Erin D. Moritz

Hepatitis E virus: seroprevalence and frequency of viral RNA detection among US blood donors

Hepatitis E virus (HEV) is a nonenveloped emerging virus of increasing worldwide interest. Antibody prevalence, RNA frequencies, and transfusion transmissions have been reported. We investigated the HEV RNA and antibody frequencies in US blood donors.

Investigational screening for Babesia microti in a large repository of blood donor samples from nonendemic and endemic areas of the United States.

Babesia microti, a transfusion‐transmissible intraerythrocytic parasite, is increasing in frequency in the United States with no available FDA‐licensed donor screening assay. We utilized investigational arrayed fluorescence immunoassay (AFIA) and polymerase chain reaction (PCR) to detect B. microti antibodies and DNA in blood donors.

Cost-effectiveness of Babesia microti antibody and nucleic acid blood donation screening using results from prospective investigational studies.

Babesia microti causes transfusion‐transmitted babesiosis (TTB); currently, blood donor screening assays are unlicensed but used investigationally.

A comparison of human immunodeficiency virus, hepatitis C virus, hepatitis B virus, and human T‐lymphotropic virus marker rates for directed versus volunteer blood donations to the American Red Cross during 2005 to 2010

BACKGROUND: At most US blood centers, patients may still opt to choose specific donors to give blood for their anticipated transfusion needs. However, there is little evidence of improved safety with directed donation when compared to volunteer donation.

Probable transfusion‐transmission of Anaplasma phagocytophilum by leukoreduced platelets

Anaplasma phagocytophilum (AP), a tick‐borne obligate intracellular bacterium, causes human granulocytic anaplasmosis (HGA) and has been implicated in seven transfusion‐transmitted (TT)‐HGA cases associated with red blood cells (RBCs). Here we report the first probable case of TT‐HGA involving leukoreduced platelets (PLTs).

Molecular and epidemiologic predictors of Staphylococcus aureus colonization site in a population with limited nosocomial exposure

BACKGROUND The anterior naris has been considered the most consistent location of asymptomatic Staphylococcus aureus colonization. However, recent studies have shown that a substantial number of individuals, ranging from 7% to 32% of colonized individuals, are exclusive throat carriers. Most of these studies have been carried out in a health care setting, limiting their generalizability to nonhospitalized populations. METHODS To evaluate anatomic carriage sites of S aureus in individuals outside of a health care setting, we combined the results of 2 cross-sectional studies conducted in Iowa. RESULTS S aureus was carried by 103 of 340 individuals (30.3%), including 31 (30.1%) exclusive throat carriers, 44 (42.7%) exclusive nose carriers, and 28 (27.2%) colonized in both sites. Nonwhite race (adjusted odds ratio [OR], 4.91; 95% confidence interval [CI], 1.26-18.3) and younger age (≥30 years: OR, 0.23; 95% CI, 0.10-0.54) were associated with increased odds of exclusive throat carriage, whereas nonwhite race (OR, 5.14; 95% CI, 1.62-16.3) and spring or summer sampling season (OR, 2.62; 95% CI, 1.32-5.18) were associated with increased odds of exclusive nasal carriage. CONCLUSIONS These findings suggest that including a throat swab in addition to a nasal swab could play an important role in the success of surveillance programs, particularly among younger adults.

Description of 15 DNA-positive and antibody-negative “window-period” blood donations identified during prospective screening for Babesia microti

Blood donation screening detecting only antibodies fails to identify donors in the earliest stage of infection, before a detectable immunologic response, that is, the “window period” (WP). We present data on WP donations identified during prospective screening for Babesia microti, a transfusion‐transmissible parasite of increasing concern in the United States.

Blood donation screening for Babesia microti: feasibility and results

Babesia microti, an intraerythrocytic parasite, causes babesiosis; transfusion‐transmitted babesiosis (TTB) is reported primarily in the United States where no licensed screening tests are available.

Cost-effectiveness of a Babesia microti blood donation intervention based on real-time prospective screening in endemic areas of the United States.

or antibody-positive (titer 256) units caused symptomatic infections in 34% of subjects. However, they are not supported by human data. Of 29 known PCR-positive units that were transfused, only one recipient (3.4%) became symptomatically ill, and there were no reported symptomatic cases from those receiving the 29 PCR-negative units. Using the transmissibility and progression estimates from Bish and coworkers, we would suppose that in 29 known PCR-positive units transfused, five to six recipients would develop uncomplicated yet symptomatic infections, while three to four would have complicated babesiosis with a mortality of 12%. Thus, Bish and colleagues have likely overstated the burden of TTB morbidity and mortality. In summary, while decision analysis and cost-effectiveness modeling are well suited to inform policy on this topic, the most recent analysis likely overestimates the burden of transfusion-transmitted babesiosis and the cost-effectiveness of blood screening in endemic areas. Policy-makers would be well served to closely inspect all available models and each of their strengths and limitations before promulgating guidance.

Across state lines: Fulminant Babesia microti infection in a liver transplant recipient

The potential for transmission of Babesia microti by blood transfusion is well recognized. Physicians may be unaware that products used for transfusion may be collected from geographically diverse regions. We describe a liver transplant recipient in South Carolina who likely acquired B. microti infection from a unit of blood collected in Minnesota.