCR detection, followed by 18S rDNA and COI sequencing. The non-zoonotic Babesia species found were Babesia capreoli, Babesia vulpes, Babesia sp. deer clade, and badger-associated Babesia species. The infection rate of zoonotic Babesia species in questing I. ricinus ticks was higher for Babesia clade I (2.6%) than Babesia clade X (1.9%). Co-infection of B. microti with Borrelia burgdorferi sensu lato and Neoehrlichia mikurensis in questing nymphs occurred more than expected, which reflects their mutual reservoir hosts, and suggests the possibility of co-transmission of these three pathogens to humans during a tick bite. The ubiquitous spread and abundance of B. microti and B. venatorum in their reservoir hosts and questing ticks imply some level of human exposure through tick bites. The restricted distribution of the wild reservoir hosts for B. divergens and its low infection rate in ticks might contribute to the absence of reported autochthonous cases of human babesiosis in the Netherlands.

Prevalence and genetic diversity of Babesia and Anaplasma species in cattle in Sudan

Optimal blood donation screening annotation.

A reassessment of the literature on the hepatitis G virus t is now abundantly clear that the hepatitis G virus (HGV)' and its strain variant, the GB agent (GBV-C),2 are prevalent agents with a high carrier rate in the vol-

A total of 4683 donated blood units were screened for HCV-Ab, HBs-Ag, VDRL, malaria parasites and ALT between January 1993 and April 1994. Of the blood units, 7.7% were positive for one or two hepatitis markers (HCV-Ab, HBs-Ag), while 4.6% were positive for HCV antibody, and 3.3% of the 4.6% were accounted for by Egyptian blood donors. Thus, 73% of all positive blood units for HCV-Ab were from Egyptian donors, while the rate of positive blood units for Saudi blood donors was 0.9%. Three and one-tenth percent of the total blood units were positive for HBs antigen, 2.3% from the Saudi population. Thus, 75% of all positive blood units were from Saudi donors. The percentage for HBs-Ag blood units for Egyptians was 0.3%. The exact prevalence of HCV-Ab-positive blood units among Saudis was 1.2% and HBs-Ag-positive units was 3.3%. Prevalence of HCV-Ab-reactive blood units among Egyptians was 34% and HBs-Ag-positive units was 3.3%. HCV-RNA using PCR was detected in a total of 86% of the individuals reactive to HCV antibody. Forty-three percent of hepatitis-B- and/or C-reactive blood donors had elevated alanine aminotransferase (ALT). Elevated ALT was observed in a higher percentage among HCV-Ab-reactive blood donors as compared to HBs-Ag-reactive donors.

This study was performed to determine the prevalence of antibodies to hepatitis B core antigen (anti-HBc) among Korean blood donors and frequencies of hepatitis B virus (HBV) DNA and antibodies to hepatitis B surface antigen (anti-HBs) in anti-HBc-positive donors. A total of 12,461 consenting blood donors were consecutively enrolled from Korean Red Cross Blood Services from April to October 2008. All of the donors were screened for anti-HBc with an electrochemiluminescence immunoassay. Repeat-reactive anti-HBc-positive donors were assayed for anti-HBs and for HBV DNA using a multiplex test (Cobas TaqScreen, Roche Molecular Systems) on individual donation. Of the 12,461 donors, 1682 (13.5%) were reactive for anti-HBc. Among different age groups, there was a steady increase in the anti-HBc-positive rate, ranging from 2.0% in the age group of less than 20 years to 80.0% in the age group of 60 years and older (p<0.0001). Of the anti-HBc-positive donors, 1523 (90.5%) were anti-HBs positive. HBV DNA was detected in two donors who were anti-HBc positive and hepatitis B surface antigen negative. The prevalence of occult HBV infection was 0.016%, and the HBV nucleic acid test (NAT) yield was 1 in 838 (0.12%). This study helps to determine the current status of hepatitis B infection and the prevalence of occult HBV infection in the blood donor population in Korea. We estimate that in Korea, up to 161 units per million donated units from blood donors may contain HBV DNA. Although the potential infectivity of these units has been debated upon, the HBV NAT assay could prevent certain transfusion-transmitted HBV infections.

Update on West Nile virus in Italy.

