Cases Of Babesiosis Research Articles

662. Tick Borne-Associated Thrombocytopenia Among United States Veterans in Long Island New York

BackgroundLong Island, New York, is highly endemic for tick borne illnesses (TBI) with rising numbers of cases in the past years. Thrombocytopenia is a known complication of babesiosis caused by Babesia microti, anaplasmosis caused by Anaplasma phagocytophilum, and ehrlichiosis caused by Ehrlichia chaffeensis. We identified cases of thrombocytopenia attributed to TBI in our institution.MethodsRetrospective chart review of patients diagnosed with babesiosis, anaplasmosis, and ehrlichiosis from 2000 to 2017 at Northport Veterans Affairs Medical Center. Demographics, method of diagnosis (PCR/serologies), CBC/chemistries, treatment choices, and outcomes were analyzed.ResultsThirty-two veterans (VETS) were identified with the following TBI: Babesiosis 22, Ehrlichiosis 6, Anaplasmosis 4. The majority of cases (19) were from Suffolk County, Long Island. The median (MED) age of this group was 62 years (range 31–89). Ninety-one percent were Caucasian, 9% Black. 37.5% had history of tick bite. The MED temperature on presentation was 101.9°F (range 97.6–105.2°F). 56% had HTN, 6% DM, 37% HLD, 9% hepatitis C, 3% HIV. Laboratory studies: MED platelet count 88,000/µL (36,000–161,000); MED hemoglobin 12 gm/dL (5.6–15.6); MED ALT 41 IU/L (6–330); MED LDH 335 IU/L (193–1,322). Twelve VETS had positive C6 peptide. The peak MED B. microti parasitemia was 1.4% (0.1–3%). PCR tests were available in the later years of the study period: three were positive for E. chaffeensis, two for A. phagocytophilum, and 14 for B. microti. The majority of the cases (19) were observed after year 2010. Morulae were seen in only one case. Haptoglobin in eight VETS was undetectable. One veteran with history of splenectomy and babesiosis with 3% parasitemia required exchange transfusion with 12 units of PRBCs. Two other babesiosis cases required regular transfusion of PRBCs. 20 babesiosis cases were treated with azithromycin-atovaquone and two with clindamycin-primaquine. Doxycycline was used in the other cases. One patient developed NSTEMI and required coronary stent placement. Platelet counts returned to baseline levels with treatment. No deaths occurred.ConclusionThe incidence of TBI in Long Island, New York is rising. PCR testing for TBI can be utilized in our VETS presenting with febrile illness and thrombocytopenia to help identify the possible tick borne pathogen during the months of high tick activity.Disclosures All authors: No reported disclosures.

Transfusion-Transmitted Babesiosis.

Babesiosis is most commonly caused by Babesia microti and is transmitted via the bite of an infected Ixodes spp tick. However, Babesia is also transmitted via blood transfusion. In the United States, the first case of transfusion-transmitted babesiosis was recognized in 1979, and in recent years, the incidence has rapidly increased. Because most of the infected blood donors do not experience any symptoms, they pose a significant risk to the blood supply. Donor deferral for a history of babesiosis is currently performed but is ineffective. In March 2018, the FDA licensed a DNA PCR and antibody assay that were used in tandem in pivotal trials for screening blood donors for B microti; with other assays still being evaluated under investigational new drug protocols. Blood donation screening is essential to reducing the risk of transfusion-transmitted babesiosis, which is why blood centers collecting in geographic regions of highest risk have been testing since approximately 2010. Investigational NAT assays of higher sensitivity are pending FDA review. Further, in July 2018, the FDA issued a draft guidance for reducing the risk of transfusion-transmitted babesiosis. Release of the final guidance may be postponed until sensitivities and specificities of all current and potential strategies have been properly evaluated.

Genetic Analysis of Babesia Isolates from Cattle with Clinical Babesiosis in Sri Lanka.

