Condition
Lyme disease is a multisystem illness caused by infection with the spirochete Borrelia burgdorferi and the body's immune response to the infection. The disease is transmitted via tick bites, from infected ticks of the genus Ixodes. There are no known cases of Borrelia transmission with blood transfusion. Antibody tests may remain positive post-treatment lifelong (IgG and IgM).
Disease stages:
- early localised Lyme disease (erythema migrans and undifferentiated febrile illness) occurs 1-30 days after the tick bite
- early disseminated Lyme disease (musculoskeletal and neurologic symptoms, cardiac disturbances, ocular manifestation) usually develops 3-10 weeks after inoculation
- late Lyme disease refers to manifestations that occur months to years after the initial infection
Guidance at RECRUITMENT
ACCEPT if:
- donor is asymptomatic after treatment (even if positive antibodies persisting after completion of Lyme disease treatment if symptoms resolved)
- donors with positive antibodies in the absence of typical Lyme disease symptoms
- donors with persistent antibodies after completion of treatment and symptom resolution
Guidance at CT/WORK-UP
Donors with a history of Lyme disease
ACCEPT if
- donor is asymptomatic after treatment (even if positive antibodies persisting after completion of Lyme disease treatment if symptoms resolved)
Donors with a positive antibody but no diagnosis of Lyme disease
Accept
DEFER if:
- donor is currently undergoing work up for Lyme disease
- treated for Lyme disease at CT/WU stage. TU until completion of treatment and symptoms resolution as a minimal requirement
- in case of chronic symptoms persisting after the completion of treatment (post-treatment Lyme disease syndrome), i.e. chronic musculoskeletal symptoms, chronic arthritis, difficulties with memory, concentration or fatigue attributed to the infection
Individual at Risk
Donor. No evidence of blood transmission therefore not thought to be a recipient risk.
Justification for guidance
References
Transfusion-Associated Lyme Disease – Although Unlikely, It Is Still a Concern Worth Considering Charles S. Pavia1* and Maria M. Plummer2
1 Department of Biomedical Sciences, New York Institute of Technology College of Osteopathic Medicine, New York, NY,
United States, 2 Department of Clinical Specialties, New York Institute of Technology College of Osteopathic Medicine,
New York, NY, United States
Signs and Symptoms of Untreated Lyme Disease | Lyme Disease | CDC
Chronic Symptoms and Lyme Disease | Lyme Disease | CDC