scholarly journals The Global Emergence of Human Babesiosis

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.


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.


2017 ◽  
Vol 55 (10) ◽  
pp. 2903-2912 ◽  
Author(s):  
Lars F. Westblade ◽  
Matthew S. Simon ◽  
Blaine A. Mathison ◽  
Laura A. Kirkman

ABSTRACT Babesia microti , a zoonotic intraerythrocytic parasite, is the primary etiological agent of human babesiosis in the United States. Human infections range from subclinical illness to severe disease resulting in death, with symptoms being related to host immune status. Despite advances in our understanding and management of B. microti , the incidence of infection in the United States has increased. Therefore, research focused on eradicating disease and optimizing clinical management is essential. Here we review this remarkable organism, with emphasis on the clinical, diagnostic, and therapeutic aspects of human disease.


2016 ◽  
Vol 82 (22) ◽  
pp. 6624-6632 ◽  
Author(s):  
Aya Zamoto-Niikura ◽  
Shigeru Morikawa ◽  
Ken-Ichi Hanaki ◽  
Patricia J. Holman ◽  
Chiaki Ishihara

ABSTRACTThe U.S. lineage, one of the major clades in theBabesia microtigroup, is known as a causal agent of human babesiosis mostly in the northeastern and upper midwestern United States. This lineage, however, also is distributed throughout the temperate zone of Eurasia with several reported human cases, although convincing evidence of the identity of the specific vector(s) in this area is lacking. Here, the goal was to demonstrate the presence of infectious parasites directly in salivary glands ofIxodes persulcatus, from which U.S. lineage genetic sequences have been detected in Asia, and to molecularly characterize the isolates. Five PCR-positive specimens were individually inoculated into hamsters, resulting in infections in four; consequently, four strains were newly established. Molecular characterization, including 18S rRNA, β-tubulin, andCCT7gene sequences, as well as Western blot analysis and indirect fluorescent antibody assay, revealed that all four strains were identical to each other and to the U.S. lineage strains isolated from rodents captured in Japan. The 18S rRNA gene sequence from the isolates was identical to those fromI. persulcatusin Russia and China, but the genetic and antigenic profiles of the Japanese parasites differ from those in the United States and Europe. Together with previous epidemiological and transmission studies, we conclude thatI. persulcatusis likely the principal vector for theB. microtiU.S. lineage in Japan and presumably in northeastern Eurasia.IMPORTANCEThe major cause of human babesiosis, the tick-borne blood parasiteBabesia microti, U.S. lineage, is widely distributed in the temperate Northern Hemisphere. However, the specific tick vector(s) remains unidentified in Eurasia, where there are people with antibodies to theB. microtiU.S. lineage and cases of human babesiosis. In this study, the first isolation ofB. microtiU.S. lineage fromIxodes persulcatusticks, a principal vector for many tick-borne diseases, is described in Japan. Limited antigenic cross-reaction was found between the Japan and United States isolates. Thus, current serological tests based on U.S. isolates may underestimateB. microtioccurrence outside the United States. This study and previous studies indicate thatI. persulcatusis part of theB. microtiU.S. lineage life cycle in Japan and, presumably, northeastern Eurasia. This report will be important for public health, especially since infection may occur through transfusion, and also to researchers in the field of parasitology.


Pathogens ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 230
Author(s):  
ThankGod E. Onyiche ◽  
Cristian Răileanu ◽  
Susanne Fischer ◽  
Cornelia Silaghi

Babesiosis caused by the Babesia species is a parasitic tick-borne disease. It threatens many mammalian species and is transmitted through infected ixodid ticks. To date, the global occurrence and distribution are poorly understood in questing ticks. Therefore, we performed a meta-analysis to estimate the distribution of the pathogen. A deep search for four electronic databases of the published literature investigating the prevalence of Babesia spp. in questing ticks was undertaken and obtained data analyzed. Our results indicate that in 104 eligible studies dating from 1985 to 2020, altogether 137,364 ticks were screened with 3069 positives with an estimated global pooled prevalence estimates (PPE) of 2.10%. In total, 19 different Babesia species of both human and veterinary importance were detected in 23 tick species, with Babesia microti and Ixodesricinus being the most widely reported Babesia and tick species, respectively. Regardless of species, adult ticks with 2.60% had the highest infection rates, while larvae had the least with 0.60%. Similarly, female ticks with 4.90% were infected compared to males with 3.80%. Nested-polymerase chain reaction (PCR) 2.80% had the highest prevalence among the molecular techniques employed. In conclusion, results obtained indicate that Babesia species are present in diverse questing tick species at a low prevalence, of which some are competent vectors.


2021 ◽  
Vol 12 (2) ◽  
pp. 101637
Author(s):  
Aine Lehane ◽  
Sarah E. Maes ◽  
Christine B. Graham ◽  
Emma Jones ◽  
Mark Delorey ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Kristen L. Knapp ◽  
Nancy A. Rice

Borrelia burgdorferi, the causative agent of Lyme disease, andBabesia microti, a causative agent of babesiosis, are increasingly implicated in the growing tick-borne disease burden in the northeastern United States. These pathogens are transmitted via the bite of an infected tick vector,Ixodes scapularis, which is capable of harboring and inoculating a host with multiple pathogens simultaneously. Clinical presentation of the diseases is heterogeneous and ranges from mild flu-like symptoms to near-fatal cardiac arrhythmias. While the reason for the variability is not known, the possibility exists that concomitant infection with bothB. burgdorferiandB. microtimay synergistically increase disease severity. In an effort to clarify the current state of understanding regarding coinfection withB. burgdorferiandB. microti, in this review, we discuss the geographical distribution and pathogenesis of Lyme disease and babesiosis in the United States, the immunological response of humans toB. burgdorferiorB. microtiinfection, the existing knowledge regarding coinfection disease pathology, and critical factors that have led to ambiguity in the literature regarding coinfection, in order to eliminate confusion in future experimental design and investigation.


2021 ◽  
pp. 221-239
Author(s):  
Oscar Calvo-Gonzalez

This chapter explores how, behind the change in economic policymaking, lies a change in the ideas of the elite. And behind the change in ideas was a relentless scanning of experience outside Spain, especially in Europe. The chapter documents how the technocrats that held increasing power in 1960s Spain consistently sought out new ideas about policymaking from Europe and the United States. They were deliberate policy entrepreneurs. Like their Western European peers, the technocrats considered a responsibility of the state to seek to advance progress for a wide spectrum of society. To pursue this objective, they considered it critical to increase efficiency and put great faith in technological progress. The chapter concludes that what truly stands out of the technocrats is that they were able to implement their practical agenda over a sustained period. There had been previous technocratic efforts to emulate European practices, sometimes from reformers that reached even higher levels of government. A long-term horizon allowed policies to evolve without unnecessary volatility, striking a balance between policy innovation and policy continuity.


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