1
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Singh P, Vydyam P, Fang T, Estrada K, Gonzalez LM, Grande R, Kumar M, Chakravarty S, Berry V, Ranwez V, Carcy B, Depoix D, Sánchez S, Cornillot E, Abel S, Ciampossin L, Lenz T, Harb O, Sanchez-Flores A, Montero E, Le Roch KG, Lonardi S, Mamoun CB. Insights Into the Evolution, Virulence and Speciation of Babesia MO1 and Babesia divergens Through Multiomics Analyses. Emerg Microbes Infect 2024:2386136. [PMID: 39148308 DOI: 10.1080/22221751.2024.2386136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
AbstractBabesiosis, caused by protozoan parasites of the genus Babesia, is an emerging tick-borne disease of significance for both human and animal health. Babesia parasites infect erythrocytes of vertebrate hosts where they develop and multiply rapidly to cause the pathological symptoms associated with the disease. The identification of new Babesia species underscores the ongoing risk of zoonotic pathogens capable of infecting humans, a concern amplified by anthropogenic activities and environmental changes. One such pathogen, Babesia MO1, previously implicated in severe cases of human babesiosis in the United States, was initially considered a subspecies of B. divergens, the predominant agent of human babesiosis in Europe. Here we report comparative multiomics analyses of B. divergens and B. MO1 that offer insight into their biology and evolution. Our analysis shows that despite their highly similar genomic sequences, substantial genetic and genomic divergence occurred throughout their evolution resulting in major differences in gene functions, expression and regulation, replication rates and susceptibility to antiparasitic drugs. Furthermore, both pathogens have evolved distinct classes of multigene families, crucial for their pathogenicity and adaptation to specific mammalian hosts. Leveraging genomic information for B. MO1, B. divergens, and other members of the Babesiidae family within Apicomplexa provides valuable insights into the evolution, diversity, and virulence of these parasites. This knowledge serves as a critical tool in preemptively addressing the emergence and rapid transmission of more virulent strains.
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Affiliation(s)
- Pallavi Singh
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Pratap Vydyam
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Tiffany Fang
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Karel Estrada
- Unidad Universitaria de Secuenciacion Masiva y Bioinformatica, Instituto de Biotecnologia, Universidad Nacional Autonoma de Mexico. Cuernavaca, Morelos, Mexico
| | - Luis Miguel Gonzalez
- Laboratorio de Referencia e Investigación en Parasitología, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, 28220, Spain
| | - Ricardo Grande
- Unidad Universitaria de Secuenciacion Masiva y Bioinformatica, Instituto de Biotecnologia, Universidad Nacional Autonoma de Mexico. Cuernavaca, Morelos, Mexico
| | - Madelyn Kumar
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sakshar Chakravarty
- Department of Computer Science and Engineering, 900 University Avenue, University of California, Riverside, CA 92521
| | - Vincent Berry
- LIRMM - Université de Montpellier, CNRS, Montpellier, France
| | - Vincent Ranwez
- AGAP Institut, Université de Montpellier, CIRAD, INRAE, Institut Agro, Montpellier, France
| | - Bernard Carcy
- MIVEGEC, Univ. Montpellier, CNRS, IRD, CHU, Montpellier, France
| | - Delphine Depoix
- Unité Molécules de Communication et Adaptation des Microorganismes (MCAM, UMR7245), Muséum National d'Histoire Naturelle, CNRS, CP52, 57 Rue Cuvier, 75005 Paris, France
| | - Sergio Sánchez
- Laboratorio de Referencia e Investigación en Infecciones Bacterianas Transmitidas por Agua y Alimentos, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, 28229, Spain
| | - Emmanuel Cornillot
