Reports that several of vector borne agents are transmitted by blood transfusion have raised concerns about blood safety. The primary agents of interest are members of the genus Babesia, but Anaplasma phagocytophilum, Rickettsia rickettsii, Colorado tick fever virus, and tick-borne encephalitis virus also have been transmitted by transfusion. Borrelia and Bartonella species have both been shown to survive harsh blood bank storage conditions for up to two years and are suspect as being able to be transfused.
Below are some selected articles with quotes and links to the studies. A recent FDA meeting transcript on this topic is located here.
QUOTE- "At inoculum levels of 20 or 2000 viable cells/ml, B. burgdorferi survived in processed blood through 48 days of storage at 4 degrees C. B. burgdorferi was isolated from packed cells after 36 days of storage at 4 degrees C even when the initial inoculum level was as low as 0.2 cells/ml. The data demonstrate that B. burgdorferi can survive the blood processing procedures normally applied to transfused blood in the USA. "
https://www.ncbi.nlm.nih.gov/pubmed/2373880
QUOTE- "Because of the rising incidence of Lymedisease in certain areas, whether its causative agent, Borrelia burgdorferi, could survive under blood banking conditions was studied. Dilutions of stock cultures of two strains of B. burgdorferi were inoculated into samples of citrated red cells (RBCs). Viable spirochetes were recovered from RBCs inoculated with 10(6) organisms per mL, after refrigeration for as long as 6 weeks. It is concluded that B. burgdorferi may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible."
https://www.ncbi.nlm.nih.gov/pubmed/2349627
QUOTE- "This study demonstrated that B. miyamotoi can survive standard storage conditions of most human bloodcomponents, suggesting the possibility of transmission by blood transfusion."
https://www.ncbi.nlm.nih.gov/pubmed/26689144
QUOTE- "These data demonstrate that transfusion transmission of B. miyamotoi can occur in mice and suggest that it also may occur in humans."
https://www.ncbi.nlm.nih.gov/pubmed/25251880
QUOTE- "Many agents have fulfilled the broad definition of emerging blood-transmitted infections, including West Nile virus (WNV), Trypanosoma cruzi, Plasmodium spp., Babesia spp., parvovirus B19, dengue virus, and the prions that cause variant Creutzfeld-Jacob disease (vCJD). Other agents such as human herpes virus-8 (HHV-8-Kaposi's sarcoma virus) and Borellia (Lyme disease) and, perhaps, avian flu virus, are known to have a viremic phase, but have not yet been proved to be transfusion-transmitted."
https://www.ncbi.nlm.nih.gov/pubmed/17198845
QUOTE- "Nine of 19 (47.7%) immunodeficient mice, 7 of 15 (46.8%) inbred immunocompetent mice, and 6 of 10 (60.0%) outbred mice became infected with B. burgdorferi after transfusion. Our results indicate that it is possible to acquire B. burgdoferi infection via transfused blood in a mouse model of Lyme borreliosis."
https://www.ncbi.nlm.nih.gov/pubmed/16995409
QUOTE- "As the risk of these diseases has decreased, other transfusion-transmitted organisms with a lower incidence in the community or newer diseases with rapidly expanding endemic areas are receiving additional attention. One group of these infections are infections in which the normal route of human infection is a vector."
https://www.ncbi.nlm.nih.gov/pubmed/14561396
QUOTE- "This review deals with the main bacterial (Syphilis, Lyme disease, Gram positive and Gram negative agents), parasite (Chagas disease, malaria, leishmaniasis, toxoplasmosis and babesiosis) and rickettsial diseases that are carried by blood products. "
https://www.ncbi.nlm.nih.gov/pubmed/8731290
QUOTE- "Other more exotic diseases which may be transmitted by transfusion of blood or blood components include Chagas' disease (Trypanosomiasis cruzi), Lyme disease (Borrelia burgdorferi), and Jakob-Creutzfeldt disease."
https://www.ncbi.nlm.nih.gov/pubmed/8447602
QUOTE- "Introduction of B. burgdorferi antibody screening is not regarded an effective means to prevent transfusion-transmitted Lyme disease."
https://www.ncbi.nlm.nih.gov/pubmed/1284777
QUOTE- "Lyme disease is caused by a spirochete, Borrelia burgdorferi, and represents a potential transfusion hazard. Some Borrelia burgdorferi-infected blood donors may not be disqualified by standard donor selection procedures, thus possibly transmitting the disease."
https://www.ncbi.nlm.nih.gov/pubmed/1725647
QUOTE- "Eighty-six of 3,157 blood donors tested showed IgG-antibodies against Borrelia Burgdorferi."
https://www.ncbi.nlm.nih.gov/pubmed/2625363
QUOTE- "There is evidence that transmission of B. burgdorferi by blood transfusion is possible, but, to date, there has been no documentation of transfusion-associated Lyme borreliosis. "
QUOTE- "However, a recent case of transfusion-transmitted babesiosis in an immunocompetent patient following total hip arthroplasty is the first reported in the literature and may represent a growing risk to a far greater segment of the population than previously thought. This article summarizes the current state of transfusion-transmitted babesiosis and the detrimental impact of this infection on blood transfusion safety."
