Skip to main content
PMC home page
Proceedings (Baylor University. Medical Center) logoLink to Proceedings (Baylor University. Medical Center)
. 2018 May 10;31(3):307–309. doi: 10.1080/08998280.2018.1459397

Pathogens transmitted in red blood cell transfusions: An up-to-date table

Herbert L Fred a,✉, Manoj Thangam b, Gabriel M Aisenberg a
PMCID: PMC5997085  PMID: 29904294

According to a recent publication, 36,000 units of red blood cells are transfused into patients each day in the United States.1 Fortunately, with excellent screening techniques now in place, the associated risk of transmitting pathogens is extremely small, even for those of greatest concern—1 in 1.5 million for HIV, 1 in 1.1 million for hepatitis C virus, and 1 in 282,000 for hepatitis B virus.2 But if you are the recipient of an infectious unit, your risk is 100%, and you could die as a result.3

Given these facts, we wondered how many and what kinds of pathogens have been transmitted in red blood cell transfusions. So we launched a painstaking review of the extensive literature on this subject. We then constructed a handy, comprehensive, and up-to-date table of our findings—categorized and alphabetized (Table 1). Sharing that information and the supporting references is the purpose of this report.

Table 1.

Pathogens transmitted in red blood cell transfusionsa

Viruses Bacteria Protozoa Prions
Chikungunya virus4 Anaplasma phagocytophilum25 Babesia microti35 Variant Creutzfeldt-Jacob41
Colorado tick fever virus5 Bartonella species26 Leishmania donovani36  
Cytomegalovirus6 Borrelia recurrentis (relapsing fever)27 Malaria37  
Dengue virus7 Brucella species28 Mansonella perstans (microfilaria)38  
Epstein-Barr virus8 Clostridium perfringens3 Toxoplasma gondi39  
Hepatitis A virus9 Enterobacter cloacae3 Trypanosoma cruzi (Chagas)40  
Hepatitis B virus2,10 Enterococci3    
Hepatitis C virus2,11 Klebsiella pneumoniae29    
Hepatitis D virus12 Propionibacterium acnes3    
Hepatitis E virus13 Pseudomonas species3,30    
Hepatitis G virus14 Rickettsia rickettsii31    
Human herpesvirus 815 Serratia liquefaciens32    
Human immunodeficiency virus2 Staphylococcus aureus3    
Japanese encephalitis virus16 Treponema pallidum (syphilis)33    
Parvovirus17 Yersinia enterocolitica3,34    
SEN virus18      
Tick-borne encephalitis virus19      
Torque-tenovirus20,21      
West Nile virus22      
Yellow fever vaccine virus23      
Zika virus24      
Open in a new tab
a

Excludes unproved cases and transfusions of platelets and other blood products.

