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. 2014 Apr;113(4):1305-11.
doi: 10.1007/s00436-014-3769-0. Epub 2014 Jan 24.

Serologic survey for exposure following fatal Balamuthia mandrillaris infection

Brendan R Jackson  1 , Zuzana Kucerova, Sharon L Roy, Glenda Aguirre, Joli Weiss, Rama Sriram, Jonathan Yoder, Rebecca Foelber, Steven Baty, Gordana Derado, Susan L Stramer, Valerie Winkelman, Govinda S Visvesvara
Affiliations

Serologic survey for exposure following fatal Balamuthia mandrillaris infection

Brendan R Jackson et al. Parasitol Res. 2014 Apr.

Abstract

Granulomatous amebic encephalitis (GAE) from Balamuthia mandrillaris, a free-living ameba, has a case fatality rate exceeding 90% among recognized cases in the USA. In August 2010, a GAE cluster occurred following transplantation of infected organs from a previously healthy landscaper in Tucson, AZ, USA, who died from a suspected stroke. As B. mandrillaris is thought to be transmitted through soil, a serologic survey of landscapers and a comparison group of blood donors in southern Arizona was performed. Three (3.6%) of 83 serum samples from landscapers and 11 (2.5%) of 441 serum samples from blood donors were seropositive (p = 0.47). On multivariable analysis, county of residence was associated with seropositivity, whereas age, sex, and ethnicity were not. Exposure to B. mandrillaris, previously unexamined in North America, appears to be far more common than GAE in Southern Arizona. Risk factors for disease progression and the ameba's geographic range should be examined.

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Figures

Fig. 1
Fig. 1
Flowchart of testing for serum antibodies to Balamuthia mandrillaris among landscapers and blood donors, Southern Arizona, USA, 2010. aDefined as absorbance value ≥ mean + 2 standard deviations of negative control sera bImmunofluorescence assay (IFA) titer ≥ 1:64 (designated as seropositive)
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