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Cai Y, Xu B, Liu X, Yang W, Mo Z, Zheng B, Chen J, Hu W. Transmission risk evaluation of transfusion blood containing low-density Babesia microti. Front Cell Infect Microbiol 2024; 14:1334426. [PMID: 38375363 PMCID: PMC10875030 DOI: 10.3389/fcimb.2024.1334426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
Background Babesia is a unique apicomplexan parasite that specifically invades and proliferates in red blood cells and can be transmitted via blood transfusion, resulting in transfusion-transmitted babesiosis. However, detecting Babesia in blood before transfusion has not received enough attention, and the risk of transfusing blood containing a low density of Babesia microti (B. microti) is unclear, possibly threatening public health and wellness. Purpose This study aimed to determine the lower detection limit of B. microti in blood and to evaluate the transmission risk of blood transfusion containing low-density B. microti. Methods Infected BALB/c mouse models were established by transfusing infected whole blood with different infection rates and densities of B. microti. Microscopic examination, nested Polymerase Chain Reaction (nested PCR), and an enzyme-linked immunosorbent assay (ELISA) were used to evaluate the infection status of the mouse models. Meanwhile, the nested PCR detection limit of B. microti was obtained using pure B. microti DNA samples with serial concentrations and whole blood samples with different densities of B. microti-infected red blood cells. Thereafter, whole mouse blood with a B. microti density lower than that of the nested PCR detection limit and human blood samples infected with B. microti were transfused into healthy mice to assess the transmission risk in mouse models. The infection status of these mice was evaluated through microscopic examination, nested PCR tests, and ELISA. Results The mice inoculated with different densities of B. microti reached the peak infection rate on different days. Overall, the higher the blood B. microti density was, the earlier the peak infection rate was reached. The levels of specific antibodies against B. microti in the blood of the infected mice increased sharply during the first 30 days of infection, reaching a peak level at 60 days post-infection, and maintaining a high level thereafter. The nested PCR detection limits of B. microti DNA and parasite density were 3 fg and 5.48 parasites/μL, respectively. The whole blood containing an extremely low density of B. microti and human blood samples infected with B. microti could infect mice, confirming the transmission risk of transfusing blood with low-density B. microti. Conclusion Whole blood containing extremely low density of B. microti poses a high transmission risk when transfused between mice and mice or human and mice, suggesting that Babesia detection should be considered by governments, hospitals, and disease prevention and control centers as a mandatory test before blood donation or transfusion.
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Affiliation(s)
- Yuchun Cai
- Laboratory of Parasite and Vector Biology, Ministry of Public Health, World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, China
| | - Bin Xu
- Laboratory of Parasite and Vector Biology, Ministry of Public Health, World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, China
| | - Xiufeng Liu
- School of Life Sciences, Fudan University, Shanghai, China
| | - Wenwu Yang
- School of Life Sciences, Fudan University, Shanghai, China
| | - Ziran Mo
- The institutes of Biomedical Sciences, College of Life Sciences, Inner Mongolia University, Hohhot, China
| | - Bin Zheng
- Laboratory of Parasite and Vector Biology, Ministry of Public Health, World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, China
| | - Jiaxu Chen
- Laboratory of Parasite and Vector Biology, Ministry of Public Health, World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, China
| | - Wei Hu
- Laboratory of Parasite and Vector Biology, Ministry of Public Health, World Health Organization (WHO) Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Shanghai, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, Shanghai, China
- School of Life Sciences, Fudan University, Shanghai, China
- The institutes of Biomedical Sciences, College of Life Sciences, Inner Mongolia University, Hohhot, China
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Zeidler H, Hudson AP. Quo vadis reactive arthritis? Curr Opin Rheumatol 2022; 34:218-224. [PMID: 35699331 DOI: 10.1097/bor.0000000000000880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW We provide an overview of recent articles which describe new thinking regarding HLA-B27-associated reactive arthritis (ReA), including those additional infection-related arthritides triggered by microbes that often are grouped under the term ReA. RECENT FINDINGS With the advent and continuation of the pandemic, an increasing number of cases and case series of post-COVID-19 arthritis have been reported and classified as ReA. Further, arthritis after COVID-19 vaccination is a new entity included within the spectrum of ReA. New causative microorganisms identified in case reports include Clostridium difficile, Mycoplasma pneumoniae, Giardia lamblia, Leptospira , and babesiosis. SARS-CoV-2 is emerging as a significant etiologic agent for apparent ReA. SUMMARY It is now clear that comprehensive clinical and laboratory investigations, synovial fluid analyses, and close follow-up of patients all are essential to differentiate ReA from diseases that may present with similar clinical attributes. Further, and importantly, additional research is required to define the wide diversity in causative agents, epidemiology, and rare case presentations of these arthritides. Finally, new classification and diagnostic criteria, and updated treatment recommendations, are essential to the advancement of our understanding of ReA.