Bovine babesiosis is a serious threat to the cattle industry. We prepared blood DNA samples from 13 cattle with clinical babesiosis from the Badulla (n = 8), Jaffna (n = 3), and Kilinochchi (n = 2) districts in Sri Lanka. These DNA samples tested positive in PCR assays specific for Babesiabovis (n = 9), Babesia bigemina (n = 9), and Babesiaovata (n = 1). Twelve cattle were positive for B. bovis and/or B. bigemina One cow was negative for the tested Babesia species but was positive for Babesia on microscopic examination; the phylogenetic positions of 18S rRNA and cytochrome oxidase subunit III gene sequences suggested that the cow was infected with Babesia sp. Mymensingh, which was recently reported from a healthy cow in Bangladesh. We then developed a novel Babesia sp. Mymensingh-specific PCR assay and obtained positive results for one other sample. Analysis of gene sequences from the cow with positive B. ovata-specific PCR results demonstrated that the animal was infected not with B. ovata but with Babesia sp. Hue-1, which was recently reported from asymptomatic cattle in Vietnam. The virulence of Babesia sp. Hue-1 is unclear, as the cow was coinfected with B. bovis and B. bigemina However, Babesia sp. Mymensingh probably causes severe clinical babesiosis, as it was the sole Babesia species detected in a clinical case. The present study revealed the presence of two bovine Babesia species not previously reported in Sri Lanka, plus the first case of severe bovine babesiosis caused by a Babesia species other than B. bovis, B. bigemina, and Babesiadivergens.

MOLECULAR DETECTION OF BABESIA ODOCOILEI IN WILD, FARMED, AND ZOO CERVIDS IN ONTARIO, CANADA.

Babesia odocoilei, a tick-borne protozoan hemoparasite of white-tailed deer ( Odocoileus virginianus), is being increasingly recognized as a cause of disease in captive cervids in North America. Historically endemic in white-tailed deer, the natural wildlife reservoir in the southeastern US, B. odocoilei has been recently associated with hemolytic anemia in captive Eurasian tundra reindeer ( Rangifer tarandus tarandus), wapiti ( Cervus canadensis), and woodland caribou ( Rangifer tarandus caribou) in the northcentral and northeastern US and several Canadian provinces. The emergence of B. odocoilei is likely related to the northward expansion of the range of the tick vector, Ixodes scapularis, and possibly to cervid translocations. Following a disease outbreak in reindeer and wapiti at the Toronto Zoo in Ontario, Canada, we utilized a prospective postmortem survey to investigate the prevalence of B. odocoilei in wild, farmed, and zoo cervids in Ontario ( n=270) in 2016-18 by PCR and DNA sequencing of spleen samples. Zoo bovids have been suggested as potential hosts of B. odocoilei in zoos affected by cervid babesiosis, so we also collected postmortem samples from five species of bovids ( n=7) at the Toronto Zoo that died or were euthanized during this time. We detected B. odocoilei in 1% (2/142) of farmed red deer ( Cervus elaphus) as well as in 3% (1/29) of captive wapiti and 4% (3/68) of wild white-tailed deer. Tissues from all zoo bovids and caribou, zoo and wild moose ( Alces alces), and farmed white-tailed deer, wapiti-red deer hybrids, and fallow deer ( Dama dama), tested negative for B. odocoilei. No clinical cases of babesiosis were encountered during this study. These findings suggest that white-tailed deer are a potential natural wildlife reservoir for B. odocoilei in Ontario and that red deer and wapiti could serve as more-localized reservoirs.

Detection of Babesia gibsoni in dogs by combining recombinase polymerase amplification (RPA) with lateral flow (LF) dipstick.

Babesia gibsoni is a protozoan parasite responsible for the majority of reported cases of canine babesiosis in China. Currently, microscopic examination of the Giemsa-stained thin blood smears is the main diagnosis method in clinic. Here, we report the recombinase polymerase amplification-lateral flow (LF-RPA) dipstick detection method for targeting B. gibsoni cytochrome c oxidase subunit I (cox I) gene. The reaction takes only 20-30min under isothermal temperatures between 30 and 45°C. Specificity was evaluated using DNA from related apicomplexan parasites and their host, while the sensitivity was calculated based on the DNA from the experimental B. gibsoni-infected dogs. Results indicated that the LF-RPA method is 20 times more sensitive than the conventional PCR based on 18S rRNA and has no cross reaction with any other test DNAs. The applicability of the LF-RPA method was further evaluated using 15 samples collected from clinic. Thirteen of the 15 samples (86.67%) were detected as positive by LF-RPA, while 10 of them (66.67%) were found positive by conventional PCR. Overall, the novel LF-RPA assay is effective for the detection of B. gobsini and has considerable advantages over the conventional PCR in sensitivity, specificity, simplicity in operation, less time consumption, and visual detection. The LF-RPA method may facilitate the surveillance and early detection of B. gibsoni infection in dogs.

