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Babesiosis is caused by intraerythrocytic protozoan parasites that are transmitted by ticks, or less commonly through blood transfusion or transplacentally. Human babesiosis was first recognized in a splenectomized patient in Europe but most cases have been reported from the northeastern and upper midwestern United States in people with an intact s...
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... In New England, seroprevalence has varied between 0.5% and 16%. 15,19 Mild to Moderate Disease Following an incubation period of about 1 to 4 weeks after a tick bite or 1 to 9 weeks (but up to 6 months) following transfusion of contaminated blood products, a gradual onset of malaise and fatigue is accompanied by fever and one or more of the following: chills, sweats, anorexia, headache, myalgia, nausea, nonproductive cough, and arthralgia (Table 1). 18,20-29 Also reported are emotional liability and depression, Outpatient cases are from Ruebush et al, 25 Krause et al, 26 and Krause et al. 27 Inpatient cases are from White et al, 20 Krause et al, 24 Hatcher et al, 28 and Joseph et al. 18 hyperesthesia, sore throat, abdominal pain, vomiting, conjunctival injection, photo- phobia, and weight loss. ...
Citations
... Babesiosis due to B. divergens is the most severe among the infections due to all Babesia species in humans with a quite high mortality, up to 40% in hospitalized patients, although nowadays it is decreasing 15 . Other Babesia species such as B. microti have a lower mortality rate reaching 10-20% in hospitalized individuals 16,17 . Mortality attributable to Babesia is not due exclusively to the pathogen or the host but also to the interaction between both of them. ...
Differences between double infection by Borrelia burgdorferi-Babesia divergens and Borrelia burgdorferi monoinfection in adult patients have not been reported so far. Both zoonosis, endemic in Northwestern Spain, are transmitted by Ixodes tick bites.
Clinical, analytical and other tests (imaging, ECG) characteristics of 120 adult patients with B.burgdorferi infection, of which 47 (39.2%) had B.burgdorferi-B.divergens double infection, diagnosed between 2014–2017, were retrospectively compared.
Cardiorespiratory symptoms were reported in 9/47 (19.2%) patients with B.burgdorferi-B.divergens double infection compared to 4/73 (5.5%) patients with B.burgdorferi monoinfection (P = 0.02). Dyspnea was recorded in 4/47 (8.5%) doubly infected compared to 1/73 (1.4%) monoinfected patients (P = 0.07). In addition ECG atrioventricular (AV) block was detected in 5/47 (15.6%) doubly infected compared to 1/73 (2.6%) monoinfected individuals (P = 0.09). No other clinical, laboratory or other tests differences were observed between doubly infected and monoinfected patients.
We conclude that doubly infected had more frequently cardiorespiratory symptoms, mostly dyspnea, compared to monoinfected individuals. These symptoms were unrelated to anemia. ECG AV block perhaps induced by summative myocardial damage due to both infections might play some role in the cardiorespiratory dysfunction.
... This study also confirmed that the lung injury caused during natural complicated Babesia rossi infection in dogs fulfils the criteria for the definitions of ALI and ARDS (Wilkins et al. 2007). The lung pathology in the current study was similar to murine malariaassociated ARDS in C57BL/6J mice infected with Plasmodium berghei NK65 (Van den Steen et al. 2010), the murine model of Babesia-associated ALI/ARDS in C3H/HeN mice infected with WA-1 Babesia (Hemmer et al. 1999) as well as human malariaassociated ALI/ARDS (Spitz 1946;Taylor et al. 2012) and human babesiosis (Vannier et al. 2015). Hyaline membranes were not a feature in this study, probably due to the acute nature of the respiratory pathology and decreased survival of the dogs. ...
A proportion of Babesia rossi infections in dogs are classified as complicated and one of the most lethal complications is acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Most dogs that die succumb within 24 hours of presentation. The pulmonary pathology caused by B. rossi in dogs has not been described. The aim of this study was to provide a thorough macroscopic, histological and immunohistochemical description of the lung changes seen in dogs naturally infected with B. rossi that succumbed to the infection. Death was invariably accompanied by alveolar oedema. Histopathology showed acute interstitial pneumonia characterised by alveolar oedema and haemorrhages, with increased numbers of mononuclear leucocytes in alveolar walls and lumens. Intra-alveolar polymerised fibrin aggregates were observed in just over half the infected cases. Immunohistochemistry showed increased numbers of MAC387- and CD204-reactive monocyte-macrophages in alveolar walls and lumens, and increased CD3-reactive T-lymphocytes in alveolar walls, compared with controls. These histological features overlap to some extent (but far from perfectly) with the histological pattern of lung injury referred to as the exudative stage of diffuse alveolar damage (DAD) as is quite commonly reported in ALI/ARDS.