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Affiliation(s)
- Henning Zeidler
- Clinic of Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Alan P Hudson
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, Michigan, USA
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Bajer A, Beck A, Beck R, Behnke JM, Dwużnik-Szarek D, Eichenberger RM, Farkas R, Fuehrer HP, Heddergott M, Jokelainen P, Leschnik M, Oborina V, Paulauskas A, Radzijevskaja J, Ranka R, Schnyder M, Springer A, Strube C, Tolkacz K, Walochnik J. Babesiosis in Southeastern, Central and Northeastern Europe: An Emerging and Re-Emerging Tick-Borne Disease of Humans and Animals. Microorganisms 2022; 10:945. [PMID: 35630388 PMCID: PMC9146636 DOI: 10.3390/microorganisms10050945] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 12/10/2022] Open
Abstract
There is now considerable evidence that in Europe, babesiosis is an emerging infectious disease, with some of the causative species spreading as a consequence of the increasing range of their tick vector hosts. In this review, we summarize both the historic records and recent findings on the occurrence and incidence of babesiosis in 20 European countries located in southeastern Europe (Bosnia and Herzegovina, Croatia, and Serbia), central Europe (Austria, the Czech Republic, Germany, Hungary, Luxembourg, Poland, Slovakia, Slovenia, and Switzerland), and northern and northeastern Europe (Lithuania, Latvia, Estonia, Iceland, Denmark, Finland, Sweden, and Norway), identified in humans and selected species of domesticated animals (cats, dogs, horses, and cattle). Recorded cases of human babesiosis are still rare, but their number is expected to rise in the coming years. This is because of the widespread and longer seasonal activity of Ixodes ricinus as a result of climate change and because of the more extensive use of better molecular diagnostic methods. Bovine babesiosis has a re-emerging potential because of the likely loss of herd immunity, while canine babesiosis is rapidly expanding in central and northeastern Europe, its occurrence correlating with the rapid, successful expansion of the ornate dog tick (Dermacentor reticulatus) populations in Europe. Taken together, our analysis of the available reports shows clear evidence of an increasing annual incidence of babesiosis across Europe in both humans and animals that is changing in line with similar increases in the incidence of other tick-borne diseases. This situation is of major concern, and we recommend more extensive and frequent, standardized monitoring using a "One Health" approach.
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Affiliation(s)
- Anna Bajer
- Department of Eco-Epidemiology of Parasitic Diseases, Faculty of Biology, Institute of Developmental Biology and Biomedical Sciences, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland; (D.D.-S.); (K.T.)
| | - Ana Beck
- Ribnjak 8, 10 000 Zagreb, Croatia;
| | - Relja Beck
- Department for Bacteriology and Parasitology, Croatian Veterinary Institute, Savska Cesta 143, 10 000 Zagreb, Croatia;
| | - Jerzy M. Behnke
- School of Life Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK;
| | - Dorota Dwużnik-Szarek
- Department of Eco-Epidemiology of Parasitic Diseases, Faculty of Biology, Institute of Developmental Biology and Biomedical Sciences, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland; (D.D.-S.); (K.T.)
| | - Ramon M. Eichenberger
- Vetsuisse Faculty, Institute of Parasitology, University of Zurich, 8057 Zürich, Switzerland; (R.M.E.); (M.S.)
| | - Róbert Farkas
- Department of Parasitology and Zoology, University of Veterinary Medicine, 1078 Budapest, Hungary;
| | - Hans-Peter Fuehrer
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Vienna, Austria;
| | - Mike Heddergott
- Department of Zoology, Musée National d’Historire Naturelle, 25, Rue Münster, 2160 Luxembourg, Luxembourg;
| | - Pikka Jokelainen
- Infectious Disease Prepardness, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen, Denmark;
| | - Michael Leschnik
- Clinical Unit of Internal Medicine Small Animals, Department/Universitätsklinik für Kleintiere und Pferde, University of Veterinary Medicine Vienna, Veterinärplatz 1, 1210 Wien, Austria;
| | - Valentina Oborina
- Small Animal Clinic of Estonian University of Life Sciences, Kreutzwaldi 62, 51014 Tartu, Estonia;
| | - Algimantas Paulauskas
- Faculty of Natural Sciences, Vytautas Magnus University, K. Donelaičio str. 58, LT-44248 Kaunas, Lithuania; (A.P.); (J.R.)
| | - Jana Radzijevskaja
- Faculty of Natural Sciences, Vytautas Magnus University, K. Donelaičio str. 58, LT-44248 Kaunas, Lithuania; (A.P.); (J.R.)
| | - Renate Ranka
- Latvian Biomedical Research and Study Centre, LV-1067 Riga, Latvia;
| | - Manuela Schnyder
- Vetsuisse Faculty, Institute of Parasitology, University of Zurich, 8057 Zürich, Switzerland; (R.M.E.); (M.S.)
| | - Andrea Springer
- Centre for Infection Medicine, Institute for Parasitology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (A.S.); (C.S.)
| | - Christina Strube
- Centre for Infection Medicine, Institute for Parasitology, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (A.S.); (C.S.)
| | - Katarzyna Tolkacz
- Department of Eco-Epidemiology of Parasitic Diseases, Faculty of Biology, Institute of Developmental Biology and Biomedical Sciences, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland; (D.D.-S.); (K.T.)
