Abstract
Babesiosis is a typical zoonotic, emerging disease caused by a tick-borne intraerythrocytic protozoan of Babesia spp. that also can be transmitted by blood transfusion. Babesiosis imposes an increasing public-health threat. We reviewed and mapped epidemiological studies on Babesia in vectors and/or rodents in the People’s Republic of China (P.R. China) and found that B. microti was the predominant species detected in the investigated regions such as Heilongjiang, Zhejiang, Fujian provinces and Taiwan island. We reviewed a series of sporadic human babesiosis cases collected from 1940’s to 2013, in Yunnan, Inner Mongolia, Taiwan and Zhejiang and other regions including a main endemic area of malaria on the China-Myanmar border areas in P.R. China. Clinical manifestations of human babesiosis were also reviewed. Human babesiosis may have previously been overlooked in P.R. China due to a lack of medical awareness and the limitation of clinical diagnostic methods.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-014-0509-3) contains supplementary material, which is available to authorized users.
Highlights
Babesiosis is a typical zoonotic, emerging disease caused by a tick-borne intraerythrocytic protozoan of Babesia spp. that can be transmitted by blood transfusion
Tetrads of merozoites that are arranged in a cross-like pattern are pathognomonic and provide a typical morphology for diagnosis of babesiosis caused by B. microti, it rarely appears as tetrads in human erythrocytes [20]
Two cases of febrile patients who were co-infected with Plasmodium and Babesia in malaria endemic areas were detected in our laboratory using molecular epidemiology survey, but the dominant parasite was unclear and to detect species of Plasmodium or Babesia by microscopy in co-infection cases was more difficult [16]
Summary
Little data is available on the prevalence of Babesia spp. in ticks or rodents in P.R. China [15]. Further sero-epidemiological and molecular epidemiological studies are urgently needed to learn more about the true distribution and medical relevance of these pathogens in various parts of P.R. China. Additional file 1: 18s RNA gene alignment results between strains of B. microti detected from febrile patients on China-Myanmar border areas babesiosis Zhejiang in P.R. China, Japan and some strains detected in wildlife rodents. Additional file 2: Beta-tubulin gene alignment of B. microti strains in patients from the China-Myanmar border areas, Australia and Babesia-strains detected in neighboring wildlife rodents. Authors’ contributions XZ and XNZ conceived the study, collected the data and analyzed it, and drafted the manuscript. HXZG and XNZ conceived the study and revised the manuscript.
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