scholarly journals Preventing Transfusion-Transmitted Babesiosis

Pathogens ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1176
Author(s):  
Evan M. Bloch ◽  
Peter J. Krause ◽  
Laura Tonnetti

Babesia are tick-borne intra-erythrocytic parasites and the causative agents of babesiosis. Babesia, which are readily transfusion transmissible, gained recognition as a major risk to the blood supply, particularly in the United States (US), where Babesia microti is endemic. Many of those infected with Babesia remain asymptomatic and parasitemia may persist for months or even years following infection, such that seemingly healthy blood donors are unaware of their infection. By contrast, transfusion recipients are at high risk of severe babesiosis, accounting for the high morbidity and mortality (~19%) observed in transfusion-transmitted babesiosis (TTB). An increase in cases of tick-borne babesiosis and TTB prompted over a decade-long investment in blood donor surveillance, research, and assay development to quantify and contend with TTB. This culminated in the adoption of regional blood donor testing in the US. We describe the evolution of the response to TTB in the US and offer some insight into the risk of TTB in other countries. Not only has this response advanced blood safety, it has accelerated the development of novel serological and molecular assays that may be applied broadly, affording insight into the global epidemiology and immunopathogenesis of human babesiosis.

2014 ◽  
Vol 143 (4) ◽  
pp. 695-703 ◽  
Author(s):  
A. LOHARIKAR ◽  
A. E. NEWTON ◽  
S. STROIKA ◽  
M. FREEMAN ◽  
K. D. GREENE ◽  
...  

SUMMARYUS cholera surveillance offers insight into global and domestic trends. Between 2001 and 2011, 111 cases were reported to the Centers for Disease Control and Prevention. Cholera was associated with international travel in 90 (81%) patients and was domestically acquired in 20 (18%) patients; for one patient, information was not available. From January 2001 to October 2010, the 42 (47%) travel-associated cases were associated with travel to Asia. In October 2010, a cholera epidemic started in Haiti, soon spreading to the Dominican Republic (Hispaniola). From then to December 2011, 40 (83%) of the 48 travel-associated cases were associated with travel to Hispaniola. Of 20 patients who acquired cholera domestically, 17 (85%) reported seafood consumption; 10 (59%) ate seafood from the US Gulf Coast. In summary, an increase in travel-associated US cholera cases was associated with epidemic cholera in Hispaniola in 2010–2011. Travel to Asia and consumption of Gulf Coast seafood remained important sources of US cholera cases.


Pathogens ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1447
Author(s):  
Abhinav Kumar ◽  
Jane O'Bryan ◽  
Peter J. Krause

Babesiosis is an emerging tick-borne disease caused by intraerythrocytic protozoa that are primarily transmitted by hard-bodied (Ixodid) ticks and rarely through blood transfusion, perinatally, and organ transplantation. More than 100 Babesia species infect a wide spectrum of wild and domestic animals worldwide and six have been identified as human pathogens. Babesia microti is the predominant species that infects humans, is found throughout the world, and causes endemic disease in the United States and China. Babesia venatorum and Babesia crassa-like agent also cause endemic disease in China. Babesia divergens is the predominant species in Europe where fulminant cases have been reported sporadically. The number of B. microti infections has been increasing globally in recent decades. In the United States, more than 2000 cases are reported each year, although the actual number is thought to be much higher. In this review of the epidemiology of human babesiosis, we discuss epidemiologic tools used to monitor disease location and frequency; demographics and modes of transmission; the location of human babesiosis; the causative Babesia species in the Americas, Europe, Asia, Africa, and Australia; the primary clinical characteristics associated with each of these infections; and the increasing global health burden of this disease.


Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1563
Author(s):  
Scott Meredith ◽  
Miranda Oakley ◽  
Sanjai Kumar

The biology of intraerythrocytic Babesia parasites presents unique challenges for the diagnosis of human babesiosis. Antibody-based assays are highly sensitive but fail to detect early stage Babesia infections prior to seroconversion (window period) and cannot distinguish between an active infection and a previously resolved infection. On the other hand, nucleic acid-based tests (NAT) may lack the sensitivity to detect window cases when parasite burden is below detection limits and asymptomatic low-grade infections. Recent technological advances have improved the sensitivity, specificity and high throughput of NAT and the antibody-based detection of Babesia. Some of these advances include genomics approaches for the identification of novel high-copy-number targets for NAT and immunodominant antigens for superior antigen and antibody-based assays for Babesia. Future advances would also rely on next generation sequencing and CRISPR technology to improve Babesia detection. This review article will discuss the historical perspective and current status of technologies for the detection of Babesia microti, the most common Babesia species causing human babesiosis in the United States, and their implications for early diagnosis of acute babesiosis, blood safety and surveillance studies to monitor areas of expansion and emergence and spread of Babesia species and their genetic variants in the United States and globally.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Cristina Jurado ◽  
Lina Mur ◽  
María Sol Pérez Aguirreburualde ◽  
Estefanía Cadenas-Fernández ◽  
Beatriz Martínez-López ◽  
...  

