Abstract
Babesiosis is attracting increasing attention as a worldwide emerging zoonosis. The first case of human babesiosis in Europe was described in the late 1950s and since then more than 60 cases have been reported in Europe. While the disease is relatively rare in Europe, it is significant because the majority of cases present as life-threatening fulminant infections, mainly in immunocompromised patients. Although appearing clinically similar to human babesiosis elsewhere, particularly in the USA, most European forms of the disease are distinct entities, especially concerning epidemiology, human susceptibility to infection and clinical management. This paper describes the history of the disease and reviews all published cases that have occurred in Europe with regard to the identity and genetic characteristics of the etiological agents, pathogenesis, aspects of epidemiology including the eco-epidemiology of the vectors, the clinical courses of infection, diagnostic tools and clinical management and treatment.
Highlights
As human babesiosis can take a fulminant course of disease, especially in immunocompromised patients infected with B. divergens, rapid diagnosis is essential
B. microti and B. duncani can be cultivated in gerbils, mice and hamsters, respectively, while B. venatorum has not yet been adapted to a laboratory animal species
Several drugs are available for the treatment of human babesiosis (Table 4), but their efficacy is variable, against B. microti, which animal studies suggest is less susceptible to classic antibabesials than are B. divergens and B. venatorum [144]
Summary
The first reported case of human babesiosis in Europe, and in the world, occurred in 1956 in the former Yugoslavia, Croatia, in a 33-year-old tailor and parttime farmer who had been splenectomized following a traffic accident 11 years earlier [1]. He presented with fever and severe hemoglobinuria eight days after first feeling unwell and died two days later. B. microti present in Europe, where it is common in rodents and ticks, are not as infectious or pathogenic to humans as those in the USA, where B. microti infections give rise to approximately 2000 zoonotic babesiosis cases annually [9]
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