DOUBLE STRIKE: A CASE OF BABESIOSIS AND ANAPLASMOSIS PRESENTING AS SEVERE HEMOLYTIC ANEMIA AND SEPTIC SHOCK IN A HEALTHY 25-YEAR-OLD MALE

SESSION TITLE: Critical Care 5 SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/09/2018 01:15 PM - 02:15 PM INTRODUCTION: Lyme disease was first identified in 1981. The first case of babesiosis was reported from Nantucket Island, Massachusetts, in 1969. Since the late 1980s, the disease spread from the islands off the New England coast to the mainland. Cases have also been reported across the United States, Europe, and Asia.In a person experiencing severe illness, more symptoms, and a longer recovery, co-infection should be highly suspicious. The CDC recommends that physicians consider possible co-infection with babesia or anaplasma when patients have more severe symptoms of Lyme disease. We are presenting a case of severe babesiosis and anaplasmosis that presented as severe hemolytic anemia and septic shock in young 25 year old male. CASE PRESENTATION: A healthy, 25 year old male, dog-owner, with Down syndrome presented with generalized malaise, intermittent fevers, chills, sweating, abdominal pain, intermittent neck pain that progressively worsened over a week. His fever was ranging from 101-105 Fahrenheit and spiked nocturnally. He had raked the yard 2 weeks ago and his parents were concerned about a tick bite, however no tick or rash was ever found. Physical exam was remarkable for hepatosplenomegaly. Upon admission he was found on septic shock requiring pressor support. Labs revealed severe pancytopenia and mildly elevated transaminases. CT scan of abdomen and pelvis showed mild hepatosplenomegaly and fatty liver. Given the severity of presentation he was started empirically on broad spectrum coverage including vancomycin, piperacillin/tazobactam, doxycycline, atovaquone, azithromycin, clindamycin and quinine to cover tick-borne disease. Positive buffy coat and intra-erythrocytic inclusions suggesting with co-infection of babesia and anaplasmosis were found. Lyme disease titer was negative but could be falsely so in the first 3-4weeks of infection. Septic shock with severe anemia resolved after 3 days. He had daily peripheral smear and babesia smears to assess for level of parasitemia – on admission it was at 1%, and then peaked to 2% and after clindamycin it decreased to 1%. He became clinically more stable and was continued on azithromycin, atovaquone, clindamycin given possible quinine toxicity and doxycycline for anaplasmosis. Daily smears for Babesia were required to assess level of parasitemia. DISCUSSION: The etiological agents responsible Lyme disease (Borrelia), human granulocytic anaplasmosis (Anaplasma), and babesiosis (Babesia microti) are primarily transmitted by the backlegged tick, Ixodes scapularis. Babesiosis is a malaria-like protozoan infection of erythrocytes that is transmitted by Ixodes. Babesia is a malaria-like parasite or “piroplasm” which infects red blood cells. Babesia microti is the commonest piroplasm infecting humans. CONCLUSIONS: Ticks can carry multiple infective agents including lyme, babesia, and anaplasmosis, placing patients as risk of a more severe presentation. Reference #1: 1. Diuk-Wasser MA1, Vannier E2, Krause PJ3. Coinfection by Ixodes Tick-Borne Pathogens: Ecological, Epidemiological, and Clinical Consequences. Trends Parasitol. 2016 Jan;32(1):30-42. https://doi.org/10.1016/j.pt.2015.09.008. Epub 2015 Nov 21. DISCLOSURES: No relevant relationships by Sylvia Alarcon Velasco, source=Web Response No relevant relationships by Amnah Andrabi, source=Web Response No relevant relationships by Preeyanka Sundar, source=Web Response

