Transfusion-transmissible infection: Malaria

Transfusion-transmissible infections are delayed (>24 hours), non-immunological transfusion reactions.

Malaria is a rare transfusion-transmitted infection but continues to pose a risk.

To minimise the risk of potential blood donors transmitting infectious agents to patients, all donations are subjected to stringent screening procedures, including collection of a comprehensive medical and travel history as part of the donor assessment process. Malarial antibody screening is performed by the Australian Red Cross Blood Service on donors with a potential malarial exposure risk.

When to suspect this adverse reaction?

Patients can present with fever, headache, nausea, vomiting and orthostatic hypotension.

Classic malarial paroxysms depend on which intraerythrocytic parasite species of the Plasmodium genus has been transmitted.

Usual causes?

Malaria is a disease involving four protozoan parasitic species of the genus Plasmodium, namely P falciparum, P vivax, P ovale and   
P malariae
which can be transmitted to humans through the bite of a mosquito or through blood transfusion from a donor infected with malaria.


Clinically assess patients for malaria. Request preparation of thick and thin blood films to demonstrate the asexual forms of the parasite.

Perform other laboratory investigations as necessary.

What to do?

Treat the specific parasite with antimalarial drugs. 

Notify the Blood Service.