... Although most persons with babesiosis experience nonspecific influenza-like symptoms, more severe and prolonged disease can occur in persons >50 years of age; those who are immunocompromised due to asplenia, cancer, or HIV/AIDS or who are receiving immunosuppressive drugs; and those who have chronic heart, lung, renal, or liver disease (2,7,8). Severe infection is associated with high-grade parasitemia and organ failure (e.g., acute respiratory distress syndrome, congestive heart failure, severe hemolytic anemia, or renal failure) and death (2,(8)(9)(10)(11). Little has been published about babesiosis-induced central nervous system dysfunction (12,13). ...
Babesiosis is a globally distributed parasitic infection caused by intraerythrocytic protozoa. The full spectrum of neurologic symptoms, the underlying neuropathophysiology, and neurologic risk factors are poorly understood. Our study sought to describe the type and frequency of neurologic complications of babesiosis in a group of hospitalized patients and assess risk factors that might predispose patients to neurologic complications. We reviewed medical records of adult patients who were admitted to Yale-New Haven Hospital, New Haven, Connecticut, USA, during January 2011-October 2021 with laboratory-confirmed babesiosis. More than half of the 163 patients experienced >1 neurologic symptoms during their hospital admissions. The most frequent symptoms were headache, confusion/delirium, and impaired consciousness. Neurologic symptoms were associated with high-grade parasitemia, renal failure, and history of diabetes mellitus. Clinicians working in endemic areas should recognize the range of symptoms associated with babesiosis, including neurologic.
... Babesiosis is one of the most common infectious diseases of wild and domestic animals worldwide. It is caused by intraerythrocytic protozoa and has been recently considered as possible emerging tick-borne zoonosis (Vannier et al., 2015;Zhou et al., 2014). Human cases in Europe were associated with B. divergens, B. venatorum (sp. ...
Background
Anaplasmosis, borreliosis, rickettsiosis and babesiosis are tick-borne diseases of medical, veterinary and economic importance. In Belgium, little is known on the prevalence of these diseases in animals and previous screenings relate only to targeted geographic regions, clinical cases or a limited number of tested samples. We therefore performed the first nationwide seroprevalence study of Anaplasma spp., A. phagocytophilum, Borrelia spp., Rickettsia spp. and Babesia spp. in Belgian cattle. We also screened questing ticks for the aforementioned pathogens.
Methods
ELISAs and IFATs were performed on a representative sample set of cattle sera stratified proportionally to the number of cattle herds per province. Questing ticks were collected in areas where the highest prevalence for the forenamed pathogens in cattle serum were observed. Ticks were analyzed by quantitative PCR for A. phagocytophilum (n = 783), B. burgdorferi sensu lato (n = 783) and Rickettsia spp. (n = 715) and by PCR for Babesia spp. (n = 358).
Results
The ELISA screening for antibodies to Anaplasma spp. and Borrelia spp. in cattle sera showed an overall seroprevalence of 15.6% (53/339) and 12.9% (52/402), respectively. The IFAT screening for antibodies against A. phagocytophilum, Rickettsia spp. and Babesia spp. resulted in an overall seroprevalence of 34.2% (116/339), 31.2% (99/317) and 3.4% (14/412), respectively. At the provincial level, the provinces of Liege and Walloon Brabant harboured the highest seroprevalence of Anaplasma spp. (44.4% and 42.7% respectively) and A. phagocytophilum (55.6% and 71.4%). East Flanders and Luxembourg exhibited the highest seroprevalence of Borrelia spp. (32.4%) and Rickettsia spp. (54.8%) respectively. The province of Antwerp showed the highest seroprevalence of Babesia spp. (11%). The screening of field-collected ticks resulted in a prevalence of 13.8% for B. burgdorferi s.l., with B. afzelii and B. garinii being the most common genospecies (65.7% and 17.1%, respectively). Rickettsia spp. was detected in 7.1% of the tested ticks and the only identified species was R. helvetica. A low prevalence was found for A. phagocytophilum (0.5%) and no Babesia positive tick was detected.