With the increasing demand from aging population and seasonal blood shortage, recruiting and retaining blood donors has become an urgent issue for the blood collection centers in China. This study aims to understand intention to donate again from a social cognitive perspective among whole blood donors in China through investigating the association between the blood donation fear, perceived rewards, self-efficacy, and intention to return. A cross-sectional survey was conducted in six cities, which are geographically and socioeconomically distinct areas in Jiangsu, China. Respondents completed a self-administrated questionnaire interviewed by two well-trained medical students. A total of 191 blood donors were included in the current study. Descriptive analysis, correlation analysis, and a generalized linear regression model were used to explore the association between demographic characteristics, psychological factors, and intention to donate again. After controlling other covariates, donors with higher fear scores reported lower intention to return (p = 0.008). Association between self-efficacy and intention to return was statistically significant (p < 0.001), whereas the association between intrinsic rewards (p = 0.387), extrinsic rewards (p = 0.939), and intention to return were statistically insignificant. This study found that either intrinsic rewards or extrinsic rewards are not significantly associated with intention to donate again among whole blood donors in China, and fear is negatively associated with intention to donate again. Therefore, purposive strategies could be enacted beyond appeals to rewards and focus on the management of donors’ fear.

Blood parasites other than malaria

Background: Hepatitis B and C viral infections, which are the most common cause of liver infection worldwide, are major health issues around the globe. People with chronic hepatitis infections remain at risk of liver cirrhosis and hepatic carcinoma, while also being a risk to other diseases. These infections are highly contagious in nature, and the prevention of hepatitis B and C transmission during blood transfusion is a major challenge for healthcare workers. Although epidemiological characteristics of hepatitis B and C infections in blood donors in Saudi Arabia have been previously investigated in multiple studies, due to targeted cohorts and the vast geographical distribution of Saudi Arabia, there are a lot of missing data points, which necessitates further investigations. Aim of the study: This study aimed to determine the prevalence of hepatitis B and hepatitis C viral infections among blood donors in the northern region of Riyadh, Saudi Arabia. Methods: To determine the given objectives, a retrospective study was performed which included data gathered from serological as well as nucleic acid test (NAT) screening of blood donors. Clinical data of 3733 blood donors were collected for a period of 2 years (from January 2019 to December 2020) at the blood bank of King Khalid General Hospital and the associated blood banks and donation camps in the region. Statistical analysis of the clinical data was performed using SPSS. Results: The blood samples of 3733 donors were analyzed to determine the seroprevalence of hepatitis B and C among the blood donors in the northern region of Riyadh, Saudi Arabia. Among the total of 3733 blood donors, 3645 (97.65%) were men and 88 (2.36%) were women. Most of the donors were younger than 27 years of age (n = 1494). The most frequent blood group in our study was O-positive (n = 1534), and the least frequent was AB-negative (n = 29). After statistically analyzing the clinical data, we observed that 7 (0.19%), 203 (5.44%) and 260 (6.96%) donor blood samples were positive for the HBV serological markers HBsAgs, HBsAbs and HBcAbs, respectively, and 12 (0.32%) blood samples reacted positively to anti-HCV antibodies. Moreover, 10 (0.27%) and 1 (0.027%) samples were NAT-HBV positive and NAT-HCV positive, respectively. Conclusion: In the current study, low prevalence rates of HBV and HCV were observed in the blood donors. Statistical correlations indicated that both serological tests and NATs are highly effective in screening potential blood donors for HBV and HCV, which, in turn, prevents potential transfusion-transmitted hepatitis.

BackgroundHuman immunodeficiency virus, hepatitis B virus and hepatitis C virus are among the greatest threats to blood safety for the recipient. They are also the leading cause of death, chronic and life-threatening abnormalities. Therefore, this study was aimed to assess the Sero-prevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital.MethodsA retrospective cross-sectional study was used to estimate the seroprevalence of HIV, Hepatitis B and C virus among blood donors at the University of Gondar Comprehensive Specialized Hospital from May–July 2018. Screening of HIV, HBV, and HCV was done by using the Enzyme-Linked ImmunoSorbent Assay. Records of 5983 first time blood donors were collected and reviewed by using a checklist from registration book. Data was entered in statistical package EP Info version 3.5.1, and data cleaned and analyzed using the statistical package SPSS version 16.0.ResultsOf 5983 blood donors, 85.5% (5118/5983) donors were males and 14.5% (865/5983) were females. The median age was 27 years and the highest blood donations age category was between 20 to 51.2% (29/5983) followed by 30 to 39 years of age, 21.6% (1295/5983). The prevalence of HIV, HBV and HCV infections were 2.5% (95% CI: 1.07–2.398), 4.1% (95% CI: 0.461–1.053) and 1.6% (95% CI: 0.845–3.354), respectively. HIV infection was significantly associated with gender (p = 0.021, x2 = 5.358) and HCV infection with age group (p = 0.003, x2 = 17.673). Of all donated blood, 8.2% (489/5983) had serological evidence for at least one of the screened pathogens and 58 (0.96%) of them had multiple infections.ConclusionsThis study showed a significant prevalence of HIV, HBV, and HCV among blood donors, 2.5% (147/5983), 4.1% (244/5983) and 1.6% (98/5983), respectively. Therefore, strict selection of blood donors with an emphasis on getting voluntary blood donors, and highly sensitive and specific tests for screening of blood donors for HIV, HBV, and HCV using standard methods are highly recommended to ensure the safety of blood for the recipient.