Transfusion‐transmitted babesiosis: one state's experience

The risk for tickborne exposure to Babesia microti infection exists statewide in Massachusetts. Broad exposure complicates investigations of transfusion-transmitted babesiosis (TTB). We summarize 8 years of the epidemiology of TTB and highlight the role of public health in prevention and control. Cases of babesiosis are routinely reported to the Massachusetts Department of Public Health. These are investigated to determine whether they meet the surveillance case definition and to identify whether they were potentially transfusion transmitted. Frequencies from 2009 to 2016 are described and incidence rates calculated using population denominators from the US census. Changes over time were analyzed using simple linear regression. From 2009 to 2016, there were 2578 cases of babesiosis reported; of these, 45 (1.7%) were transfusion transmitted. Of the 45 cases of TTB, 15 (33%) received blood products from two or more suppliers. In 11 TTB cases, the Department of Public Health was notified first, who in turn notified the appropriate blood provider. In 2009, the crude rate of reported babesiosis was 1.2 per 100,000 population and increased significantly through 2016 to 7.8 per 100,000 population (p = 0.006). The number of blood donors reported with laboratory evidence of B. microti infection increased from 19 in 2012 to 78 in 2016; at the same time, the number of TTB cases decreased from six to three. TTB remains a major challenge, and blood donor screening strategies are currently in the process of implementation. While population and environmental changes facilitate increases in babesiosis, donor screening has the potential to eliminate TTB.

Diagnosis and Treatment of Canine Babesiosis in Pakistan, A Case Report

A German shepherd bitch of age 2 years, weighing 20kg, was presented at Clinical Medicine and Surgery Department of University of Agriculture Faisalabad, Pakistan. Anamnesis revealed of anorexia since 12 days, 2 episodes of emesis, brown urine and excessive water intake and intermittent lethargy. Visually, bitch was emaciated with dull hair coat. Clinical examination showed increased temperature, heart rate and respiration rate of 104.2 oF, 128/min and 54/min, respectively along with pale conjunctiva and mucous membrane, increased CRT and skin tent twisting time. For diagnosis, examination of stained thin blood smear under microscope and complete blood count (CBC) was performed. The blood examination and CBC report declared the case of canine babesiosis which was treated with single shot of IMIDOCARB DIPROPIONATE, Doxycycline Monohydrate for 21 days and metronidazole for 7 days. Supportive therapy was also given until proper feed intake. Bitch recovered completely when the treatment regime of 21 days ended.

Retrospective study of epidemiological, clinical and pathological findings of bovine babesiosis in Mato Grosso do Sul, Brazil (1995 –2017)

Babesiosis is a tick-borne hemolytic disease caused by intraerythrocytic protozoan parasites of the genus Babesia. The present study describes epidemiological, clinical, and pathological features of cases of bovine babesiosis diagnosed over the last two decades in the state of Mato Grosso do Sul in central-western Brazil. Examination of a total of 5298 bovine samples resulted in a definitive or presumptive diagnosis of babesiosis in 41 cases from 33 outbreaks. Babesia bovis was the most common causal agent of bovine babesiosis, and animals of all ages were affected. Zebu cattle, which are more frequent in the study region than are taurine cattle, were the cattle most often affected. Although zebu cattle have been claimed to be highly tolerant, the present findings show that they can develop severe illness and die due to Babesia spp. infection. The disease was diagnosed almost every year over the time period covered in this study (1995–2017). However, the number of cases of bovine babesiosis diagnosed was low compared to the total number of cases reviewed. Veterinary practitioners that work on cattle farms should to be able to diagnose the disease in its early stages so that treatment can be initiated promptly and economic losses can be minimized.

Tick abundance, pathogen prevalence, and disease incidence in two contrasting regions at the northern distribution range of Europe

BackgroundEmergence of tick-borne diseases is impacting humans and livestock across the Northern Hemisphere. There are, however, large regional variations in number of cases of tick-borne diseases. Some areas have surprisingly few cases of disease compared to other regions. The aim here is to provide a first step towards a better understanding of such contrasting regional patterns of disease emergences at the northern distribution range of Ixodes ricinus in Europe.MethodsWe compare disease incidence, vector abundance and pathogen prevalence in eastern and western Norway differing in the number of tick-borne disease cases. First, we analysed the incidence of Lyme borreliosis in humans, tick-borne fever (anaplasmosis) in sheep and anaplasmosis and babesiosis in cattle to verify if incidence differed. Secondly, we analysed extensive field data on questing tick density, pathogen prevalence, as well as the broad spatial pattern of human and livestock distribution as it may relate to tick exposure.ResultsThe incidences of all diseases were lower in eastern, compared to western, Norway, but this was most marked for the livestock diseases. While the prevalence of Borrelia burgdorferi (sensu lato) in ticks was similar in the two regions, the prevalence of Anaplasma phagocytophilum was markedly lower in eastern, compared to western, Norway. We found overall a lower abundance of questing nymphs in the east. In the east, there were cases of babesiosis in cattle where anaplasmosis was absent, suggesting absence of the pathogen rather than differences in exposure to ticks as part of the explanation for the much lower incidence of anaplasmosis in eastern Norway.ConclusionsMany factors contribute to different disease incidence across ecosystems. We found that regional variation in tick-borne disease incidence may be partly linked to vector abundance and pathogen prevalence, but differently for human and livestock diseases. Further studies are needed to determine if there is also regional variation in specific genospecies and strain frequencies differing in pathogenicity.

