B.b studies of transfusion transmission of Lyme

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http://lymerick.net/Transmission-Bb-transfusion.htm

***Wormser GP. *** is this the same gary Wormser who wrote the new guidelines??

Notice he is one of the researchers who believes Lyme can be transmitted through

blood transfer!

Dawn

Transmission of Borrelia burgdorferi by Blood transfusion?

While babesia has been transferred via bloodtransfusion in several cases, there

has not been any verified case of borreliosis transferred via blood transfusion,

but there is a potential risk as the spirochete may remain viable and infectious

during the normal bank blood storage period.

Survival of Borrelia burgdorferi in blood products.

Badon SJ, Fister RD, Cable RG.

Transfusion 1989 Sep; 29(7): 581-3 PMID: 2773025

The incidence of Lyme disease is rapidly increasing in the United States. To

assess the potential of transmission of the disease through blood transfusion,

we studied the survival of Borrelia burgdorferi in blood products under blood

bank storage conditions. Two units of whole blood, separated into red cells

(RBCs), fresh-frozen plasma (FFP), and platelet concentrates (PCs), were

inoculated with B. burgdorferi (strain B31) in concentrations of approximately

3000 organisms per mL of RBCs and FFP and 200 organisms per mL of PCs. Products

were then stored under blood banking conditions and sampled at several storage

times. The viability of the spirochete in blood components was determined by

darkfield microscopic examination of cultures in modified 's medium. The

organism was shown to survive in RBCs (4 degrees C) and FFP (below -18 degrees

C) for 45 days and in PCs (20-24 degrees C) for 6 days. The results of this

study do not exclude the possibility of transmission of Lyme disease through

blood transfusion.

Prevalence of Erythema migrans Borreliosis in blood donors.

Schmidt R, Gollmer E, Zunser R, Kruger J, Ackermann R.

Infusionstherapie 1989 Dec; 16(6): 248-51 PMID: 2625363

European Erythema migrans Borreliosis and North American Lyme disease are

closely related to syphilis. This implicates a potential risk of infection for

blood recipients. Eighty-six of 3,157 blood donors tested showed IgG-antibodies

against Borrelia Burgdorferi. From among 47 persons of this group who could be

examined, clinical signs of diseased skin, joints or nervous system, not

diagnosed before, were found or could be suspected in 13 cases. Since

intrauterine transmission of Borrelia infection has been described, the

inevitable question of whether this disease can also be transmitted as a result

of blood transfusion becomes a major concern. As the pathogen can persist even

in the presence of serum antibodies, it seems advisable to examine blood donors

serologically, whenever Erythema migrans Borreliosis is suspected. Though

further research is required to document a transfusion-transmitted Borrelia

infection, infected persons should be treated to avoid serious or late

manifestations.

Survival of Borrelia burgdorferi in human blood stored under blood banking

conditions.

Nadelman RB, Sherer C, Mack L, Pavia CS, Wormser GP.

Transfusion 1990 May; 30(4): 298-301 PMID: 2349627

Hematogenous dissemination of organisms occurs in many spirochetal diseases,

including Lyme disease and syphilis. Although syphilis has been transmitted by

transfusion, in the vast majority of cases, only fresh blood products were

involved, in part because Treponema pallidum survives poorly when refrigerated

in citrated blood. Because of the rising incidence of Lyme disease 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.

Borrelia burgdorferi: survival in experimentally infected human blood processed

for transfusion.

SE, Swaminathan B, P, Broome CV, Parvin M.

J Infect Dis 1990 Aug; 162(2): 557-9 PMID: 2373880

The isolation of Borrelia burgdorferi from blood raises the possibility of

bloodborne transmission of Lyme borreliosis through transfusions. To assess this

possibility, the ability of B. burgdorferi to survive in human blood processed

for transfusion was studied. Human blood was inoculated with B. burgdorferi type

strain B-31 (ATCC 35210) at 0.2, 20, or 2000 viable cells/ml, processed by

conventional blood banking procedures, stored at 4 degrees C, and cultured for

B. burgdorferi at 12, 23, 36, and 48 days of storage. After processing, most B.

burgdorferi were found in the packed cell fraction. 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.

Since hematogenous spread of the spirochete seems to occur early in the illness,

primarily in symptomatic patients, the risk of transfusion-associated Lyme

disease may be small. However, the possibility of survival of B. burgdorferi

under blood banking conditions warrants a heightened awareness of this potential

problem.

[Retrospective study of a borreliosis infected blood donor]

Weiland T, Kuhnl P, Darda C, Sibrowski W, Pulz M.

Beitr Infusionsther 1991; 28: 32-4 PMID: 1725647

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. In a follow-up of 14 recipients of blood products

donated by such a donor, no clinical signs or serologic evidence of a

transfusion-transmitted borreliosis could be demonstrated.