- Institut de Biologie Computationnelle (IBC), and Institut de Recherche en Cancérologie de Montpellier (IRCM - INSERM U1194), Institut régional du Cancer Montpellier (ICM) & Université de Montpellier, France
| | - Steven Abel
- Department of Molecular, Cell and Systems Biology, 900 University Avenue, University of California, Riverside, CA 92521
| | - Loic Ciampossin
- Department of Molecular, Cell and Systems Biology, 900 University Avenue, University of California, Riverside, CA 92521
| | - Todd Lenz
- Department of Molecular, Cell and Systems Biology, 900 University Avenue, University of California, Riverside, CA 92521
| | - Omar Harb
- Department of Biology, University of Pennsylvania, Philadelphia, PA 19145
| | - Alejandro Sanchez-Flores
- Unidad Universitaria de Secuenciacion Masiva y Bioinformatica, Instituto de Biotecnologia, Universidad Nacional Autonoma de Mexico. Cuernavaca, Morelos, Mexico
| | - Estrella Montero
- Laboratorio de Referencia e Investigación en Parasitología, National Center for Microbiology, Instituto de Salud Carlos III, Majadahonda, 28220, Spain
| | - Karine G Le Roch
- Department of Molecular, Cell and Systems Biology, 900 University Avenue, University of California, Riverside, CA 92521
| | - Stefano Lonardi
- Department of Computer Science and Engineering, 900 University Avenue, University of California, Riverside, CA 92521
| | - Choukri Ben Mamoun
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
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Maggi RG, Calchi AC, Moore CO, Kingston E, Breitschwerdt EB. Human Babesia odocoilei and Bartonella spp. co-infections in the Americas. Parasit Vectors 2024; 17:302. [PMID: 38992682 PMCID: PMC11241936 DOI: 10.1186/s13071-024-06385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/29/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND In recent years, Babesia and Bartonella species co-infections in patients with chronic, nonspecific illnesses have continued to challenge and change the collective medical understanding of "individual pathogen" vector-borne infectious disease dynamics, pathogenesis and epidemiology. The objective of this case series is to provide additional molecular documentation of Babesia odocoilei infection in humans in the Americas and to emphasize the potential for co-infection with a Bartonella species. METHODS The development of improved and more sensitive molecular diagnostic techniques, as confirmatory methods to assess active infection, has provided increasing clarity to the healthcare community. RESULTS Using a combination of different molecular diagnostic approaches, infection with Babesia odocoilei was confirmed in seven people suffering chronic non-specific symptoms, of whom six were co-infected with one or more Bartonella species. CONCLUSIONS We conclude that infection with Babesia odocoilei is more frequent than previously documented and can occur in association with co-infection with Bartonella spp.
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Affiliation(s)
- Ricardo G Maggi
- College of Veterinary Medicine, North Carolina State University, Intracellular Pathogens Research Laboratory Comparative Medicine Institute, Raleigh, NC, USA
| | - Ana Cláudia Calchi
- Department of Pathology, Reproduction and One Health, Vector-Borne Bioagents Laboratory (VBBL), School of Agricultural and Veterinarian Sciences (FCAV) - São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Charlotte O Moore
- College of Veterinary Medicine, North Carolina State University, Intracellular Pathogens Research Laboratory Comparative Medicine Institute, Raleigh, NC, USA
| | - Emily Kingston
- College of Veterinary Medicine, North Carolina State University, Intracellular Pathogens Research Laboratory Comparative Medicine Institute, Raleigh, NC, USA
| | - Edward B Breitschwerdt
- College of Veterinary Medicine, North Carolina State University, Intracellular Pathogens Research Laboratory Comparative Medicine Institute, Raleigh, NC, USA.
