SPECIFIC ANTIBODIES TO TRYPANOSOMA-CRUZI AMONG BLOOD-DONORS IN LOS-ANGELES, CALIFORNIA

BACKGROUND: Trypanosoma cruzi, the cause of Chagas' disease, is often transmitted by transfusion in Latin America. Previous studies showed t hat at least 1 in 1000 eligible blood donors at the Los A?ge[es County +University of Southern California (LAC+USC) Medical Center Blood Bank had specific antibodies to T. cruzi. In June 1993, serologic screenin g of prospective allogeneic donors at epidemiologic risk for T. cruzi infection was begun voluntarily. STUDY DESIGN AND METHODS: The risk of T. cruzi infection in all eligible donors was assessed by questionnai re. At-risk donors were screened serologically for antibodies to T. cr uzi with an enzyme immunoassay, and confirmatory testing was done with a radioimmunoprecipitation assay. RESULTS: During the 29-month study period 1311 (39.5%) of 3320 donors were judged to be at risk for T. cr uzi infection. Seven donors (1/475) were reactive by an enzyme immunoa ssay, and six of these seven (1/553) were positive in a radioimmunopre cipitation assay. All radioimmunoprecipitation assay-positive donors h ad been born in countries in which Chagas' disease is endemic. One per son in this group had received a transfusion in his homeland. CONCLUSI ON: These results demonstrate that a substantive proportion of eligibl e blood donors at our institution have antibodies specific for T. cruz i and that a commercially available assay can be used to detect these antibodies. Our data suggest that the risk of transmission of T. cruzi by transfusion could be eliminated by serologic testing limited to pe rsons born in or transfused in countries in which Chagas' disease is e ndemic.