Babesia microti (Franca, 1909), an intraerythrocytic, ticktransmitted haemoprotozoan parasite is a common pathogen of free-living small mammals, particularly rodents. Babesiosis caused by this species of Babesia is gaining increasing interest as emerging zoonosis in humans (Parry M.F., Fox M., Burka S.A., Richar W.J. 1977: J. Am. Vet. Med. Assoc. 238: 1282– 1283; Homer M.J., Aguilar-Delfini, Telford III, S.R., Krause P.J., Persing D.H. 2000: Clin. Microbiol. Rev. 13: 451–469). This is especially the case in North America, where human babesiosis is caused predominantly by B. microti and occasionally by a newly recognized species called WA1 piroplasm (Dammin G.J., Spielman A., Benach J.L., Piesman J. 1981: Hum. Pathol. 12: 398–400; Persing D.H., Herwaldt B.L., Glaser C., Lane R.S., Thomford J.W., Mathiesen D., Krause P.J., Phillip D.F., Conrad P.A. 1995: New Engl. J. Med. 332: 298–303). However, in Europe, human babesiosis is rather unique but more lethal, and mostly caused by Babesia divergens (Mac Fadyean et Stockman, 1911). Human infections occur always or nearly always in persons who lack a spleen (Brasseur P., Gorenflot A. 1992: Mem. Inst. Oswaldo Cruz 87, Suppl. 3: 131–132). Also, quite recently a new pathogenic B. microti-like species from dogs was described in Germany (Zahler M., Rinder H., Schein E., Gothe R. 2000: Vet. Parasitol. 89: 241–248). In natural conditions, B. microti is transmitted by Ixodes ricinus complex ticks, in Europe, predominantly by nymphs of I. ricinus. Free-living small rodents (Clethrionomys glareolus, Apodemus flavicollis, Microtus arvalis) are important reservoir hosts. Although in enzootic regions these animals generally are parasitaemic, chronic infection (less than 0.5% infected erythrocytes) evidently persists for few weeks (Karbowiak G., Sinski E. 1996: Acta Parasitol. 41: 50–51; Bajer A., Pawelczyk A., Behnke J.M., Gilbert F.S., Sinski E. 2001: Parasitology 122: 43–54). Babesia microti is widely used as an experimental model for the study of mechanisms of protective immunity induced by both natural and controlled infections (Cox F.E.G., Young A.S. 1969: Parasitology 59: 257–268; Hu R., Yeh M.T., Hyland K.E., Mather T.N. 1996: J. Parasitol. 82: 728–732). Protection to subsequent infection is afforded partly by antibodies against surface and E/S antigens of free merozoites or infected erythrocytes (Winger C.M., Canning E.U., Culverhouse J.D. 1989: Parasitology 3: 341–348). In the acute phase of infection IgM antibodies are produced as a first response against the parasite (Chen D., Copeman D.B., Burnell J., Hutchinson G.W. 2000: Parasite Immunol. 22: 81–88). Also, specific IgG antibodies are responsible for reducing the number of parasites in the blood (Hu et al. 1996, op. cit.). However, the role of humoral immunity to B. microti infection in rodents is not fully clarified (Clawson M.L., Paciorkowski N., Rajan T.V., La Vake C., Pope C., La Vake M., Wikel S.K., Krause P.J., Radolf J.D. 2002: Infect. Immun. 70: 5304– 5306). The present study was designed to test the protective effect of a B. microti strain maintained by syringe passage under laboratory conditions since 1991 to challenge the infection of BALB/c mice. We have measured and compared the parasitaemia of primary and challenge infections as well as IgM, IgG1 and IgG2a antibody response, against specific B. microti antigens. Babesia microti strain (King’s 67 strain), originally obtained in 1991 from Dr. S. Randolph (Oxford University) has been maintained by weekly syringe passage using both sexes of BALB/c mice. Fifty two male BALB/c mice aged 8– 12 weeks, used in this study, were divided in two groups (26 animals each). Animals were kept in clean labelled plastic cages and provided with food and water ad libitum. The first group was injected once with 5 × 10 parasitized mouse erythrocytes by the intraperitoneal route. The second group was infected twice; the first infection on day 0 (as in group 1) and the second infection on day 38 after the first injection. Parasitaemia was examined on days 2, 4, 6, 7, 8, 9, 10, 11, 13, 14, 18 and 24 post primary infection (DPPI) and on 4, 8, 14, 18 and 24 days post challenge infection (DPCHI). The presence of B. microti was detected by microscopic examination of blood smears stained with Giemsa. Two smears were obtained from the tail tip of each mouse on these days. One hundred erythrocytes were examined and the level of parasitaemia was expressed as the percentage of parasitized erythrocytes. Heparinized blood was collected from the mice when the level of parasitaemia was about 75% of infected erythrocytes. The blood samples were centrifuged at 1000 g for 5 min and the parasites were isolated according to Machado et al. (Machado R.Z., Valadao C.A.A., Melo W.R., Alessi A.C. 1994: Braz. J. Med. Biol. Res. 27: 2591–2598). Purified piroplasms were homogenized in 0.1 M PBS, pH 7.4, containing protease inhibitors (PMSF, TPCC), sonicated FOLIA PARASITOLOGICA 50: 237–239, 2003