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Singh P, Vydyam P, Fang T, Estrada K, Gonzalez LM, Grande R, Kumar M, Chakravarty S, Berry V, Ranwez V, Carcy B, Depoix D, Sánchez S, Cornillot E, Abel S, Ciampossin L, Lenz T, Harb O, Sanchez-Flores A, Montero E, Le Roch KG, Lonardi S, Ben Mamoun C. Multiomics analysis reveals B. MO1 as a distinct Babesia species and provides insights into its evolution and virulence. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.17.575932. [PMID: 38293033 PMCID: PMC10827214 DOI: 10.1101/2024.01.17.575932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Babesiosis, caused by protozoan parasites of the genus Babesia , is an emerging tick-borne disease of significance for both human and animal health. Babesia parasites infect erythrocytes of vertebrate hosts where they develop and multiply rapidly to cause the pathological symptoms associated with the disease. The identification of various Babesia species underscores the ongoing risk of new zoonotic pathogens capable of infecting humans, a concern amplified by anthropogenic activities and environmental shifts impacting the distribution and transmission dynamics of parasites, their vectors, and reservoir hosts. One such species, Babesia MO1, previously implicated in severe cases of human babesiosis in the midwestern United States, was initially considered closely related to B. divergens , the predominant agent of human babesiosis in Europe. Yet, uncertainties persist regarding whether these pathogens represent distinct variants of the same species or are entirely separate species. We show that although both B. MO1 and B. divergens share similar genome sizes, comprising three nuclear chromosomes, one linear mitochondrial chromosome, and one circular apicoplast chromosome, major differences exist in terms of genomic sequence divergence, gene functions, transcription profiles, replication rates and susceptibility to antiparasitic drugs. Furthermore, both pathogens have evolved distinct classes of multigene families, crucial for their pathogenicity and adaptation to specific mammalian hosts. Leveraging genomic information for B. MO1, B. divergens , and other members of the Babesiidae family within Apicomplexa provides valuable insights into the evolution, diversity, and virulence of these parasites. This knowledge serves as a critical tool in preemptively addressing the emergence and rapid transmission of more virulent strains.
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Montero E, Folgueras M, Rodriguez-Pérez M, Pérez-Ls L, Díaz-Arias J, Meana M, Revuelta B, Haapasalo K, Collazos J, Asensi V, Gonzalez LM. Retrospective study of the epidemiological risk and serological diagnosis of human babesiosis in Asturias, Northwestern Spain. Parasit Vectors 2023; 16:195. [PMID: 37296439 DOI: 10.1186/s13071-023-05817-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Babesiosis is a globally growing tick-borne disease in humans. Severe babesiosis caused by Babesia divergens has been reported in two patients from Asturias (Northwestern Spain), suggesting an undetected risk for the disease. To analyze this risk, we retrospectively evaluated the seroprevalence of babesiosis in the Asturian population from 2015 through 2017, a period covering the intermediate years in which these two severe cases occurred. METHODS Indirect fluorescent assay (IFA) and Western blot (WB) were performed to detect B. divergens IgG antibodies in 120 serum samples from Asturian patients infected with the tick-transmitted spirochete Borrelia burgdorferi sensu lato, a condition that indicates exposure to tick bites. RESULTS This retrospective study confirmed a B. divergens seroprevalence rate of 39.2% according to IFA results. B. divergens incidence was 7.14 cases/100,000 population, exceeding previously reported seroprevalence rates. No differences in epidemiology and risk factors were found between patients infected solely with B. burgdorferi s.l. and those infected with B. burgdorferi s.l. and with IgG antibodies against B. divergens. This last group of patients lived in Central Asturias, had a milder clinical course and, according to WB results, developed different humoral responses against B. divergens. CONCLUSIONS Babesia divergens parasites have circulated for several years in Asturias. Epidemiological evidence of babesiosis makes Asturias an emerging risk area for this zoonosis. Human babesiosis could also be relevant in other Spanish and European regions affected by borreliosis. Hence, the potential risk of babesiosis on human health in Asturias and other European forest regions needs to be addressed by the health authorities.
