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Investigation of a Case of Suspected Transfusion-Transmitted Malaria
  • Published Date:
    Sep 03 2018
  • Source:
    Transfusion. 58(9):2115-2121
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Public Access Version Available on: September 03, 2019 information icon
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  • Description:

    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.


    A 15-year-old male with a history of sickle cell disease developed fever following a blood transfusion. He was diagnosed with Plasmodium falciparum malaria and 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 re-interview of all donors to clarify malaria risk factors.


    One donor had evidence of infection with P. falciparum by PCR, elevated antibody titers, and previously undisclosed malaria risk factors. Re-interview revealed that the donor immigrated to the US from Togo just short of 3 years prior to the blood donation. The donor was treated for asymptomatic low parasitemia infection.


    This investigation used standard procedure 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 complimentary epidemiologic information to confirm the infected donor.

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