LETTER TO THE EDITOR

Filariasis due to blood transfusion

Enrico Rino Bregani
Dipartimento di Medicina d'Emergenza, Fondazione Policlinico, Mangiagalli e Regina Elena, IRCCS,
Milano, Italy

Dear Sir,
In his letter to Blood Transfusion, Viroj Wiwanitkit
emphasises the screening of donated blood to look
for microfilariae in order to prevent a possible risk of
transmitting a communicable disease1 . Cases of
tourism-acquired microfilariosis by Mansonella
ozzardi and M. perstans were cited. The case of M.
perstans microfilariasis2 described, actually occurred
in an endemic zone in south Chad, and was not a case
imported into a non-endemic area. An infant with
malaria-related severe anaemia received blood from
a parent carrying M. perstans microfilariae. The
patients follow-up showed a progressive clearance
of microfilariae from the blood without any
occurrence of symptoms or eosinophilia for 4 months.
Our conclusion was that, at least in endemic zones,
M. perstans microfilariae transfusion could be safe,
the disease probably being due to the action of or
immunological reaction against the adult worm. It is
likely that only adult worms are responsible for
symptoms and eosinophilia, while microfilariae in the
blood are unable to give clinical manifestations.
The eosinophilia that can be observed in some but
not all patients with M. perstans infection is probably
due to the bodys reaction against the adult worm
rather than against microfilariae and the absence of
eosinophilia in the case described could indicate that
M. perstans microfilariaemia is quite well tolerated

and can be considered a possible confirmation of the

absence of pathogenicity due to the presence of
microfilariae alone.
M. perstans microfilariae can persist in the host
for up to 3 years after transfusion3, but from our
observation we suggest that transfused M. perstans
microfilariae may be eliminated from the blood quite
quickly in endemic areas.
In the case of real need of blood, the presence of
M. perstans microfilariae in donated blood is probably
not an absolute contra-indication to perform a
transfusion, at least in endemic areas in which chronic
immunological stimulation against filarial infection
is possible.

References
1) Viroj W. Filariasis due to blood transfusion: a topic in
tropical medicine. Blood Transfus 2009;7:151.
2) Bregani ER, Balzarini L, Ghiringhelli C, Tarsia P.
Transfusional Mansonella perstans microfilariasis.
Parassitologia 2003;45:71-2.
3) Nutman TB. Experimental infection of humans with
filariae. Rev Infect Dis 1991;13:1018-22.

Received: 21 September 2009 - Accepted: 24 September 2009

Correspondence: Bregani Enrico Rino
Fondazione Policlinico, Mangiagalli e Regina Elena, IRCCS
Via Francesco Sforza
20122, Milano Italy
e-mail: ino_bregani@yahoo.it

Blood Transfus 2010; 8:129 DOI 10.2450/2009.0140-09

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