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Affiliation(s)
- Estrella Montero
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain.
| | - María Folgueras
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Mercedes Rodriguez-Pérez
- Microbiology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Laura Pérez-Ls
- Researcher, Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Javier Díaz-Arias
- Researcher, Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Maria Meana
- Internal Medicine, Hospital Alvarez-Buylla, Mieres, Asturias, Spain
| | - Belén Revuelta
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain
| | - Karita Haapasalo
- Department of Bacteriology and Immunology, Medicum, University of Helsinki, 00014, Helsinki, Finland
| | - Julio Collazos
- Infectious Diseases Unit, Hospital de Galdácano, Vizcaya, Spain
| | - Víctor Asensi
- Infectious Diseases Unit, Hospital Universitario Central de Asturias and Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Miguel Gonzalez
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain
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Hildebrandt A, Gray J, Montero E. Characteristics of Human Babesiosis in Europe. Pathogens 2023; 12:pathogens12020323. [PMID: 36839594 PMCID: PMC9961061 DOI: 10.3390/pathogens12020323] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
One of the Editor's choice articles in 2021 published in Pathogens was a review of human babesiosis in Europe [...].
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Affiliation(s)
- Anke Hildebrandt
- Department of Internal Medicine I, St. Vincenz Hospital Datteln, 45711 Datteln, Germany
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
- Correspondence:
| | - Jeremy Gray
- UCD School of Biology and Environmental Science, University College Dublin, D04 N2E5 Dublin, Ireland
| | - Estrella Montero
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220 Madrid, Spain
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Zeng Z, Zhou S, Xu G, Liu W, Han T, Liu J, Wang J, Deng Y, Xiao F. Prevalence and phylogenetic analysis of Babesia parasites in reservoir host species in Fujian province, Southeast China. Zoonoses Public Health 2022; 69:915-924. [PMID: 35819239 DOI: 10.1111/zph.12988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 01/25/2023]
Abstract
Babesiosis is a tick-borne disease that mainly affects small mammals and has been reported in at least five provinces in China. However, the host range and geographical distribution of the parasite in Fujian province are unclear. Therefore, we investigated the prevalence and genetic characteristics of Babesia in Fujian province, Southeast China, between 2015 and 2020. Rodent blood samples were collected from 26 different surveillance sites across Fujian province. Genomic DNA was extracted to screen for Babesia infection using polymerase chain reaction based on 18S rRNA. DNA samples from 316 domestic goats, 85 water buffalo, 56 domestic dogs and 18 domestic pigs were examined. The prevalence of Babesia was statistically analysed using the Chi-square test or Fisher's exact test. Babesia infections were detected in 3.96% (43/1,087; 95%CI: 2.80%, 5.12%) of rodents and 1.26% (6/475; 95%CI: 0.26%, 2.26%) of other mammals. Multivariate logistic regression analysis revealed that irrigated cropland, shrubs and forests were risk factors for Babesia microti infections. The infection rates among domestic pigs, dogs and goats were 5.56%, 1.79% and 1.27%, respectively, with no infection found in water buffalo. The 18S rRNA gene sequencing revealed that rodents were infected with Babesia (sensu lato), whereas other mammals were infected with Babesia (sensu stricto). The geographical distribution and phylogenetic relationship of Babesia was determined in Southeast China. Mammals, particularly wild rodents, maybe the main natural hosts of Babesia in Fujian. Our findings provide a foundation for public health officials to develop prevention and control measures for Babesia.