Screening of blood donors and recipients for Borrelia burgdorferi antibodies: no

evidence of B. burgdorferi infection transmitted by transfusion.

Bohme M, Schwenecke S, Fuchs E, Wiebecke D, Karch H.

Infusionsther Transfusionsmed 1992 Aug; 19(4): 204-7 PMID: 1422081

In the study presented here, the prevalence of antibodies against Borrelia

burgdorferi, the etiologic agent of Lyme borreliosis, was determined in a group

of blood donors from the Wurzburg area (Southern Germany). 13 of 472 donors

(2.7%) tested were positive by immunoblotting (IB). These 13 donors were

examined in more detail by physical examination, anamnesis and determination of

inflammation parameters of the blood. All persons were asymptomatic for Lyme

borreliosis. One of 5 who remembered a tick bite actually had suffered from an

erythema chronicum migrans 5 years ago. Another one had been affected by fever,

headaches and pain in the limbs, arthralgia and motoric disorder in both hands 6

months before examination. Analysis of the blood did not provide any evidence of

an acute infection. Moreover, each of the 472 serum samples was analyzed by a

hemagglutination test (HAT). 26 (5.5%) showed a positive test result. In order

to investigate whether a seroconversion of the recipients by transfusion of B.

burgdorferi antibody-positive blood had taken place, 9 recipients of blood

products originating from the 13 IB-positive donors were serologically

reexamined. All samples taken proved to be antibody-negative. Consequently, the

transfusion did not produce any seroconversion in the patients thus treated.

[Prevalence of Borrelia burgdorferi antibodies in Hamburg blood donors]

Weiland T, Kuhnl P, Laufs R, Heesemann J.

Beitr Infusionsther 1992; 30: 92-5 PMID: 1284777

One thousand regular blood donors of the Department of Transfusion Medicine at

the University Hospital in Hamburg were screened for antibodies against the Lyme

disease spirochete, B. burgdorferi. 7.2% were initially reactive in the enzyme

immunoassay, 37.5% of which were confirmed by immunoblot. The seroprevalence of

anti-B. burgdorferi antibodies thus is 2.7% in Hamburg blood donors. 25 of 27

positive donors received a physical exam, which did not reveal any symptoms of

acute or chronic Lyme disease. 24 of these 25 donors were tested for B.

burgdorferi-specific DNA in urine by polymerase chain reaction, which came out

negative in all cases. Introduction of B. burgdorferi antibody screening is not

regarded an effective means to prevent transfusion-transmitted Lyme disease.

[infections with Borrelia burgdorferi in Wurzburg blood donors: antibody

prevalence, clinical aspects and pathogen detection in antibody positive donors]

Bohme M, Schembra J, Bocklage H, Schwenecke S, Fuchs E, Karch H, Wiebecke D.

Beitr Infusionsther 1992; 30: 96-9 PMID: 1284778

The prevalence of antibodies against Borrelia burgdorferi, the etiologic agent

of Lyme borreliosis, was determined in a group of blood donors from the Wurzburg

area (Southern Germany). 26 of 472 donors (5.5%) tested positive in a

hemagglutination test. When performing immunoblots only 13 donors (2.7%) gave

rise to B. burgdorferi-specific antibodies. 9 of them were examined in more

detail by anamnesis, physical examination, determination of inflammation

parameters of the blood and polymerase chain reaction (PCR) analysis of urine.

All persons were asymptomatic for Lyme borreliosis. One of 4, who remembered a

tick bite, actually had suffered from an erythema migrans 5 years ago. Another

one had been affected by fever, headaches and pains in the limbs, arthralgia and

motoric disorder in both hands 6 months before examination. Analysis of the

blood did not provide any evidence of an acute infection. In the urine of 2

donors we detected B. burgdorferi-specific DNA by PCR. No seroconversion due to

blood transfusion could be observed, when 9 recipients of blood products

provided by the 13 seropositive donors were serologically reexamined. PCR

analysis of urine samples of 5 recipients was also negative.

Transfer of Borrelia burgdorferi s.s. infection via blood transfusion in a

murine model.

Gabitzsch ES, Piesman J, Dolan MC, Sykes CM, Zeidner NS.

J Parasitol. 2006 Aug;92(4):869-70. PMID: 16995409

Without antibiotic treatment, the Lyme-disease-causing bacterium, Borrelia

burgdorferi can be cultured from the peripheral blood of human patients nearly 6

wk post-tick bite. To determine if Lyme disease spirochetes can be transmitted

from a spirochetemic donor mouse to a naive recipient during blood transfusion,

blood taken from immunocompetent infected mice was transfused into either

immunodeficient (SCID) mice, inbred immunocompetent animals (C3H/HeJ), or

outbred mice. 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.

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Checked by AVG Free Edition.

Version: 7.1.409 / Virus Database: 268.14.11/543 - Release Date: 11/20/2006