This review examines recent research on the prevalence and importance of iron deficiency in blood donors, and on efforts to mitigate it. Premenopausal females, teenagers, and high-frequency donors are at the highest risk for donation-induced iron deficiency, in both high-resource and low-resource settings. The physiology relating iron stores to hemoglobin levels and low hemoglobin deferral is well elucidated in blood donor populations, yet the clinical effects attributable to iron loss in the absence of anemia are challenging to identify. Expanded adoption of ferritin testing is improving donor management but may cause decreases in the blood supply from temporary donor loss. The potential for personalized donor management is emerging with development of computational models that predict individual interdonation intervals that aim to optimize blood collected from each donor while minimizing low hemoglobin deferrals. Measures to reduce iron deficiency are available that can be deployed on a standardized or, increasingly, personalized basis. Blood centers, regulators, and donors should continue to evaluate different tactics for addressing this problem, to obtain a balanced approach that is optimal for maintaining adequate collections while safeguarding donor health.

The Food and Drug Administration Approves Second West Nile Virus Screening Test for Donated Blood and Organs

Background:Nowadays, one of the main challenges of the blood transfusion organization is the procurement, distribution, and monitoring of the appropriate use of blood and its products. Therefore, the aim of this study was to investigate the prevalence of Transfusion Transmitted Infections (TTIs) including human immunodeficiency virus (HIV+), hepatitis B virus (HBV+), and hepatitis C virus (HCV+), and also to determine the relationship between the prevalence of Transfusion Transmitted Infections and characteristics of Infected blood donors, which can be useful in the selection of blood donors. Methods: This retrospective study was conducted on all blood donors in Kerman Province during five years (from March 2014 to February 2019). Individuals whose initial test and supplementary test results were positive, were considered as definitely positive. Chi-square test was used to investigate the relationship between measured factor and outcome. Data were analyzed by SPSS version 20. Statistically significant value was considered at P≤0.05. Results: After confirmatory tests, it was revealed that 500 cases were infected with one of the three blood-borne viruses of HIV+, HBs+, and HCV+. Considering a 95% confidence interval, the prevalence of HIV+, HBs+, and HCV+ was, 0.0006%, 0.1%, and 0.04%, respectively. There was a significant relationship between the prevalence of infections and age, educational status (P=0.008), and donation status (P=0.007), but there was no significant relationship between the prevalence of infections and gender and marital status (P>0.05). Conclusion: The overall prevalence of TTIs among blood donors of Kerman province was 0.14%, indicating that the prevalence of TTIs is very low, it can be due to the appropriate screening of blood donors prior to the blood donation and performing advanced screening approved by the World Health Organization. According to the results, the healthiest blood donors are regular blood donors and those with a history of blood donation.