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Affiliation(s)
- Zhiwei Zeng
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Shuheng Zhou
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Guoying Xu
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Weijun Liu
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Tengwei Han
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Jing Liu
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Jiaxiong Wang
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Yanqin Deng
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
| | - Fangzhen Xiao
- Fujian Center for Disease Control and Prevention, Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, China
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Kukina IV, Zelya OP. Extraordinary high level of propagation of Babesia divergens in severe human babesiosis. Parasitology 2022; 149:1160-1163. [PMID: 35591780 PMCID: PMC11010513 DOI: 10.1017/s0031182022000439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/18/2022] [Accepted: 03/23/2022] [Indexed: 11/06/2022]
Abstract
Babesias are obligate apicomplexan parasites that affect the red blood cells (RBCs) of animals. Humans can serve as accidental hosts for them. Asexual reproduction of a parasite occurs in a vertebrate host through asynchronous binary fission, yielding a complex pleomorphic population of intraerythrocytic forms. In natural hosts (Bos taurus), paired pyriforms (‘figure 8’) of Babesia divergens are usual, but tetrads (‘Maltese Cross’) are very rare (only in 0.02% infected erythrocytes); in humans, however, up to 5% of infected erythrocytes show tetrads. The current study shows that B. divergens proliferating in an accidental human host can promote extraordinarily high level of fission. This phenomenon is expressed as the simultaneous division of the parasite into 6 and possibly a greater number of merozoites, forming a ‘daisy head’ (vs the usual 2, less often 4 merozoites). Reproduction is possible without egressing merozoites from the erythrocyte, which results in multi-occupancy of an RBC (≥5 parasites per RBC). An unusually high polyparasitism – up to 14 parasites developed in the affected erythrocytes – was observed. This phenomenon is rare in natural hosts (usually ≤5), but when B. divergens is cultured in vitro it can be 10–12.
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Affiliation(s)
- Irina V. Kukina
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, Sechenov University, Moscow, Russia
| | - Olga P. Zelya
- Martsinovsky Institute of Medical Parasitology, Tropical and Vector-Borne Diseases, Sechenov University, Moscow, Russia
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9
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The Global Emergence of Human Babesiosis. Pathogens 2021; 10:pathogens10111447. [PMID: 34832603 PMCID: PMC8623124 DOI: 10.3390/pathogens10111447] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/05/2022] Open
Abstract
Babesiosis is an emerging tick-borne disease caused by intraerythrocytic protozoa that are primarily transmitted by hard-bodied (ixodid) ticks and rarely through blood transfusion, perinatally, and organ transplantation. More than 100 Babesia species infect a wide spectrum of wild and domestic animals worldwide and six have been identified as human pathogens. Babesia microti is the predominant species that infects humans, is found throughout the world, and causes endemic disease in the United States and China. Babesia venatorum and Babesia crassa-like agent also cause endemic disease in China. Babesia divergens is the predominant species in Europe where fulminant cases have been reported sporadically. The number of B. microti infections has been increasing globally in recent decades. In the United States, more than 2000 cases are reported each year, although the actual number is thought to be much higher. In this review of the epidemiology of human babesiosis, we discuss epidemiologic tools used to monitor disease location and frequency; demographics and modes of transmission; the location of human babesiosis; the causative Babesia species in the Americas, Europe, Asia, Africa, and Australia; the primary clinical characteristics associated with each of these infections; and the increasing global health burden of this disease.
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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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Stanley J, Stramer SL, Erickson Y, Cruz J, Gorlin J, Janzen M, Rossmann SN, Straus T, Albrecht P, Pate LL, Galel SA. Detection of Babesia RNA and DNA in whole blood samples from US blood donations. Transfusion 2021; 61:2969-2980. [PMID: 34368968 PMCID: PMC9290686 DOI: 10.1111/trf.16617] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 01/03/2023]
Abstract
Background Human babesiosis is a zoonotic infection caused by an intraerythrocytic parasite. The highest incidence of babesiosis is in the United States, although cases have been reported in other parts of the world. Due to concerns of transfusion‐transmitted babesiosis, the US Food and Drug Administration (FDA) recommended year‐round regional testing for Babesia by nucleic acid testing or use of an FDA‐approved device for pathogen reduction. A new molecular test, cobas Babesia (Roche Molecular Systems, Inc.), was evaluated for the detection of the four species that cause human disease, Babesia microti, Babesia duncani, Babesia divergens, and Babesia venatorum. Study design and methods Analytical performance was evaluated followed by clinical studies on whole blood samples from US blood donations collected in a special tube containing a chaotropic reagent that lyses the red cells and preserves nucleic acid. Sensitivity and specificity of the test in individual samples (individual donation testing [IDT]) and in pools of six donations were determined. Results Based on analytical studies, the claimed limit of detection of cobas Babesia for B. microti is 6.1 infected red blood cells (iRBC)/mL (95% confidence interval [CI]: 5.0, 7.9); B. duncani was 50.2 iRBC/mL (95% CI: 44.2, 58.8); B. divergens was 26.1 (95% CI: 22.3, 31.8); and B. venatorum was 40.0 iRBC/mL (95% CI: 34.1, 48.7). The clinical specificity for IDT was 99.999% (95% CI: 99.996, 100) and 100% (95% CI: 99.987, 100) for pools of six donations. Conclusion cobas Babesia enables donor screening for Babesia species with high sensitivity and specificity.
