Results of lookback for Chagas disease since the inception of donor screening at New York Blood Center.
BACKGROUND
Chagas disease is a parasitic infection by Trypanosoma cruzi, typically transmitted via infected triatomine bug fecal contamination of bite sites. Other routes of infection include congenital, oral, organ transplantation, and blood product transmission.


METHODS
From 2007 until 2011, New York Blood Center screened donations for the presence of T. cruzi antibodies using a Food and Drug Administration-approved test. Confirmatory testing was performed and recipients of units donated by confirmed-positive donors were investigated via lookback.


RESULTS
A total of 204 donors were T. cruzi antibody positive representing 0.019% of all donors during this time period (1,066,516 unique donors screened). Of the enzyme-linked immunosorbent assay-reactive donors, 77 were confirmed positive by radioimmunoprecipitation assay (0.007%). At least 154 units from 29 of the confirmed-positive donors had been transfused to 141 recipients. At the time of lookback, 48 of the 141 recipients were alive and seven underwent T. cruzi screening. Two recipients were found to be immunofluorescence assay (IFA) positive. Both IFA-positive recipients received a leukoreduced apheresis platelet unit (two separate donations) from the same confirmed positive donor, a 72-year-old immigrant from Argentina.


CONCLUSIONS
Lookback analysis was able to identify the first two cases of probable transfusion-transmitted T. cruzi infection since implementation of the national screening program, which increases the total number of reported cases in the United States to 8.
New York Blood Center, New York, New York 10065, USA. dkessler@nybloodcenter.org
Debra A
DA
Kessler
Patricia A
PA
Shi
Scott T
ST
Avecilla
Beth H
BH
Shaz
D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood*; D000094902:Blood Banking / Q000379:methods*; D058731:Blood Safety / Q000379:methods*; D014355:Chagas Disease / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D017713:Platelet Transfusion; D014349:Trypanosoma cruzi / Q000276:immunology*
D000913:Antibodies, Protozoan