Molecular evidence for the transovarial passage of Babesia gibsoni in Haemaphysalis hystricis (Acari: Ixodidae) ticks from Taiwan: a novel vector for canine babesiosis

BackgroundBabesia gibsoni is the predominant tick-borne protozoan blood parasite affecting dogs throughout the Oriental region. Babesia gibsoni is transmitted by Haemaphysalis longicornis, whereas a similar role has been suggested for Rhipicephalus sanguineus. Haemaphysalis longicornis does not occur in Taiwan, but R. sanguineus is widely distributed on dogs. However, clinical cases of babesiosis are mainly restricted to the northern part of the island. The discrepancy between tick distribution and clinical cases stimulated us to investigate the tick species distribution on dogs in northern Taiwan, with the aim to identify the local vector for canine babesiosis.MethodsTicks were collected from stray dogs or free ranging pet dogs in northern Taiwan between 2015 and 2017 and, after identification, were tested for the presence of tick-borne Babesia parasites using PCR and reverse line blot (RLB) hybridisation. Moreover, engorged ticks collected from the dogs were incubated at 28 °C to allow them to oviposit. Their subsequent larval progeny was also examined by PCR/RLB.ResultsA total of 1085 ticks collected from 144 stray dogs at different residential areas consisted of 5 different species: H. hystricis (n = 435), R. sanguineus (n = 582), R. haemaphysaloides (n = 43), Amblyomma testudinarium (n = 14) and Ixodes ovatus (n = 11) were identified. Babesia gibsoni DNA was detected in H. hystricis females (10.3%), males (7.0%) and in 2.6% of the nymphs. One R. sanguineus female and one A. testudinarium female tick also carried B. gibsoni DNA. DNA of B. gibsoni was demonstrated in 11 out of 68 (16.2%) batches of larval ticks derived from engorged H. hystricus ticks only. Babesia vogeli DNA was detected only in R. sanguineus females (2.6%) and males (2.4%). DNA of B. vogeli was detected in 13 out of 95 (13.7%) batches of larval ticks derived from engorged R.sanguineus females.ConclusionsBabesia gibsoni DNA was detected in the larval progeny of H. hystricis ticks only, whereas B. vogeli was restricted to the larvae of R. sanguineus. This provides evidence for transovarial passage of B. gibsoni in H. hystricis and evidence that this tick does act as the local vector for this parasite on dogs in northern Taiwan where most cases of babesiosis are reported. The vectorial capacity of R. sanguineus for babesiosis is probably restricted to the transmission of B. vogeli only.

Molecular characterization of Babesia microti seroreactive antigen 5-1-1 and development of rapid detection methods for anti-B. microti antibodies in serum

Babesiosis has become a new global threat impacting human health, and most human babesiosis cases are caused by Babesia microti. Until now few antigens of B. microti have been described which can be used for the diagnosis of human babesiosis. In the present study, we report on the bioinformatic analysis, cloning and expression of the sequence encoding the B. microti seroreactive antigen 5-1-1 to investigate its potential incorporation in serologic diagnostic tools for babesiosis. Bioinformatic analysis and recombinant gene expression were performed to molecularly characterize seroreactive antigen 5-1-1. Enhanced chemiluminescence (ECL)-Western blot methods were used to detect specific antibodies in infected mice. Immunofluorescence antibody assays (IFA) were performed to detect the localization of BmSA5-1-1 in B. microti parasites. ELISA and immunochromatographic (ICT) tests were developed using recombinant BmSA5-1-1 to evaluate its potential use in rapid detection methods for B. microti antibodies and for the diagnosis of babesiosis. A recombinant expression plasmid was constructed by inserting the target gene fragment in the pET28a vector after double digestion with BamHI and XhoI restriction enzymes. The recombinant BmSA5-1-1 protein was expressed in Escherichia coli (rBmSA5-1-1) and purified by means of Ni-nitrilotriacetic acid (NTA) agarose columns. Polyclonal antibodies were generated against rBmSA5-1-1. Based on indirect immunofluorescence assay results, BmSA5-1-1 appeared to localize on the surface of B. microti. ELISA tests using the rBmSA5-1-1 antigen detected specific antibodies from infected mice as early as 4 days post-infection. Our results indicate that the two methods we developed can detect specific antibodies in mice at different stages of infection with sensitivities of 100% (rBmSA5-1-1 ELISA) and 90% (ICT). The specificity of the two methods was 100%. Sera of patients suffering from other closely related parasitic diseases, such as malaria and toxoplasmosis, produced negative results. In conclusion, seroreactive antigen 5-1-1, a member of the BMN1 protein family, is expressed on the outer surface of B. microti and is a promising candidate antigen for the early diagnosis of babesiosis. rBmSA5-1-1 ELISA and ICT methods show good potential for detecting specific antibodies in mice at different stages of infection.

