-Caveat Lector-

>From http://www.upi.com/view.cfm?StoryID=20020726-054352-4838r

Tick disease poses threat to blood supply

By Steve Mitchell
UPI Medical Correspondent
>From the Science & Technology Desk
Published 7/29/2002 2:00 AM
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A potentially fatal disease spread by ticks may be on the increase and government and 
public health officials
are
concerned it could be infiltrating the blood supply.

Babesiosis, a mild malaria-like illness, is transmitted by Ixodes scapularis, the 
black-legged tick, the same
creature that carries Lyme disease. So far, babesiosis largely has been confined to 
Nantucket and Martha's
Vineyard, Mass., and parts of Long Island, N.Y.

In recent years, however, the tiny black-legged ticks -- also called deer ticks -- 
that carry the disease appear
to be expanding their range, Sam Telford, a researcher at Harvard University, in 
Cambridge, Mass., who
focuses on tickborne diseases, told United Press International.

"We do believe it's probably spreading," Peter Krause of the Connecticut Children's 
Medical Center in Hartford
and the University of Connecticut School of Medicine in Farmington, told UPI. Krause 
noted people have
become infected with the disease in New Jersey and farther inland in Connecticut, 
indicating it is spreading
westward in that state.

This raises concern on two levels. People who pick up the disease from a tick are at 
risk of death because the
disease can be fatal in 5 percent of cases and there is a risk they could transmit the 
protozoan that causes
the disease to others if they donate blood, Krause said.

More than 30 cases of people contracting the disease through blood transfusions have 
been documented but
the total number of cases is likely much higher because the disease often goes 
unrecognized and unreported,
he said. In most people, the disease causes fever and aches for about a week, but it 
can have severe
consequences and some people may have to be placed on life support.

"This disease is definitely underestimated," Krause said. "There are more cases than 
we realize and it's
increasing." He added many physicians are becoming more aware of the disease and more 
labs are starting to
test for it, "so we're going to be seeing more cases just because of increased 
recognition. Scientists know the
risk of transmitting babesiosis via blood transfusions is a problem ... and they are 
looking for ways to
decrease the possibility of this."

Krause noted both the American Red Cross and the Centers for Disease Control and 
Prevention in Atlanta
are involved in a study to determine the prevalence of the disease and the risk posed 
to the blood supply.

Barbara Herwaldt, a medical epidemiologist with the CDC, told UPI the threat of 
babesiosis getting into the
blood supply is "of concern," but she declined to elaborate further on the study or 
how much of a risk
contaminated blood poses to the general population.

The Red Cross did not respond to phone calls from UPI seeking comment. Other blood 
bank organizations also
are worried about the threat of babesiosis.

"It is relatively high on our priority list for transfusion infections," said Louis 
Katz, vice president of medical
affairs at the Mississippi Valley Regional Blood Center in Davenport, Iowa, and chair 
of the American
Association of Blood Banks transfusion/transmitted diseases committee.

"The reason it is an issue in blood banking now is due to environmental and 
demographic changes over the
past years and people are now living where ticks are," Katz said. This means 
babesiosis infections are
increasing so it is more likely infected people will donate blood, he said.

Although there is no test for screening blood for babesiosis, the Food and Drug 
Administration does require
blood centers to ask about the disease and bar people from donating if they report 
ever having the disease,
an FDA spokesman told UPI. However, this may not catch everyone infected with the 
disease because often
people will catch it but the symptoms are so minor they do not realize they are 
infected, Krause said.

The FDA spokesman stressed, "The benefit of receiving a blood transfusion far 
outweighs any theoretical risk
associated with receiving that transfusion." But he said, "The FDA would be very 
interested in a blood
screening test (for babesiosis) being brought forward for evaluation," adding the 
agency is attempting to
develop such a test.

People at greatest risk of contracting babesiosis via blood transfusions are the 
elderly, patients whose
spleens have been removed and those with weakened immune systems due to surgery, 
cancer or HIV/AIDS,
Krause said. In these patients, babesiosis is more likely to cause serious health 
problems or death. The
disease also could interfere with recovery from surgery.

Krause said children also are at risk of contracting the disease but they seem to be 
protected from the
serious complications.

Scientists likely will continue to focus on babesiosis in the near future. Telford 
said "the disease will get a lot
of interest" next month at an international conference on Lyme and other tickborne 
diseases in New York
City. He also predicted it will continue to spread and become more of an issue with 
the public at large.

Copyright � 2002 United Press International

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