{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:02:16Z","timestamp":1785290536449,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T00:00:00Z","timestamp":1626480000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000014","name":"Canadian Blood Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Babesia microti<\/jats:italic> has gained a foothold in Canada as tick vectors become established in broader geographic areas. <jats:italic>B. microti<\/jats:italic> infection is associated with mild or no symptoms in healthy individuals but is transfusion\u2010transmissible and can be fatal in immunocompromised individuals. This is the first estimate of clinically significant transfusion\u2010transmitted babesiosis (TTB) risk in Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and methods<\/jats:title><jats:p>The proportion of <jats:italic>B. microti<\/jats:italic>\u2010antibody (AB)\/nucleic acid amplification test (NAT)\u2010positive whole blood donations was estimated at 5.5% of the proportion of the general population with reported Lyme Disease (also tick\u2010borne) based on US data. Monte Carlo simulation estimated the number and proportion of infectious red cell units for three scenarios: base, localized incidence (risk in Manitoba only), and donor study informed (prevalence from donor data). The model simulated 1,029,800 donations repeated 100,000 times for each.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the base scenario 0.5 (0.01, 1.75), <jats:italic>B. microti<\/jats:italic>\u2010NAT\u2010positive donations would be expected per year, with 0.08 (0, 0.38) recipients suffering clinically significant TTB (1 every 12.5\u2009years). In the localized incidence scenario, there were 0.21(0, 0.7) <jats:italic>B. microti<\/jats:italic>\u2010NAT\u2010positive donations, with 0.04 (0, 0.14) recipient infections (about 1 every 25\u2009years). In the donor study informed scenario, there were 4.6 (0.3, 15.8) <jats:italic>B. microti<\/jats:italic>\u2010NAT\u2010positive donations expected, and 0.81 (0.05, 3.14) clinically significant TTB cases per year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The likelihood of clinically relevant TTB is low. Testing would have very little utility in Canada at this time. Ongoing pathogen surveillance in tick vectors is important as <jats:italic>B. microti<\/jats:italic> prevalence appears to be slowly increasing in Canada.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16595","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T12:24:17Z","timestamp":1626524657000},"page":"2958-2968","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of transfusion\u2010transmitted <i>Babesia microti<\/i> in Canada"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5332-2789","authenticated-orcid":false,"given":"Sheila F.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Epidemiology &amp; Surveillance Canadian Blood Services  Ottawa Ontario Canada"},{"name":"School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2519-1109","authenticated-orcid":false,"given":"Steven J.","family":"Drews","sequence":"additional","affiliation":[{"name":"Department of Microbiology Canadian Blood Services  Edmonton Alberta Canada"},{"name":"Department of Laboratory Medicine and Pathology University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi\u2010Long","family":"Yi","sequence":"additional","affiliation":[{"name":"Epidemiology &amp; Surveillance Canadian Blood Services  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-9517","authenticated-orcid":false,"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas H.","family":"Ogden","sequence":"additional","affiliation":[{"name":"Public Health Risk Sciences Division, National Microbiology Laboratory Public Health Agency of Canada  Saint\u2010Hyacinthe Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jules K.","family":"Koffi","sequence":"additional","affiliation":[{"name":"Public Health Risk Sciences Division, National Microbiology Laboratory Public Health Agency of Canada  Saint\u2010Hyacinthe Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie Robbin","family":"Lindsay","sequence":"additional","affiliation":[{"name":"Zoonotic Diseases &amp; Special Pathogens, National Microbiology Laboratory Public Health Agency of Canada  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Gregoire","sequence":"additional","affiliation":[{"name":"Epidemiology and Statistics H\u00e9ma\u2010Qu\u00e9bec  Quebec City Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Delage","sequence":"additional","affiliation":[{"name":"Medical Microbiology H\u00e9ma\u2010Qu\u00e9bec  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.02.008"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1202018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00362"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15425"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpara.2018.11.007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1307799"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP57"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v43i10a01"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/209521"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.13339"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.15470"},{"key":"e_1_2_8_13_1","first-page":"221","article-title":"Identification of Babesia microti in a Canadian blood donor and lookback in a red blood cell recipient","volume":"115","author":"Drews SJ","year":"2020","journal-title":"Vox Sang"},{"key":"e_1_2_8_14_1","unstructured":"Food and Drug Administration.Recommendations for reducing the risk of transfusion\u2010transmitted babesiosis. 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