Piroplasmoses bovines dans les provinces de Skikda et d’Oum El Bouaghi (nord-est de l’Algérie) : étude épidémiologique et estimation des pertes de production laitière

Au cours d’une enquête menée dans 88 fermes de deux provinces du nord-est de l’Algérie – Oum El Bouaghi et Skikda –, 89 cas cliniques de piroplasmoses, soit un taux d’infection de 11,6 % des bovins examinés, ont été enregistrés entre mai et septembre 2011 dans 86,4 % des fermes visitées. Trois espèces de piroplasmes ont été identifiées dans les étalements sanguins colorés au Giemsa : Theileria annulata (chez 94,0 % des bovins malades), Babesia bovis (33,7 %) et Babesia bigemina (3,4 %), avec 31 % de co-infections. Il n’y avait pas de différence significative de prévalence entre les deux provinces ni entre les races bovines. La theilériose tropicale a provoqué une baisse significative de la production laitière, estimée à 319 litres par vache infectée pendant les deux mois suivant la maladie. Sept espèces de tiques ont été collectées dans les fermes pendant l’étude. Le pic d’infestation a été observé en juillet pour Hyalomma scupense (syn. H. detritum), H. lusitanicum, H. anatolicum, Rhipicephalus bursa et R. turanicus, et en août pour H. marginatum et H. excavatum. Une corrélation positive a été observée entre les cas cliniques de theilériose tropicale bovine et la charge parasitaire en H. scupense, d’une part, et entre les cas cliniques de babésioses et la charge parasitaire en R. bursa, d’autre part.

A fatal case of Babesia divergens infection in Northwestern Spain

We describe a fatal case caused by the intra-erythrocytic Babesia divergens parasite in an elderly woman. This is the third case of fatal babesiosis reported in the last 15 years in Europe, and the only one in a patient with an intact spleen.

Transfusion-transmitted and community-acquired babesiosis in New York, 2004 to 2015.

Babesiosis is a potentially life-threatening zoonotic infection most frequently caused by the intraerythrocytic parasite Babesia microti. The pathogen is usually tickborne, but may also be transfusion or vertically transmitted. Healthy persons, including blood donors, may be asymptomatic and unaware they are infected. Immunocompromised patients are at increased risk for symptomatic disease. All reported community-acquired babesiosis cases in New York from 2004 to 2015 were evaluated, enumerated, and characterized. All potential transfusion-transmitted babesiosis (TTB) cases reported through one or more of three public health surveillance systems were investigated to determine the likelihood of transfusion transmission. In addition, host-seeking ticks were actively collected in public parks and other likely sites of human exposure to B.microti. From 2004 to 2015, a total of 3799 cases of babesiosis were found; 55 (1.4%) of these were linked to transfusion. The incidence of both community-acquired babesiosis and TTB increased significantly during the 12-year study period. The geographic range of both ticks and tickborne infections also expanded. Among TTB cases, 95% of recipients had at least one risk factor for symptomatic disease. Implicated donors resided in five states, including in 10 New York counties. More than half of implicated donors resided in counties known to be B.microti endemic. The increasing incidence of TTB correlated with increases in community-acquired babesiosis and infection of ticks with B.microti. Surveillance of ticks and community-acquired cases may aid identification of emerging areas at risk for Babesia transfusion transmission.