https://www.ncbi.nlm.nih.gov/pubmed/26375547
QUOTE- "The risk of transfusion-transmitted babesiosis is higher than usually appreciated and in endemic areas represents a major threat to the blood supply. ... The extension of the geographic range of various Babesia spp. and the movement of donors and blood products around the United States has resulted in the risk extending to non-endemic areas. Clinicians should maintain a high degree of clinical suspicion for transfusion-transmitted babesiosis."
https://www.ncbi.nlm.nih.gov/pubmed/14564169
QUOTE- "Transplant patients may contract babesiosis after tick exposure and/or via blood transfusion."
https://www.ncbi.nlm.nih.gov/pubmed/10919602
QUOTE- "Although the major diseases transmitted by transfusion today are AIDS and hepatitis, many others also are known. These include CMV, syphilis, Chagas disease, babesiosis, parvovirus B19, malaria, Epstein-Barr infection, and many others that have been reported only once or twice."
https://www.ncbi.nlm.nih.gov/pubmed/1963503
QUOTE- "The authors present the case of a young man with aplastic anemia who went into shock and died after several red blood cell unit transfusions. ... The ultrastructural findings, allied with current scientific knowledge, permitted the diagnosis of Bartonella sp. infection."
https://www.ncbi.nlm.nih.gov/pubmed/19728230
QUOTE- "It has been reported that other members of the genus Bartonella, such as B. henselae are able to survive more than 35 days in red blood cell units stored at 4 °C, and it has also been detected in blood donors and suspicious cases of transfusion infections have been described."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496215/
QUOTE- "To our knowledge, only one study from 1926 reported the ability of B. bacilliformis to survive in blood samples of experimentally infected monkeys kept at 4 °C for at least 152 days4. These results suggest that the risk of B. bacilliformis infection by transfusion may be underestimated, especially when no specific test for detection in blood donors is performed in endemic areas."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496215/
QUOTE- "Fifty-five peripheral blood samples of patients with a clinical diagnosis of Carrion’s disease and a confirmatory positive Giemsa-stained blood smear were stored at 4 °C for a minimum of 24 months."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496215/
QUOTE- "The initial culture showed the growth of 11 out of 55 samples (20%) after 2–5 weeks of incubation, requiring an average of 3.9 weeks to obtain positive growth, while after 24–30 months of storage at 4 °C, 6 out of these 55 (11%) samples, all belonging to the 11 with previous positive cultures (54.5%), showed bacterial growth requiring between 4 and 10 weeks of incubation. Thus 2 out of these 6 cultures were positives after 4 weeks, while the remaining isolates were positive after 6–10 weeks of growth (Table I) requiring an average time of 6.6 weeks to grow. Thus after storage the average time needed to obtain a positive culture was 71% longer that at the time of collection."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496215/
QUOTE- "140 donor blood samples were analyzed to detect the presence of B. henselae, using the polymerase chain reaction technique. 13.6% of the blood donors with positive polymerase chain reaction for B. henselae were obtained."
https://www.ncbi.nlm.nih.gov/pubmed/29488546
QUOTE- "These risk factors should be considered during donor screening, as bacteremia by these Bartonella species may not be detected by traditional laboratory screening methods, and it may be transmitted by blood transfusion."
https://www.ncbi.nlm.nih.gov/pubmed/26999057
QUOTE- "Transmission of B. henselae by transfusion is possible in mice even when donor animals have undetectable bloodstream infection. The impact of human Bartonella sp. transmission through blood transfusion recipients must be evaluated."
https://www.ncbi.nlm.nih.gov/pubmed/26968530
QUOTE- "In this review, we summarize the rationale suggesting that Bartonella henselae could favour atherogenesis by infecting and damaging EPCs, thus reducing their vascular repair potential. These mechanisms suggest a novel link between communicable and non-communicable human diseases, and put forward the possibility that Bartonella henselae could enhance the susceptibility and worsen the prognosis in cardiovascular disease."
https://www.ncbi.nlm.nih.gov/pubmed/26066633
QUOTE- "We found a B. henselae significant antibody positivity rate of 21% in patients awaiting heart transplant (p = 0.002). ... Although this study was conducted in a small number of patients, we suggest that the identification of these bacteria should be included as a routine screening analysis in pretransplant patients."
https://www.ncbi.nlm.nih.gov/pubmed/26051222
QUOTE- "The seropositivity rate of IgG antibodies to B.henselae was found as 3.3% (11/333) in blood donors."
https://www.ncbi.nlm.nih.gov/pubmed/25052114
QUOTE- "Blood transfusion as an alternative bartonellosis transmission in a pediatric liver transplant."
https://www.ncbi.nlm.nih.gov/pubmed/19804481
QUOTE- "Bartonella spp. structures within erythrocytes were confirmed by electron microscopy. The viability of B. henselae was demonstrated after a storage period of RBC units. These data reinforce the possibility of infection by transfusion of blood units collected from asymptomatic blood donors."
QUOTE- "Results indicated a C. burnetii prevalence of 26.1% (screening titre 1∶16), and prevalence rates of 11.9% and 14.9% (screening titre 1∶100) for spotted fever group and typhus group rickettsiae, respectively. ... Three (2.9%) samples were positive for B. henselae possibly indicating low levels of exposure to a pathogen never reported in Namibia."
https://www.ncbi.nlm.nih.gov/pubmed/25259959