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Can Lyme patients be blood donors?

Can Lyme-patients be blood donors?

According to the American Red Cross a person who has been diagnosed with Lyme disease is eligible to donate blood one year after their treatment has finished and if they no longer have symptoms. Individuals with Babesia or Ehrlichia infections are not eligible to donate blood. Blood donation centers throughout the world hold their own standards and criteria with regards to tick borne infections and these can vary widely.

The WHO writes in their guidelines on assessing donor suitability for blood donation:

Endogenous bacteria that are transfusion-transmissible include Treponema pallidum, Borrelia burgdorferi, Brucella melitensis and Yersinia enterocolitica, but blood donations are routinely screened only for T. pallidum.  On page 83.

The spirochete Borrelia burgdorferi is carried by insect vectors including ticks, horseflies and mosquitoes. It can survive blood storage temperatures. Transfusion transmission is possible but has not been reported. On page 84.

Babesia

Babesia can be transmitted by a blood transfusion and this is the reason why patients with this co infection are not eligible to donate blood. This parasite is potentially harmful for patients who are already immune compromised. Estimated 70 cases of infection with Babesia transmitted through blood transfusions were reported between 1979 and 2007. Another study from 2018 reports that the increasing incidence of tick transmitted Babesia correlates with increases in blood transfusion transmission of Babesia and the infection rate of ticks with Babesia. Safety of the blood supply with regards to Babesia cannot be guaranteed by current tests that are available.

Bartonella

Bartonella can cause a chronic, sub-clinical infection without or with minimal symptoms. This makes it possible that someone with a Bartonella infection donates blood because they feel healthy. Bartonella can survive long-term in multiple blood products.

Transmission by blood transfusion has been established in mice even when the numbers of Bartonella bacteria in the blood are so low that they cannot be detected by PCR tests. Safety of the blood supply with regards to Bartonella cannot be guaranteed by the current tests that are available.

Borrelia

There is little evidence that suggests Borrelia burgdorferi can be transmitted between humans by blood transfusion – but absence of evidence is not evidence of absence. Multiple studies conclude that Borrelia spirochetes can survive in blood products stored under blood banking conditions. In 2006 it has been proven that Borrelia burgdorferi can be transmitted between mice by blood transfusion. In 2014 the same has been established for Borrelia myamotoi. The scientists used untreated mice for these transmission experiments. Whether these results also apply to human beings is unknown.

Conclusion

Although the risk of transmitting Borrelia burgdorferi by blood transfusion is probably limited, the position of multiple blood donation centers worldwide is short-sighted. There are currently no tests that can tell us whether antibiotic treatment for Lyme disease was effective. Treated patients with lingering symptoms could have living spirochetes in their blood and organs which asks for caution.

Safety of the blood supply cannot be guaranteed with regards to multiple co-infections.  In the meanwhile, patients should take their own responsibility and don’t donate blood  and don’t become organ donors.

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References