Status:
Ready to upload
Record number:
1671
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Rare outside endemic areas, depending on immigration patterns. Targeted screening of blood donors for T. cruzi antibodies can identify asymptomatic infection.
Time to detection:
8 weeks, as a result of a look back exercise.
Alerting signals, symptoms, evidence of occurrence:
Discretionary testing for T. cruzi antibody was introduced in Belgium in 2013. A look back exercise following identification of a seropositve donor revealed a recipient of RBC. The patient was a 7-year-old boy born in Belgium from two parents of Burundi origin, who suffered from sickle-cell disease. No symptoms suggestive of acute Chagas disease could be retrospectively identified; he was treated with benznidazole, 5 mg/kg twice daily, for 8 weeks. Two other recipients were identified; the recipient of another unit of RBC died 1 month post-transfusion and tests could not be performed. A third recipient received a platelet pool prepared from 6 whole blood samples, one of which from the infected donor. This unit received pathogen reduction treatment with amotosalen and UVA; the recipient did not show any evidence of T. cruzi infection.
Demonstration of imputability or root cause:
Pre-transfusion serology was negative for T. cruzi antibodies and a series of post-transfusion follow up samples tested positive for T. cruzi antibody and DNA. The donor was born in an endemic area in Brazil and moved to Belgium as an adult; he was asymptomatic but he was parasitaemic, with detectable T. cruzi DNA in blood by PCR.
Imputability grade:
2 Probable
Groups audience:
Keywords:
Suggest new keywords:
asymptomatic infection
undiagnosed infection
chronic infection
benznidasole
Reference attachment:
Suggest references:
Blumental S, Lambermont M, Heijmans C, Rodenbach M-P, El Kenz H, Sondag D, et al. (2015). First Documented Transmission of Trypanosoma
cruzi Infection through Blood Transfusion in a Child with Sickle-Cell Disease in Belgium. PLoS Negl Trop Dis 9(10): e0003986
Expert comments for publication:
Chagas disease is increasingly encountered in Europe, North America, and other non-endemic countries due to immigration of asymptomatic and undiagnosed, chronically infected individuals from Latin America. These individuals, though harboring very low parasite burden, have a lifelong risk of developing severe cardiac or digestive complications and remain as potential sources of infection through blood transfusion, organ donation and maternal-fetal transmission.