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Adverse Occurrence type:
Transfusion-transmitted malaria (TTM) varies dramatically depending on the prevalence of active disease in the donor pool and screening measures. The article claims to report the first case of TTM in Malaysia.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Described only as "malaria-like" symptoms. Both the donor and recipient were PCR positive for P. vivax.
Demonstration of imputability or root cause:
The recipient received blood (presumed whole blood, but not specified) from 3 donors, and only one donor was positive by PCR for infection. Both donor and recipient were PCR positive for P. vivax with identical sequences. It does not appear the recipient has other risk factors for infection. The donor was asymptomatic for infection at time of donation, and blood was negative by microscopy, but had recent travel to a highly endemic area of Myanmar.
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Anthony CN, et al. Malaysian child infected with Plasmodium vivax via blood transfusion: a case report.Malar J. 2013 Sep 4;12:308 Mungai et al NEJM 2001 Owusu-Ofori et al Clin Inf Dis 2010 Verra et al Malar J 2018
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Expert comments for publication:
Transfusion-transmitted malaria is rarely identified, but its incidence may be higher than appreciated and is difficult to detect in endemic areas. Transmission occurs in whole blood, red blood cells, and rarely in platelets that have residual red cells. Plasmodium spp. can survive at refrigerated temperatures. Although less common than P. falciparum, P. vivax is a relapsing illness and can recur for as long as 3-4 years after initial infection, and infected donors (particularly those partially immune) may not be detected even with screening using direct microscopy. The article recommends immune testing for at risk donors, and even discusses "processing of blood using antimalarials".