Abstract African swine fever causes substantial economic losses in the swine industry in affected countries. Traditionally confined to Africa with only occasional incursions into other regions, ASF began spreading into Caucasian countries and Eastern Europe in 2007, followed by Western Europe and Asia in 2018. Such a dramatic change in the global epidemiology of ASF has resulted in concerns that the disease may continue to spread into disease-free regions such as the US. In this study, we estimated the risk of introduction of ASF virus into the US through smuggling of pork in air passenger luggage. Results suggest that the mean risk of ASFV introduction into the US via this route has increased by 183.33% from the risk estimated before the disease had spread into Western Europe or Asia. Most of the risk (67.68%) was associated with flights originating from China and Hong Kong, followed by the Russian Federation (26.92%). Five US airports accounted for >90% of the risk. Results here will help to inform decisions related to the design of ASF virus surveillance strategies in the US.


Genealogy ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. 40
Author(s):  
Rosemarie Peña

William Gage’s Geborener Deutscher, a print newsletter distributed by traditional mail from the late 1980s until 2003, and the eponymous Internet forum Gage established in 2000 on Yahoo Groups, provide search resources and community support specifically for German born adoptees. The archived newsletters and conversations offer early insight into the search and reunion activities of many who were transnationally adopted to the United States as infants and small children in the wake of the Second World War. Among Gage’s mailing list and Yahoo Group subscribers are members of the post-war cohort of Black German Americans living in Germany and in the US. Gage’s archive provides a unique opportunity to begin to explore Black German adoptee search, reunion, and community development over nearly a two-decade span.


2010 ◽  
Vol 17 (11) ◽  
pp. 1729-1733 ◽  
Author(s):  
Harry E. Prince ◽  
Mary Lapé-Nixon ◽  
Hemlata Patel ◽  
Cindy Yeh

ABSTRACT All reported cases of WA1 babesiosis have occurred in the Pacific coast region of the United States, suggesting that WA1 is limited to this geographic area. However, we detected WA1 IgG in 27% of clinical sera sent to our laboratory for WA1 IgG testing from across the United States over a 2-year period, suggesting that exposure to WA1 or a closely related organism occurs outside Pacific coast states. We sought to determine if this high WA1 IgG detection rate among clinical specimens merely reflects WA1 seroprevalence outside the Pacific region. WA1 IgG, as well as Babesia microti IgG, was measured in 900 blood donor specimens from 9 states. Overall seroprevalence was 2.0% for WA1 and 0.4% for B. microti; regional seroprevalences ranged from 0 to 4% and 0 to 2%, respectively. Additional studies were performed to determine if WA1 IgG reactivity was attributable to polyclonal B-cell activation associated with acute Epstein-Barr virus (EBV) infection; 40 WA1 IgG-positive clinical sera and the 18 WA1 IgG-positive blood donor specimens were all negative for EBV capsid antigen (EBVCA) IgM (a marker of acute EBV infection), and 40 EBVCA IgM-positive sera were all negative for WA1 IgG. These findings indicate that the high WA1 IgG detection rate among clinical specimens does not simply reflect the national WA1 seroprevalence among blood donors or nonspecific reactivity due to acute EBV infection. Rather, the findings suggest that infection with WA1 or a related organism is more common than indicated by the literature and is not limited to Pacific coast states.


Author(s):  
Suzanne Moshier ◽  
William O'Dell ◽  
Raychel Watkins ◽  
Aelita Pinter

In a review of the parasites of Microtus, Timm (1985) lists no protozoan endoparasites whatsoever for this genus. The role of parasitism, whether macro- or microparasites, and whether endo- or ectoparasites, in the demographic machinery of microtines is poorly understood. Timm (1985) astutely observes that one of the most challenging and fruitful directions of future research with Microtus will be the statistical quantification of the cost of parasitism. In addition, since humans in the Grand Teton National Park may encounter protozoon parasites that are potentially pathogenic to humans, it is useful to characterize the occurrence and biology of such organisms in the parko Babesia microti, a parasitic protozoon, is transmitted by a tick vector and reproduces in the erythrocytes of its mammalian host. Initially, Babesia was thought to be restricted to small mammals; however, in 1970 the first human cases were diagnosed in residents of Nantucket Island, Massachusetts (Western et al, 1970). Over 200 cases of human babesiosis have been documented worldwide. In the United States, human babesiosis is caused by B. microti. Most of these cases have occurred in the eastern United States. The earliest report of an organism that fits the description of Babesia in human erythrocytes is that of Wilson et al. (1904), who found an unknown organism in human erythrocytes while investigating the cause of Rocky Mountain Spotted fever. Documented cases of babesiosis in many areas of the United States are increasing (Steketee et al, 1985). As humans insert themselves into places where they have historically been present only occasionally, they often contract new diseases. A second protozoon parasite, Hepatozoon sp., which is widespread in small mammals in Europe, is also found in reptiles throughout the world. The record of Hepatozoon in North American small mammals is not extensive. Fewer than 10 species of mammals have been shown to harbor Hepatozoon parasites. Like Babesia, Hepatozoon is a two-host parasite. Unlike Babesia, for which the intermediate host is always a tick, the intermediate host in the Hepatozoon may be a tick, a mite, a flea, or a mosquito. The method of transmission by the vector also differs in the two parasites. Babesia is transmitted in saliva when the tick bites, whereas Hepatozoon infection requires the vertebrate host to swallow the vector. In our 1994 studies, we sought to extend knowledge of these two parasites. The specific objectives for 1994 were: to sample specific populations of M. molltanus, in which we have previously documented Hepatozoon infections, to determine whether there are differences in the infection rates at different study sites in the park; to search for the vector of Hepatozoon sp. infections in M. montanus by examining ectoparasites; to collect and rear ticks from M. montanus for use in R microti transmission studies; and to complete a comparison of the spleen histology of babesiosis in infected and uninfected laboratory animals, with inclusion of data from wild animals, as available. Our long-term objectives are to document the effects and cost of parasitism on vole populations and to determine the potential of small mammals of Grand Teton National Park to serve as reservoirs of human parasites.


