Abstract

Fifty years ago, the index case of human babesiosis due to Babesia microti was diagnosed in a summer resident of Nantucket Island. Human babesiosis, once called “Nantucket fever” due to its seeming restriction to Nantucket and the terminal moraine islands of southern New England, has emerged across the northeastern United States to commonly infect people wherever Lyme disease is endemic. We review the history of babesiosis on Nantucket, analyze its epidemiology and ecology there, provide summaries of the first case histories, and comment on its future public health burden.

Highlights

  • Published: 9 September 2021Fifty years ago, a New England Journal of Medicine [1] case report summarized the index case of human babesiosis due to Babesia microti

  • Babesiosis had previously been reported in 4 patients (1 from Yugoslavia, 2 from Ireland, 1 from California), all of whom had been splenectomized; the Yugoslavian and Irish cases were due to B. divergens, a cattle parasite, and the California case was due to an unidentified Babesia sp

  • The first cases of Nantucket fever provided the general details of the course of illness and its management, as well as parasite strains that have been widely used in laboratory studies of the pathobiology of B. microti babesiosis

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Summary

Introduction

A New England Journal of Medicine [1] case report summarized the index case of human babesiosis due to Babesia microti. The new case was in a spleen-intact person. Through 1976, 14 cases of symptomatic B. microti babesiosis had been identified on Nantucket and the infection was given the popular name “Nantucket fever” [2], even though sporadic cases were reported from nearby Martha’s Vineyard, Shelter Island, NY and Montauk, NY by 1977. Nantucket County still reports more cases of babesiosis than any other in the U.S, with annual incidence of >100 per 100,000 (compared to about 1 per 100,000 nationally). We revisit the early investigations of Nantucket fever in the 1970s and highlight the major findings that defined the epidemiology and ecology of this infection

The Grey Lady
Index and Other Early Cases
Holbrook
Nymphal
The Deer
Control and Prevention
Findings
What Can We Predict for Nantucket Fever at Its Centennial?

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