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Affiliation(s)
- Jean Stanley
- Clinical Development and Medical Affairs, Roche Molecular Systems, Inc., Pleasanton, California, USA
| | - Susan L Stramer
- Scientific Services, American Red Cross, Gaithersburg, Maryland, USA
| | | | - Julie Cruz
- Medical Science Institute, Versiti Blood Center, Indianapolis, Indiana, USA
| | - Jed Gorlin
- Physician Services, Innovative Blood Resources, St. Paul, Minnesota, USA
| | - Mark Janzen
- Laboratory Services, Innovative Blood Resources, St. Paul, Minnesota, USA
| | - Susan N Rossmann
- Medical Services, Gulf Coast Regional Blood Center, Houston, Texas, USA
| | - Todd Straus
- Medical Services, The Community Blood Center, Appleton, Wisconsin, USA
| | - Patrick Albrecht
- Assay Development, Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - Lisa Lee Pate
- Clinical Development and Medical Affairs, Roche Molecular Systems, Inc., Pleasanton, California, USA
| | - Susan A Galel
- Clinical Development and Medical Affairs, Roche Molecular Systems, Inc., Pleasanton, California, USA
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13
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Chan WY, MacDonald C, Keenan A, Xu K, Bain BJ, Chiodini PL. Severe babesiosis due to Babesia divergens acquired in the United Kingdom. Am J Hematol 2021; 96:889-890. [PMID: 33460475 DOI: 10.1002/ajh.26097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Wei Yee Chan
- Department of Haematology University College London Hospitals NHS Foundation Trust London UK
| | - Caitlin MacDonald
- Department of Haematology North Devon District Hospital Barnstaple UK
| | - Andrew Keenan
- Department of Haematology North Devon District Hospital Barnstaple UK
| | - Ke Xu
- Department of Haematology University College London Hospitals NHS Foundation Trust London UK
| | - Barbara J. Bain
- Department of Haematology St Mary's Hospital Campus of Imperial College London Faculty of Medicine, St Mary's Hospital London UK
| | - Peter L. Chiodini
- Department of Clinical Parasitology Hospital for Tropical Diseases, Mortimer Market, London, WC1E 6JB, UK and London School of Hygiene & Tropical Medicine London UK
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14
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A historical review of Babesia spp. associated with deer in Europe: Babesia divergens/Babesia divergens-like, Babesia capreoli, Babesia venatorum, Babesia cf. odocoilei. Vet Parasitol 2021; 294:109433. [PMID: 33930692 DOI: 10.1016/j.vetpar.2021.109433] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 04/10/2021] [Accepted: 04/17/2021] [Indexed: 01/17/2023]
Abstract
This review is intended to provide an overview of the occurrence and diversity of Babesia spp. in European deer. Babesiosis is an emerging vector-borne disease with negative implications on animal and public health. Cervidae are important hosts for Ixodidae ticks, playing a critical role in the epidemiology of the parasite. Deer are susceptible to different Babesia spp., some of them with zoonotic potential. The infection is usually asymptomatic with high prevalence rates, although some fatal cases due to B. capreoli and B. venatorum have been reported. In Europe, 3 main Babesia spp. have been described in deer: Babesia divergens/B. divergens-like, B. capreoli and B. venatorum. Additionally, close relatives of B. odocoilei, the Babesia species of the American white-tailed deer (Odocoileus virginianus), have been isolated in several European countries. The occurrence of B. divergens/B. divergens-like generated concerns about the role of