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Cost‐effectiveness of a Babesia microti blood donation intervention based on real‐time prospective screening in endemic areas of the United States

or antibody-positive (titer 256) units caused symptomatic infections in 34% of subjects. However, they are not supported by human data. Of 29 known PCR-positive units that were transfused, only one recipient (3.4%) became symptomatically ill, and there were no reported symptomatic cases from those receiving the 29 PCR-negative units. Using the transmissibility and progression estimates from Bish and coworkers, we would suppose that in 29 known PCR-positive units transfused, five to six recipients would develop uncomplicated yet symptomatic infections, while three to four would have complicated babesiosis with a mortality of 12%. Thus, Bish and colleagues have likely overstated the burden of TTB morbidity and mortality. In summary, while decision analysis and cost-effectiveness modeling are well suited to inform policy on this topic, the most recent analysis likely overestimates the burden of transfusion-transmitted babesiosis and the cost-effectiveness of blood screening in endemic areas. Policy-makers would be well served to closely inspect all available models and each of their strengths and limitations before promulgating guidance.