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, 5A Pawińskiego Str, 02-106 Warsaw, Poland
| | - Julia Walochnik
- Institute for Specific Prophylaxis and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria;
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Bonsergent C, de Carné MC, de la Cotte N, Moussel F, Perronne V, Malandrin L. The New Human Babesia sp. FR1 Is a European Member of the Babesia sp. MO1 Clade. Pathogens 2021; 10:pathogens10111433. [PMID: 34832590 PMCID: PMC8618789 DOI: 10.3390/pathogens10111433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022] Open
Abstract
In Europe, Babesia divergens is responsible for most of the severe cases of human babesiosis. In the present study, we describe a case of babesiosis in a splenectomized patient in France and report a detailed molecular characterization of the etiological agent, named Babesia sp. FR1, as well as of closely related Babesia divergens, Babesia capreoli and Babesia sp. MO1-like parasites. The analysis of the conserved 18S rRNA gene was supplemented with the analysis of more discriminant markers involved in the red blood cell invasion process: rap-1a (rhoptry-associated-protein 1) and ama-1 (apical-membrane-antigen 1). The rap-1a and ama-1 phylogenetic analyses were congruent, placing Babesia sp. FR1, the new European etiological agent, in the American cluster of Babesia sp. MO1-like parasites. Based on two additional markers, our analysis confirms the clear separation of B. divergens and B. capreoli. Babesia sp. MO1-like parasites should also be considered as a separate species, with the rabbit as its natural host, differing from those of B. divergens (cattle) and B. capreoli (roe deer). The natural host of Babesia sp. FR1 remains to be discovered.
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Affiliation(s)
- Claire Bonsergent
- BIOEPAR, INRAE, Oniris, 44300 Nantes, France;
- Correspondence: (C.B.); (L.M.)
| | - Marie-Charlotte de Carné
- Service de Maladies Infectieuses et Tropicales, Hôpital F. Quesnay, 78200 Mantes-la Jolie, France; (M.-C.d.C.); (V.P.)
| | | | - François Moussel
- Laboratoire de Biologie Médicale, Hôpital F. Quesnay, 78200 Mantes-la-Jolie, France;
| | - Véronique Perronne
- Service de Maladies Infectieuses et Tropicales, Hôpital F. Quesnay, 78200 Mantes-la Jolie, France; (M.-C.d.C.); (V.P.)
| | - Laurence Malandrin
- BIOEPAR, INRAE, Oniris, 44300 Nantes, France;
- Correspondence: (C.B.); (L.M.)
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Hildebrandt A, Zintl A, Montero E, Hunfeld KP, Gray J. Human Babesiosis in Europe. Pathogens 2021; 10:1165. [PMID: 34578196 PMCID: PMC8468516 DOI: 10.3390/pathogens10091165] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022] Open
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.
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Affiliation(s)
- Anke Hildebrandt
- St. Vincenz Hospital Datteln, Department of Internal Medicine I, 45711 Datteln, Germany;
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
| | - Annetta Zintl
- UCD School of Veterinary Sciences, University College Dublin, D04 W6F6 Dublin, Ireland;
| | - Estrella Montero
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid, Spain;
| | - Klaus-Peter Hunfeld
- Institute of Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Center, Medical Faculty Goethe University Frankfurt, Steinbacher Hohl 2-26, 60488 Frankfurt am Main, Germany;
- Society for Promoting Quality Assurance in Medical Laboratories (INSTAND, e.v.), Ubierstraße 20, 40223 Düsseldorf, Germany
- ESGBOR Study Group of the European Society for Clinical Microbiology & Infectious Diseases (ESCMID), ESCMID Executive Office, P.O. Box 214, 4010 Basel, Switzerland
| | - Jeremy Gray
- UCD School of Biology and Environmental Science, University College Dublin, D04 N2E5 Dublin, Ireland
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Emerging Human Babesiosis with "Ground Zero" in North America. Microorganisms 2021; 9:microorganisms9020440. [PMID: 33672522 PMCID: PMC7923768 DOI: 10.3390/microorganisms9020440] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/15/2022] Open
Abstract
The first case of human babesiosis was reported in the literature in 1957. The clinical disease has sporadically occurred as rare case reports in North America and Europe in the subsequent decades. Since the new millennium, especially in the last decade, many more cases have apparently appeared not only in these regions but also in Asia, South America, and Africa. More than 20,000 cases of human babesiosis have been reported in North America alone. In several cross-sectional surveys, exposure to Babesia spp. has been demonstrated within urban and rural human populations with clinical babesiosis reported in both immunocompromised and immunocompetent humans. This review serves to highlight the widespread distribution of these tick-borne pathogens in humans, their tick vectors in readily accessible environments such as parks and recreational areas, and their phylogenetic relationships.
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