Author(s):  
F. E. G. Cox

Babesiosis and malaria are rare zoonoses that, with new developments in diagnosis and the application of molecular techniques, are becoming increasingly frequently recognised. Babesia species infect millions of cattle and unknown numbers of sheep, dogs, horses, and wildlife throughout the world but human infections are very uncommon. There are two distinct forms of human babesiosis. In Europe the causative agent is Babesia divergens, a natural parasite of cattle transmitted by the tick Ixodes ricinis. B. divergens infections in humans are extremely rare and nearly all have been recorded from asplenic or otherwise immunocompromised patients. In the USA, human babesiosis is more common than in Europe, although still very rare, and is not restricted to immunocompromised individuals. The causative agents are Babesia microti and B. duncani, common parasites of rodents, transmitted by the tick Ixodes scapularis. In addition there have been sporadic reports of human babesiosis from other parts of the world but in most cases the species of Babesia involved has not been characterised. Malaria parasites and Babesia both inhabit red blood cells during part of their life cycles and these stages cause the diseases, malaria and babesiosis, which are similar in many respects. The facts that humans can occasionally acquire malaria and babesiosis from animals, that both parasites appear similar when seen in blood films and that both cause similar symptoms can cause problems in diagnosis and these rare infections are, therefore, of interest to clinicians and epidemiologists.


2019 ◽  
Vol 5 (1) ◽  
pp. 26 ◽  
Author(s):  
Hariprasath Prakash ◽  
Arunaloke Chakrabarti

Mucormycosis is an angio-invasive fungal infection, associated with high morbidity and mortality. A change in the epidemiology of mucormycosis has been observed in recent years with the rise in incidence, new causative agents and susceptible population. The rise has been perceived globally, but it is very high in the Asian continent. Though diabetes mellitus overshadow all other risk factors in Asia, post-tuberculosis and chronic renal failure have emerged as new risk groups. The rhino-cerebral form of mucormycosis is most commonly seen in patients with diabetes mellitus, whereas, pulmonary mucormycosis in patients with haematological malignancy and transplant recipients. In immunocompetent hosts, cutaneous mucormycosis is commonly seen following trauma. The intriguing clinical entity, isolated renal mucormycosis in immunocompetent patients is only reported from China and India. A new clinical entity, indolent mucormycosis in nasal sinuses, is recently recognized. The causative agents of mucormycosis vary across different geographic locations. Though Rhizopus arrhizus is the most common agent isolated worldwide, Apophysomyces variabilis is predominant in Asia and Lichtheimia species in Europe. The new causative agents, Rhizopus homothallicus, Mucor irregularis, and Thamnostylum lucknowense are reported from Asia. In conclusion, with the change in epidemiology of mucormycosis country-wise studies are warranted to estimate disease burden in different risk groups, analyse the clinical disease pattern and identify the new etiological agents.


2018 ◽  
Vol 143 (1) ◽  
pp. 130-134 ◽  
Author(s):  
Tatiana Villatoro ◽  
Julie Katz Karp

Babesiosis is most commonly caused by Babesia microti and is transmitted via the bite of an infected Ixodes spp tick. However, Babesia is also transmitted via blood transfusion. In the United States, the first case of transfusion-transmitted babesiosis was recognized in 1979, and in recent years, the incidence has rapidly increased. Because most of the infected blood donors do not experience any symptoms, they pose a significant risk to the blood supply. Donor deferral for a history of babesiosis is currently performed but is ineffective. In March 2018, the FDA licensed a DNA PCR and antibody assay that were used in tandem in pivotal trials for screening blood donors for B microti; with other assays still being evaluated under investigational new drug protocols. Blood donation screening is essential to reducing the risk of transfusion-transmitted babesiosis, which is why blood centers collecting in geographic regions of highest risk have been testing since approximately 2010. Investigational NAT assays of higher sensitivity are pending FDA review. Further, in July 2018, the FDA issued a draft guidance for reducing the risk of transfusion-transmitted babesiosis. Release of the final guidance may be postponed until sensitivities and specificities of all current and potential strategies have been properly evaluated.


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