Conclusions
The seroprevalence data in cattle indicate hot spots for tick-borne pathogens in specific provinces and highlights the importance of veterinary surveillance in anticipating the emergence of diseases among humans. The detection of all pathogens, with the exception of Babesia spp. in questing ticks, underlines the need of raising awareness among public and professionals on other tick-borne diseases along with lyme borreliosis.
... In certain patients, severe complications can occur, including thrombocytopenia, renal failure, and acute respiratory distress syndrome (1). Babesiosis can be treated using a combination of antimicrobial medications, such as azithromycin and atovaquone (2). ...
... The expansion of babesiosis risk could have implications for the blood supply. Babesia is transmissible via blood transfusion, and persons who acquire babesiosis through contaminated blood have been shown to have significantly worse health outcomes and a higher risk for death than do those who acquire the disease from a tick bite (1). Currently, the FDA recommends blood donation screening for babesiosis in 14 states and the District of Columbia (6). ...
Babesiosis is a tickborne disease caused by intraerythrocytic Babesia parasites. In the United States, most babesiosis cases are caused by Babesia microti, transmitted from bites of blacklegged ticks, Ixodes scapularis, in northeastern and midwestern states. Transmission can also occur through blood transfusions, transplantation of organs from infected donors, or congenital (mother-to-child) transmission (1). Babesia infection can be asymptomatic or cause mild to severe illness that can be fatal. Overall, U.S. tickborne disease cases have increased 25%, from 40,795 reported in 2011 to 50,856 in 2019 (2). Babesiosis trends were assessed in 10 states* where babesiosis was reportable during 2011-2019. Incidence increased significantly in Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont (p<0.001), with the largest increases reported in Vermont (1,602%, from two to 34 cases), Maine (1,422%, from nine to 138), New Hampshire (372%, from 13 to 78), and Connecticut (338%, from 74 to 328). Unlike the other seven states, Maine, New Hampshire, and Vermont, were not included as states with endemic disease in previous CDC babesiosis surveillance summaries. These three states should now be considered to have endemic transmission comparable to that in other high-incidence states; they have consistently identified newly acquired cases every year during 2011-2019 and documented presence of Babesia microti in the associated tick vector (3). Because incidence in Northeastern states, including Maine, New Hampshire, and Vermont, is increasing, tick prevention messaging, provider education, and awareness of infection risk among travelers to these states should be emphasized.
... Currently, more than 100 Babesia spp. have been identified worldwide and they impose a significant burden on domestic animals (Vannier et al., 2015). During the past 50 years, increasing numbers of Babesia spp. ...
Parasites of the Babesia genus are prevalent worldwide and infect a wide diversity of domestic animals and humans. Herein, using Oxford Nanopore Technology and Illumina sequencing technologies, we sequenced two Babesia sub-species, Babesia motasi lintanensis and Babesia motasi hebeiensis. We identified 3,815 one-to-one ortholog genes that are specific to ovine Babesia spp. Phylogenetic analysis reveals that the two B. motasi subspecies form a distinct clade from other Piroplasma spp. Consistent with their phylogenetic position, comparative genomic analysis reveals that these two ovine Babesia spp. share higher colinearity with Babesia bovis than with Babesia microti. Concerning the speciation date, B. m. lintanensis split from B. m. hebeiensis approximately 17 million years ago. Genes correlated to transcription, translation, protein modification and degradation, as well as differential/specialized gene family expansions in these two subspecies may favor adaptation to vertebrate and tick hosts. The close relationship between B. m. lintanensis and B. m. hebeiensis is underlined by a high degree of genomic synteny. Compositions of most invasion, virulence, development, and gene transcript regulation-related multigene families, including spherical body protein, variant erythrocyte surface antigen, glycosylphosphatidylinositol anchored proteins, and transcription factor Apetala 2 genes, is largely conserved, but in contrast to this conserved situation, we observe major differences in species-specific genes that may be involved in multiple functions in parasite biology. For the first time in Babesia spp., we find abundant fragments of long terminal repeat-retrotransposons in these two species. We provide fundamental information to characterize the genomes of B. m. lintanensis and B. m. hebeiensis, providing insights into the evolution of B. motasi group parasites.
