Leishmania: risk to the blood supply.
Leishmania infection is most often transmitted to humans via the bite of the phlebotomine sandfly, but transmission of Leishmania by transfusion has also been reported. There has been a huge increase in the incidence of cutaneous and visceral leishmaniasis in Iraq and Afghanistan. The deployment of US troops to these countries and published case reports of transmission to soldiers in endemic areas, by transfusion to infants with immature immune systems, and to individuals immunocompromised by disease or immunosuppressive therapy beckon a reexamination of blood donor deferral procedures. The length of the ongoing military conflict and the nature of exposure indicate that prior decisions regarding blood donor deferral made during the first Gulf War may no longer apply. Operation Iraqi Freedom and Operation Enduring Freedom present a much greater Leishmania threat than did Operation Desert Storm. Because most transmission by transfusion occurs in endemic areas, and visceral infection is asymptomatic in healthy individuals such as blood donors, it is difficult to determine the absolute risk of transmission by transfusion, but review of the literature provides many clues as to the appropriate measures to be taken for blood donor deferral.
Cardo
Lisa J
LJ
Walter Reed Army Institute of Research, Silver Spring, Maryland 20910, USA. Lisa.Cardo@us.army.mil
D000346:Afghanistan / Q000453:epidemiology; D000818:Animals; D001782:Blood Donors; D001803:Blood Transfusion / Q000592:standards; D046148:Donor Selection; D019353:Endemic Diseases; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D007896:Leishmaniasis / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D008889:Military Personnel; D015995:Prevalence; D012307:Risk Factors; D065227:Transfusion Reaction; D014857:Warfare