cervidae in the life cycle of the parasite, and the potential threat for public health. Few human cases have been attributed to B. venatorum so far, including hunters. Although this species is strictly related to the presence of roe deer (Capreolus capreolus), it has been occasionally reported in moose (Alces alces) and captive reindeer (Rangifer tarandus). Over recent years, vector-borne diseases received increased attention from International Organizations. However, technical difficulties persist, affecting surveillance efficiency. Given the veterinary and zoonotic importance of babesiosis, the author advocates the need for an effective monitoring at wildlife-domestic animals-humans interface and the implementation of management plans to reduce the risk of Babesia spp. infection for both humans and domestic animals.
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15
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Wilhelmsson P, Pawełczyk O, Jaenson TGT, Waldenström J, Olsen B, Forsberg P, Lindgren PE. Three Babesia species in Ixodes ricinus ticks from migratory birds in Sweden. Parasit Vectors 2021; 14:183. [PMID: 33794970 PMCID: PMC8017608 DOI: 10.1186/s13071-021-04684-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Migratory birds can cross geographical and environmental barriers and are thereby able to facilitate transmission of tick-borne pathogens both as carriers of infected ticks and as reservoirs of pathogenic microorganisms. Ixodes ricinus is one of the most abundant tick species in the Northern Hemisphere and a main vector of several Babesia species, some which pose a potential threat to human and animal health. At present only two cases of overt babesiosis in humans have so far been reported in Sweden. To better understand the potential role of birds as disseminators of zoonotic Babesia protozoan parasites, we investigated the presence of Babesia species in ticks removed from migratory birds. Methods Ticks were collected from birds captured at Ottenby Bird Observatory, south-eastern Sweden, from March to November 2009. Ticks were molecularly identified to species, and morphologically to developmental stage, and the presence of Babesia protozoan parasites was determined by real-time PCR. Results In total, 4601 migratory birds of 65 species were examined for tick infestation. Ticks removed from these birds have previously been investigated for the presence of Borrelia bacteria and the tick-borne encephalitis virus. In the present study, a total of 1102 ticks were available for molecular analysis of Babesia protozoan parasites. We found that 2.4% of the ticks examined, all I. ricinus, were positive for mammal-associated Babesia species. Out of all Babesia-positive samples, Babesia venatorum was the most prevalent (58%) species, followed by Babesia microti (38%) and Babesia capreoli (4.0%). B. venatorum and B. capreoli were detected in I. ricinus larvae, whereas B. microti was only present in I. ricinus nymphs. This supports the view that the two first-mentioned species are vertically (transovarially) transmitted in the tick population, in contrast to B. microti. The largest number of Babesia-infected ticks was removed from the common redstart (Phoenicurus phoenicurus) and European robin (Erithacus rubecula). Conclusions This study reveals that Babesia protozoan parasites are present in ticks infesting migratory birds in south-eastern Sweden, which could potentially lead to the dissemination of these tick-borne microorganisms into new areas, thus posing a threat to humans and other mammals. ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04684-8.