... Infection can result in fever, hemolytic anemia, and in severe cases, respiratory distress, pulmonary edema, and even death [2]. Patients who are immunocompromised or have undergone splenectomy are more susceptible to the disease and have a higher mortality rate [3], indicating that Babesia is a serious health risk for humans. ...
Human babesiosis is an emerging tick-borne disease, caused by haemoprotozoa genus of Babesia. Cases of transfusion-transmitted and naturally acquired Babesia infection have been reported worldwide in recent years and causing a serious public health problem. Babesia duncani is one of the important pathogens of human babesiosis, which seriously endangers human health. The in vitro culture systems of B. duncani have been previously established, and it requires fetal bovine serum (FBS) to support long-term proliferation. However, there are no studies on serum-free in vitro culture of B. duncani. In this study, we reported that B. duncani achieved long-term serum-free culture in VP-SFM AGTTM (VP-SFM) supplemented with AlbuMaxTM I. The effect of adding different dilutions of AlbuMaxTM I to VP-SFM showed that 2 mg/mL AlbuMaxTM I had the best B. duncani growth curve with a maximum percentage of parasitized erythrocytes (PPE) of over 40%, and it can be used for long-term in vitro culture of B. duncani. However, the commonly used 20% serum-supplemented medium only achieves 20% PPE. Clearly, VP-SFM with 2 mg/mL AlbuMaxTM I (VP-SFMA) is more suitable for the in vitro proliferation of B. duncani. VP-SFM supplemented with CD lipid mixture was also tested, and the results showed it could support the parasite growth at 1:100 dilution with the highest PPE of 40%, which is similar to that of 2 mg/mL AlbuMaxTM I. However, the CD lipid mixture was only able to support the in vitro culture of B. duncani for 8 generations, while VP-SFMA could be used for long-term culture. To test the pathogenicity, the VP-SFMA cultured B. duncani was also subjected to hamster infection. Results showed that the hamster developed dyspnea and chills on day 7 with 30% PPE before treatment, which is similar to the symptoms with un-cultured B. duncani. This study develops a unique and reliable basis for further understanding of the physiological mechanisms, growth characteristics, and pathogenesis of babesiosis, and provides good laboratory material for the development of drugs or vaccines for human babesiosis and possibly other parasitic diseases.
... Ten gatunek cechuje się również minimalnymi wymaganiami metabolicznymi dla wewnątrzerytrocytarnego pasożytnictwa [1,11,12]. Pierwotniaki z gatunku B. microti są głównym czynnikiem etiologicznym babeszjozy u ludzi w północno-wschodnich i środkowo-zachodnich Stanach Zjednoczonych [1,13]. Badania epidemiologiczne prowadzone w tych rejonach USA wykazały, że kontakt z B. microti miało 4-7% populacji, z czego u większości nie występowały żadne objawy kliniczne wskazujące na infekcję [6,7]. ...
... 50 przypadków ludzkiej babeszjozy wywołanej przez B. divergens oraz B. venatorum [9,14]. Wykryte w Polsce i opisane przypadki babeszjozy u ludzi były w większości zawleczone z krajów tropikalnych i stwierdzono je u pacjentów ze współistniejącymi innymi chorobami z tych rejonów lub były wykrywane w ramach badań naukowych [13,14]. ...
... Inną drogą zarażenia tymi patogenami może być transmisja pierwotniaków poprzez transfuzję krwi, przy czym śmierć z powodu babeszjozy występuje nawet u 20% osób zakażonych w ten sposób [1,16]. Badania przeprowadzone w Stanach Zjednoczonych wykazały znaczny odsetek wyników seropozytywnych wśród dawców krwi (3,3-4,9%) [13]. Zarażenie może wystąpić również w wypadku infekcji okołoporodowej od matki poprzez łożysko lub przy przeszczepie organów, jednak ten rodzaj transmisji jest bardzo rzadki [1,17]. ...
... Babesia infection can cause a wide range of severity of illnesses ranging from asymptomatic infection to fatal disease [3]. Physical examination fndings include fever, pallor, jaundice, retinopathy with splinter hemorrhages and retinal infarcts, splenomegaly, or hepatomegaly [3,4]. Laboratory abnormalities include hemolytic anemia, thrombocytopenia, and elevated liver enzyme levels [4]. ...
