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Lynn MK, Dye-Braumuller KC, Beatty NL, Dorn PL, Klotz SA, Stramer SL, Townsend RL, Kamel H, Vannoy JM, Sadler P, Montgomery SP, Rivera HN, Nolan MS. Evidence of likely autochthonous Chagas disease in the southwestern United States: A case series of Trypanosoma cruzi seropositive blood donors. Transfusion 2022; 62:1808-1817. [PMID: 35895440 PMCID: PMC9543114 DOI: 10.1111/trf.17026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
Background Chagas disease is a parasitic infection that can insidiously cause non‐ischemic cardiomyopathy. Given the largely silent nature of this progressive disease, asymptomatic blood donors pose potential blood transfusion risk. Blood donation screening has become an unintentional form of Chagas disease surveillance, with thousands of new cases identified since national surveillance was initiated in 2007. Study Design and Methods We recruited T. cruzi‐positive blood donors identified from California and Arizona blood centers for confirmatory blood screening and assessment of lifetime infection risk. Results Among eight suspected cases, we identified four confirmed US autochthonous infections. The current manuscript details the transmission sources, healthcare‐seeking behaviors post‐blood donation resulting, and clinical course of disease among persons without any history of travel to endemic Latin American countries. Discussion This manuscript presents four additional US‐acquired Chagas disease cases and identifies an opportunity for blood centers to assist in confronting barriers surrounding Chagas disease in the US.
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Affiliation(s)
- Mary K Lynn
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Kyndall C Dye-Braumuller
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Norman L Beatty
- Division of Infectious Diseases & Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida, USA.,Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Patricia L Dorn
- Department of Biological Sciences, Loyola University New Orleans, New Orleans, Louisiana, USA
| | - Stephen A Klotz
- Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, Maryland, USA
| | | | - Hany Kamel
- Corporate Medical Affairs, Vitalant, Scottsdale, Arizona, USA
| | | | - Patrick Sadler
- Central California Blood Center, Fresno, California, USA
| | - Susan P Montgomery
- Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hilda N Rivera
- Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa S Nolan
- Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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Saá P, Fink RV, Bakkour S, Jin J, Simmons G, Muench MO, Dawar H, Di Germanio C, Hui AJ, Wright DJ, Krysztof DE, Kleinman SH, Cheung A, Nester T, Kessler DA, Townsend RL, Spencer BR, Kamel H, Vannoy JM, Dave H, Busch MP, Stramer SL, Stone M, Jackman RP, Norris PJ. Frequent detection but lack of infectivity of SARS-CoV-2 RNA in pre-symptomatic, infected blood donor plasma. J Clin Invest 2022; 132:159876. [PMID: 35834347 PMCID: PMC9435642 DOI: 10.1172/jci159876] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Respiratory viruses such as influenza do not typically cause viremia; however, SARS-CoV-2 has been detected in the blood of COVID-19 patients with mild and severe symptoms. Detection of SARS-CoV-2 in blood raises questions about its role in pathogenesis as well as transfusion safety concerns. Blood donor reports of symptoms or a diagnosis of COVID-19 after donation (post-donation information, PDI) preceded or coincided with increased general population COVID-19 mortality. Plasma samples from 2,250 blood donors who reported possible COVID-19–related PDI were tested for the presence of SARS-CoV-2 RNA. Detection of RNAemia peaked at 9%–15% of PDI donors in late 2020 to early 2021 and fell to approximately 4% after implementation of widespread vaccination in the population. RNAemic donors were 1.2- to 1.4-fold more likely to report cough or shortness of breath and 1.8-fold more likely to report change in taste or smell compared with infected donors without detectable RNAemia. No infectious virus was detected in plasma from RNAemic donors; inoculation of permissive cell lines produced less than 0.7–7 plaque-forming units (PFU)/mL and in susceptible mice less than 100 PFU/mL in RNA-positive plasma based on limits of detection in these models. These findings suggest that blood transfusions are highly unlikely to transmit SARS-CoV-2 infection.
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Affiliation(s)
- Paula Saá
- Scientific Affairs, American Red Cross, Gaithersburg, United States of America
| | | | - Sonia Bakkour
- Vitalant Research Institute, San Francisco, United States of America
| | - Jing Jin
- Department of Virology, Vitalant Research Institute, San Francisco, United States of America
| | - Graham Simmons
- Department of Pathology and Laboratory Medicine, Vitalant Research Institute, San Francisco, United States of America
| | - Marcus O Muench
- Vitalant Research Institute, San Francisco, United States of America
| | - Hina Dawar
- Vitalant Research Institute, San Francisco, United States of America
| | - Clara Di Germanio
- Department of Laboratory Medicine, Vitalant Research Institute, San Francisco, United States of America
| | - Alvin J Hui
- Vitalant Research Institute, San Francisco, United States of America
| | | | - David E Krysztof
- Scientific Affairs, American Red Cross, Gaithersburg, United States of America
| | | | | | | | - Debra A Kessler
- Special Services, New York Blood Center, New York, United States of America
| | - Rebecca L Townsend
- Scientific Affairs, American Red Cross, Gaithersburg, United States of America
| | | | - Hany Kamel
- Central Office, Vitalant, Scottsdale, United States of America
| | | | - Honey Dave
- Vitalant Research Institute, San Francisco, United States of America
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, United States of America
| | - Susan L Stramer
- Scientific Affairs, American Red Cross, Gaithersburg, United States of America
| | - Mars Stone
- Department of Laboratory Medicine, Vitalant Research Institute, San Francisco, United States of America
| | - Rachael P Jackman
- Vitalant Research Institute, San Francisco, United States of America
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, United States of America
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