VA Resident Report: Are there cases in the United States of malaria transmitted via blood transfusions?

The Bottom Line: CDC received 1,925 reported cases of malaria with an onset of symptoms in 2011 among persons in the United States, including 1,920 cases classified as imported, one laboratory-acquired case, one transfusion-related case, two congenital cases, and one cryptic case. The total number of cases represents an increase of 14% from the 1,691 cases reported for 2010 and the largest number of reported cases since 1971.

Cullen, K., & Arguin, P. (n.d.). Malaria surveillance–United States, 2011. Morbidity and Mortality Weekly Report. MMWR., 62(5), 1-17.

Transfusion Transmitted Infection
Case. In April, a man aged 76 years who was a veteran was admitted to a military hospital for presumed urosepsis. He had a 1-day history of fevers and, although he had been admitted several times during the previous 6 months for other conditions, had not complained of any symptoms consistent with acute malaria. A hematologist identified malaria parasites incidentally while performing a manual differential of a complete blood count, and the species was subsequently confirmed by PCR to be P. malariae. The patient was treated with an oral antimalarial regimen and recovered fully. The patient’s travel history included a 1- year tour of duty in Vietnam and a short stay in Brazil, both in the early 1970s. The patient had no recent travel to malaria-endemic regions. The patient had been treated for anemia of chronic disease for several years and since December 2010 had been transfused with eight units of red blood cells. The blood bank was contacted and a trace-back investigation was initiated using banked serum samples from the eight donors. One of the donor serum samples had elevated titers against P. malariae and P. falciparum, indicating a previous infectious exposure at an indeterminate time. The implicated donor was contacted and his travel history and malaria exposure was ascertained. The donor lived in Liberia for the first five years of life (1990-1995) with no other travel history.

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