References

  • 1.Sacks CA, Goldstein RH, Walensky RP. Rethinking the ban―the U.S. blood supply and men who have sex with men. N Engl J Med. 2017;376:174–177. doi: 10.1056/NEJMms1613425. PMID: 27959708. [DOI] [PubMed] [Google Scholar]
  • 2.Carson JL, Grossman BJ, Kleinman S, et al. Clinical Transfusion Medicine Committee of the AABB. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2012;157:49–58. doi: 10.7326/0003-4819-157-1-201206190-00429. PMID: 22751760. [DOI] [PubMed] [Google Scholar]
  • 3.Sazama K. Reports of 355 transfusion-associated deaths: 1976 through 1985. Transfusion. 1990;30:583–590. doi: 10.1046/j.1537-2995.1990.30790385515.x. PMID: 2402771. [DOI] [PubMed] [Google Scholar]
  • 4.Petersen LR, Epstein JS. Chikungunya virus: new risk to transfusion safety in the Americas. Transfusion. 2014;54:1911–1915. doi: 10.1111/trf.12790. PMID: 25130331. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Randall WH, Simmons J, Casper EA, Philip RN. Transmission of Colorado tick fever virus by blood transfusion. MMWR Morb Mortal Wkly Rep. 1975;24:422–427. [Google Scholar]
  • 6.Kääriäinen L, Klemola E, Paloheimo J. Rise of cytomegalovirus antibodies in an infectious-mononucleosis-like syndrome after transfusion. BMJ. 1966;1:1270–1272. doi: 10.1136/bmj.1.5498.1270. PMID: 4287282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Oh HB, Muthu V, Daruwalla ZJ, Lee SY, Koay ES, Tambyah PA. Bitten by a bug or a bag? Transfusion-transmitted dengue: a rare complication in the bleeding surgical patient. Transfusion. 2015;55:1655–1661. doi: 10.1111/trf.13054. PMID: 25728040. [DOI] [PubMed] [Google Scholar]
  • 8.Trottier H, Buteau C, Robitaille N, et al. Transfusion-related Epstein-Barr virus infection among stem cell transplant recipients: a retrospective cohort study in children. Transfusion. 2012;52:2653–2663. doi: 10.1111/j.1537-2995.2012.03611.x. PMID: 22420319. [DOI] [PubMed] [Google Scholar]
  • 9.Giacoia GP, Kasprisin DO. Transfusion-acquired hepatitis A. South Med J. 1989;82:1357–1360. doi: 10.1097/00007611-198911000-00007. PMID: 2683125. [DOI] [PubMed] [Google Scholar]
  • 10.Soldan K, Ramsay M, Collins M. Acute hepatitis B infection associated with blood transfusion in England and Wales, 1991–7: review of database. BMJ. 1999;318:95. doi: 10.1136/bmj.318.7176.95. PMID: 9880282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Namasopo SO, Ndugwa C, Tumwine JK. Hepatitis C and blood transfusion among children attending the sickle cell clinic at Mulago Hospital, Uganda. Afr Health Sci. 2013;13:255–260. PMID: 24235921. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Rosina F, Saracco G, Rizzetto M. Risk of post-transfusion infection with the hepatitis delta virus. A multicenter study. N Engl J Med. 1985;312:1488–1491. doi: 10.1056/NEJM198506063122305. PMID: 3990749. [DOI] [PubMed] [Google Scholar]
  • 13.Hewitt PE, Ijaz S, Brailsford SR, et al. Hepatitis E virus in blood components: a prevalence and transmission study in southeast England. Lancet. 2014;384:1766–1773. doi: 10.1016/S0140-6736(14)61034-5. PMID: 25078306. [DOI] [PubMed] [Google Scholar]
  • 14.Salama KM, Selim OS. Hepatitis G virus infection in multitransfused Egyptian children. Pediatr Hematol Oncol. 2009;26:232–239. doi: 10.1080/08880010902897591. PMID: 19437325. [DOI] [PubMed] [Google Scholar]
  • 15.Hladik W, Dollard SC, Mermin J, et al. Transmission of human herpesvirus 8 by blood transfusion. N Engl J Med. 2006;355:1331–1338. doi: 10.1056/NEJMoa055009. PMID: 17005950. [DOI] [PubMed] [Google Scholar]
  • 16.Cheng VCC, Sridhar S, Wong SC, et al. Japanese encephalitis virus transmitted via blood transfusion, Hong Kong, China. Emerg Infect Dis. 2018;24:49–57. doi: 10.3201/eid2401.171297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Satake M, Hoshi Y, Taira R, Momose SY, Hino S, Tadokoro K. Symptomatic parvovirus B19 infection caused by blood component transfusion. Transfusion. 2011;51:1887–1895. doi: 10.1111/j.1537-2995.2010.03047.x. PMID: 21332725. [DOI] [PubMed] [Google Scholar]
  • 18.Umemura T, Yeo AE, Sottini A, et al. SEN virus infection and its relationship to transfusion-associated hepatitis. Hepatology. 2001;33:1303–1311. doi: 10.1053/jhep.2001.24268. PMID: 11343260. [DOI] [PubMed] [Google Scholar]
  • 19.Wahlberg P, Saikku P, Brummer-Korvenkontio M. Tick-borne encephalitis in Finland. The clinical features of Kumlinge disease during 1959–1987. J Intern Med. 1989;225:173–177. doi: 10.1111/j.1365-2796.1989.tb00059.x. PMID: 2703799. [DOI] [PubMed] [Google Scholar]
  • 20.Nishizawa T, Okamoto H, Konishi K, Yoshizawa H, Miyakawa Y, Mayumi M. A novel DNA virus (TTV) associated with elevated transaminase levels in posttransfusion hepatitis of unknown etiology. Biochem Byophys Res Commun. 1997;241:92–97. doi: 10.1006/bbrc.1997.7765. [DOI] [PubMed] [Google Scholar]