... Physical examination fndings include fever, pallor, jaundice, retinopathy with splinter hemorrhages and retinal infarcts, splenomegaly, or hepatomegaly [3,4]. Laboratory abnormalities include hemolytic anemia, thrombocytopenia, and elevated liver enzyme levels [4]. Babesiosis can be complicated by severe anemia, disseminated intravascular coagulation, congestive heart failure, pulmonary edema, renal failure, or splenic rupture [1,2,4,5]. ...
... Laboratory abnormalities include hemolytic anemia, thrombocytopenia, and elevated liver enzyme levels [4]. Babesiosis can be complicated by severe anemia, disseminated intravascular coagulation, congestive heart failure, pulmonary edema, renal failure, or splenic rupture [1,2,4,5]. ARDS is a type of noncardiogenic pulmonary edema, characterized by an acute onset of difuse infammation responding to an inciting event including infection [6,7]. Among 15 patients whose sequence of antibabesia therapy and ARDS development was documented, all developed ARDS several days (ranging from 1 to 5 days) after receiving therapy for babesiosis except for one patient from a case report and two patients from a case series who developed ARDS prior to the initiation of therapy (Table 1) [6,[8][9][10][11][12][13]. We report a case of babesiosis, in which the patient developed respiratory symptoms within 2 hours and ultimately ARDS within 24 hours of antibabesia therapy. ...
Babesiosis, a tick-borne protozoan disease, has been increasing in frequency in recent years. Familiarity with presentations of babesiosis is important for clinicians. Acute respiratory distress syndrome (ARDS) is a rarely seen complication of severe babesiosis. In most cases, the patients with babesiosis developed ARDS several days after initiation of antibabesia therapy. We present a unique case of babesiosis without any respiratory symptoms on presentation who developed ARDS within 24 hours of babesiosis treatment initiation. Furthermore, we reviewed published cases of ARDS in babesiosis.
... Human babesiosis is a vector-borne disease caused by protozoan parasites of the genus Babesia, including B. duncani, B. microti, B. divergens, B. crassa, and B. venatorum (Schnittger et al. 2012;Jia et al. 2018;Lobo et al. 2020). The main Babesia infection routes include infected ixodid tick bites (Vannier et al. 2015;Young et al. 2019), blood transfusion, and transplacental transmission (Fox et al. 2006;Joseph et al. 2012). In recent years, the number of reported human babesiosis cases in Asia, Africa, South and North America, and Europe has increased ( Fang et al. 2015;Man et al. 2016;Scott and Scott 2018;Krause 2019;Chen et al. 2019;Karshima et al. 2022). ...
Human babesiosis is caused by Babesia duncani that is transmitted through tick bites, blood transfusions, and transplacental transmission. Despite its health burden, diagnostic assays for this pathogen are either unsuitable for clinical applications or have a low detection efficiency; therefore, it remains undetected during transfusion and utilization of blood and blood-component transfusions. This study used a molecular approach via nested quantitative polymerase chain reaction (qPCR) by designing primers and probes corresponding to the variable regions of B. duncani 18S rRNA gene to specifically detect B. duncani DNA in experimentally infected LVG Golden Syrian hamster (n = 70) and human (n = 492; tick bite patients from Gansu Province, China) blood samples. Moreover, comparative analyses of this technique with previously reported nested PCR and microscopy were conducted. The newly optimized diagnostic technique exhibited no cross-reactivity with genomic DNA or plasmids containing the 18S rRNA gene of other zoonotically important Babesia spp., including B. microti, B. divergens, B. crassa, and B. motasi Hebei. The detection limit of nested qPCR was approximately one plasmid copy in 20 μL or one infected red blood cell in 200 μL whole blood. The specificity and sensitivity of the method were 100% and 98.6%, respectively. Comparative analyses revealed that nested qPCR detected B. duncani had relatively higher efficacy and specificity than microscopic examination and nested PCR. The 492 human blood samples were negative for B. duncani infection. Thus, the present study provides an improved diagnostic assay for the efficient and effective detection and analysis of B. duncani infections and its prevalence in infection-prone areas.