The Epidemiological Survey and Analysis of Canine Babesiosis in Xi’an City, China

The canine babesiosis is one of the major diseases that significantly harm to the dogs. In order to analyze the characteristics of babesiosis in dogs, and to explore the characteristics of blood changes in canine babesiosis in Xi’an city, 194 cases of canine babesiosis were diagnosed in the animal teaching hospital of the Northwest AF the mean corpuscular volume, the number of white blood cell, the concentration of alkaline phosphatase, total bilirubin, urea nitrogen, phosphorus, alanine aminotransferase and aspartate aminotransferase was elevated. Moreover, the liver and kidney function was also destroyed in a certain degree. It indicated that the dogs suffered from severe anemia (regenerative anemia), accompanied by inflammatory reaction, which can cause the blood coagulation dysfunction, some drugs with protecting liver and kidney should be used in the process of treatment so as to improve the cure rate of this disease. These findings provided important reference information for the prevention and treatment of babesiosis.

Fatal human babesiosis caused by Babesia divergens in an asplenic host.

We report a fatal case of human babesiosis caused by bovine pathogen Babesia divergens in Russia. Falciparum malaria was falsely diagnosed due to the presence of small ring forms in the blood smear. Laboratory diagnosis can distinguish between babesiosis and malaria according to the examination of stained blood smears.

Hematologic Manifestations of Babesiosis

Background: Babesiosis, a zoonotic parasitic infection transmitted by the Ixodes tick, has become an emerging health problem in the human host that is attracting attention worldwide. Most cases of human babesiosis are reported in the United States and Europe. The disease is caused by the protozoa of the genus Babesia, which invade human erythrocytes and lyse them causing a febrile hemolytic anemia. The infection is usually asymptomatic or self-limited in the immunocompetent host, or follows a persistent, relapsing, and/or life threatening course with multi-organ failure, mainly in the splenectomized or immunosuppressed patients. Hematologic manifestations of the disease are common. They can range from mild anemia, to severe pancytopenia, splenic ruture, disseminated intravascular coagulopathy (DIC), or even hemophagocytic lymphohistiocytosis (HLH). Case presentation: A 70-year-old immunocompetent female patient living in New York City presented with a persistent fever, night sweats, and fatigue of five days duration. Full evaluation showed a febrile hemolytic anemia along with neutropenia and thrombocytopenia. Blood smear revealed intraerythrocytic Babesia, which was confirmed by PCR. Bone marrow biopsy was remarkable for dyserythropoiesis, suggesting possible HLH, supported by other blood workup meeting HLH-2004 trial criteria. Conclusion: Human babesiosis is an increasing healthcare problem in the United States that is being diagnosed more often nowadays. We presented a case of HLH triggered by Babesia microti that was treated successfully. Also, we presented the hematologic manifestations of this disease along with their pathophysiologies.

Molecular detection and characterisation of Babesia and Theileria in Australian hard ticks

Babesia and Theileria are intraerythrocytic protozoans of the phylum Apicomplexa. These species are capable of infecting wild and domestic animals and have historically caused great economic loss in the agricultural industry. In recent years human babesiosis has been deemed an emerging zoonosis in North America, Europe and Asia. The first locally acquired case of babesiosis in Australia, caused by Babesia microti, was reported in March 2012. A number of native Babesia and Theileria species have been identified in Australian marsupials, however their associated tick vectors and threat to human health is unknown. In the present study DNA was extracted from 1154 ticks collected from across Australia. PCR was used to amplify a Babesia and Theileria-specific partial region of the 18S ribosomal RNA gene. Positive samples were sequenced and phylogenetic analysis was performed. Twenty-nine sequences were obtained from ticks belonging to the genera Ixodes, Haemaphysalis and Bothriocroton. The sequences were closely related to Babesia macropus, and Theileria recently identified in marsupials and monotremes. Bayesian inference and maximum likelihood methods showed that Australian Babesia and Theileria species form monophyletic groups.

Peculiarities of Dog Babesiosis Distribution in Kyiv City

Abstract The article presents the information on the distribution of babesiosis among domestic dogs of Kyiv City investigated in 2014–first half of 2017. Among 2030 examined dogs, Babesia canis was found in 416 animals. The prevalence of infection was 20.5 %. Dependence of the number of cases of babesiosis on the temperature of the environment was indicated. The highest level of dogs’ infection was observed in spring (April–May) and autumn (September–October). Ixodid tick Dermаcentor reticulatus was found to be the most common vector of dog babesiosis in Kyiv.