  • 21.Di Minno G, Perno CF, Tiede A, et al. Current concepts in the prevention of pathogen transmission via blood/plasma-derived products for bleeding disorders. Blood Rev. 2016;30:35–48. doi: 10.1016/j.blre.2015.07.004. PMID: 26381318. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Centers for Disease Control and Prevention Update: investigations of West Nile virus infections in recipients of organ transplantation and blood transfusion. MMWR Morb Mortal Wkly Rep. 2002;51:833–836. PMID: 12353745. [PubMed] [Google Scholar]
  • 23.Centers for Disease Control and Prevention Transfusion-related transmission of yellow fever vaccine virus―California, 2009. MMWR Morb Mortal Wkly Rep. 2010;59:34–37. PMID: 20094025. [PubMed] [Google Scholar]
  • 24.Barjas-Castro ML, Angerami RN, Cunha MS, et al. Probable transfusion-transmitted Zika virus in Brazil. Transfusion. 2016;56:1684–1688. doi: 10.1111/trf.13681. PMID: 27329551. [DOI] [PubMed] [Google Scholar]
  • 25.Alhumaidan H, Westley B, Esteva C, Berardi V, Young C, Sweeney J. Transfusion-transmitted anaplasmosis from leukoreduced red blood cells. Transfusion. 2013;53:181–186. doi: 10.1111/j.1537-2995.2012.03685.x. PMID: 22563784. [DOI] [PubMed] [Google Scholar]
  • 26.Magalhães RF, Urso Pitassi LH, Lania BG, Barjas-Castro ML, Neves Ferreira Velho PE. Bartonellosis as cause of death after red blood cell transfusion. Ultrastruct Pathol. 2009;33:151–154. doi: 10.3109/01913120902785567. PMID: 19728230. [DOI] [PubMed] [Google Scholar]
  • 27.Nadelman RB, Wormser GP, Sherer C. Blood transfusion-associated relapsing fever. Transfusion. 1990;30:380–381. doi: 10.1046/j.1537-2995.1990.30490273451.x. PMID: 2349638. [DOI] [PubMed] [Google Scholar]
  • 28.Economidou J, Kalafatas P, Vatopoulou T, Petropoulou D, Kattamis C. Brucellosis in two thalassaemic patients infected by blood transfusions from the same donor. Acta Haematol. 1976;55:244–249. doi: 10.1159/000208021. PMID: 816164. [DOI] [PubMed] [Google Scholar]
  • 29.Niu MT, Knippen M, Simmons L, Holness LG. Transfusion-transmitted Klebsiella pneumoniae fatalities, 1995 to 2004. Transfus Med Rev. 2006;20:149–157. doi: 10.1016/j.tmrv.2005.11.007. PMID: 16565027. [DOI] [PubMed] [Google Scholar]
  • 30.Tabor E, Gerety RJ. Five cases of Pseudomonas sepsis transmitted by blood transfusions. Lancet. 1984;1:1403. doi: 10.1016/S0140-6736(84)91891-9. PMID: 6145848. [DOI] [PubMed] [Google Scholar]
  • 31.Wells GM, Woodward TE, Fiset P, Hornick RB. Rocky Mountain spotted fever caused by blood transfusion. JAMA. 1978;239:2763–2765. doi: 10.1001/jama.239.26.2763. PMID: 418193. [DOI] [PubMed] [Google Scholar]
  • 32.Roth VR, Arduino MJ, Nobiletti J, et al. Transfusion-related sepsis due to Serratia liquefaciens in the United States. Transfusion. 2000;40:931–935. doi: 10.1046/j.1537-2995.2000.40080931.x. PMID: 10960519. [DOI] [PubMed] [Google Scholar]
  • 33.McCluskie JA. Transmission of syphilis by blood transfusion. Br Med J. 1939;1:264–266. doi: 10.1136/bmj.1.4075.264. PMID: 20782109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Beresford AM. Transfusion reaction due to Yersinia enterocolitica and review of other reported cases. Pathology. 1995;27:133–135. doi: 10.1080/00313029500169732. PMID: 7567139. [DOI] [PubMed] [Google Scholar]
  • 35.Glanternik JR, Baine IL, Rychalsky MR, Tormey CA, Shapiro ED, Baltimore RS. A cluster of cases of Babesia microti among neonates traced to a single unit of donor blood. Pediatr Infect Dis J. 2018;37:269–271. doi: 10.1097/INF.0000000000001803. PMID: 28945680. [DOI] [PubMed] [Google Scholar]
  • 36.Dey A, Singh S. Transfusion transmitted leishmaniasis: a case report and review of literature. Indian J Med Microbiol. 2006;24:165–170. PMID: 16912434. [PubMed] [Google Scholar]
  • 37.Cadham FT. Transmission of malaria by blood transfusion. Can Med Assoc J. 1936;34:428–430. PMID: 20320233. [PMC free article] [PubMed] [Google Scholar]
  • 38.Obebe OO, Falohun OO, Onyiche ET, Otuneme GO. Parasitological profile of perstans filariasis among blood donors in Ife-Ife, Southwest, Nigeria. Afr J Biomed Res. 2016;19:99–102. [Google Scholar]
  • 39.Ebrahim Zadeh A, Bamedi T, Etemadi S, Shahrakipour M, Saryazdipour Kh. Toxoplasmosis as a complication of transfusion in hemodialysis patients. Iran J Ped Hematol Oncol. 2014;4:22–25. PMID: 24734160. [PMC free article] [PubMed] [Google Scholar]
  • 40.Flores-Chavez M, Fernandez B, Puente S, et al. Transfusional Chagas disease: parasitological and serological monitoring of an infected recipient and blood donor. Clin Infect Dis. 2008;46:e44–e47. doi: 10.1086/527448. PMID: 18257698. [DOI] [PubMed] [Google Scholar]
  • 41.Llewelyn CA, Hewitt PE, Knight RS, et al. Possible transmission of variant Creutzfeldt-Jakob disease by blood transfusion. Lancet. 2004;363:417–421. doi: 10.1016/S0140-6736(04)15486-X. PMID: 14962520. [DOI] [PubMed] [Google Scholar]

Articles from Proceedings (Baylor University. Medical Center) are provided here courtesy of Baylor University Medical Center

RESOURCES