Abstract
Most reported U.S. zoonotic cases of babesiosis have occurred in the Northeast and been caused by Babesia microti. In Washington State, three cases of babesiosis have been reported previously, which were caused by WA1 (for “Washington 1”)-type parasites. We investigated a case of babesiosis in Washington in an 82–year-old man whose spleen had been removed and whose parasitemia level was 41.4%. The complete 18S ribosomal RNA gene of the parasite was amplified from specimens of his whole blood by polymerase chain reaction. Phylogenetic analysis showed the parasite is most closely related, but not identical, to B. divergens (similarity score, 99.5%), a bovine parasite in Europe. By indirect fluorescent-antibody testing, his serum reacted to B. divergens but not to B. microti or WA1 antigens. This case demonstrates that babesiosis can be caused by novel parasites detectable by manual examination of blood smears but not by serologic or molecular testing for B. microti or WA1-type parasites.
Highlights
Most reported U.S zoonotic cases of babesiosis have occurred in the Northeast and been caused by Babesia microti
Serologic Testing Serum specimens were tested at the Centers for Disease Control and Prevention (CDC), in serial fourfold dilutions, by indirect fluorescent-antibody (IFA) testing, Hundreds of zoonotic cases of babesiosis have been reported in the United States, approximately 30 in Europe, and a few elsewhere [1,2,3,4,5,6,7,8,9,10,11,12,13,14]
Serologic Testing and Animal Inoculation The patient’s serum did not react to B. microti or WA1 antigens but showed marked IFA reactivity to B. divergens antigens, which slowly decreased during the 9-month monitoring period (Table 2)
Summary
Serologic Testing Serum specimens were tested at the Centers for Disease Control and Prevention (CDC), in serial fourfold dilutions, by indirect fluorescent-antibody (IFA) testing, Hundreds of zoonotic cases of babesiosis have been reported in the United States, approximately 30 in Europe, and a few elsewhere [1,2,3,4,5,6,7,8,9,10,11,12,13,14]. The other two cases occurred in 1994: one in a person transfused with infected erythrocytes and the other in the implicated blood donor, who lived in King County, in the western foothills of the Cascade Mountains [10]. All three of these cases were caused by WA1 Both hamsters and jirds are competent hosts for B. microti and WA1-type parasites, and jirds are competent hosts for B. divergens [18].
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