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Affiliation(s)
- Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. .,Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
| | - Olga Pawełczyk
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Parasitology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Thomas G T Jaenson
- Department of Organismal Biology, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden
| | - Jonas Waldenström
- Center for Ecology and Evolution in Microbial Model Systems, Linnaeus University, Kalmar, Sweden
| | - Björn Olsen
- Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Pia Forsberg
- Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
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16
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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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17
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Springer A, Glass A, Probst J, Strube C. Tick-borne zoonoses and commonly used diagnostic methods in human and veterinary medicine. Parasitol Res 2021; 120:4075-4090. [PMID: 33459849 PMCID: PMC8599405 DOI: 10.1007/s00436-020-07033-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/21/2020] [Indexed: 12/20/2022]
Abstract
Around the world, human health and animal health are closely linked in terms of the One Health concept by ticks acting as vectors for zoonotic pathogens. Animals do not only maintain tick cycles but can either be clinically affected by the same tick-borne pathogens as humans and/or play a role as reservoirs or sentinel pathogen hosts. However, the relevance of different tick-borne diseases (TBDs) may vary in human vs. veterinary medicine, which is consequently reflected by the availability of human vs. veterinary diagnostic tests. Yet, as TBDs gain importance in both fields and rare zoonotic pathogens, such as Babesia spp., are increasingly identified as causes of human disease, a One Health approach regarding development of new diagnostic tools may lead to synergistic benefits. This review gives an overview on zoonotic protozoan, bacterial and viral tick-borne pathogens worldwide, discusses commonly used diagnostic techniques for TBDs, and compares commercial availability of diagnostic tests for humans vs. domestic animals, using Germany as an example, with the aim of highlighting existing gaps and opportunities for collaboration in a One Health framework.
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Affiliation(s)
- Andrea Springer
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Buenteweg 17, 30559, Hanover, Germany
| | - Antje Glass
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Buenteweg 17, 30559, Hanover, Germany
| | - Julia Probst
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Buenteweg 17, 30559, Hanover, Germany
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Buenteweg 17, 30559, Hanover, Germany.
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18
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Hülskötter K, Pfankuche VM, van Dyck L, Höltershinken M, Springer A, Lienhart F, Ermel S, Rehage J, Hoedemarker M, Strube C, Hirzmann J, Bauer C, Baumgärtner W, Lehmbecker A, Wohlsein P. Bovine Babesiosis Diagnosed in Formalin-Fixed, Paraffin-Embedded Tissues by Using In Situ Hybridization. Vet Pathol 2020; 57:812-820. [PMID: 32841102 DOI: 10.1177/0300985820948816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Bovine babesiosis, caused by Babesia divergens, is in general a rare disease in Europe. Nonetheless, local outbreaks can cause severe economic damage, and postmortem identification represents a diagnostic challenge. During a recent outbreak in May 2018 in northern Germany, 21 animals of a herd of 150 cattle died within 40 days having had clinical signs of fever and hemoglobinuria. Gross examination of 4 of the 21 deceased animals revealed a tick infestation, jaundice, and dark brown staining of urine and kidneys. Histologically, there were iron-positive deposits, hyperplasia of the red pulp of the spleen, and centrilobular necrosis of hepatocytes. In several locations, small basophilic granules suggestive of intraerythrocytic parasites were visible in hematoxylin-eosin- and Giemsa-stained sections. Peripheral blood smears from a living cow from the herd and polymerase chain reaction (PCR) of feeding ticks revealed B. divergens infection. In situ hybridization (ISH) was applied on formalin-fixed, paraffin-embedded (FFPE) tissue of the necropsied cattle to confirm babesiosis in these animals postmortem. Digoxigenin-labeled DNA probes were generated based on a specific nucleotide sequence for B. divergens, obtained by PCR and sequencing of DNA isolates from infected Ixodes ricinus ticks from deceased cattle. ISH using these probes allowed postmortem diagnosis of B. divergens infection in routinely fixed FFPE tissues.
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Affiliation(s)
- Kirsten Hülskötter
- 26556University of Veterinary Medicine Hannover, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - Vanessa M Pfankuche
- 26556University of Veterinary Medicine Hannover, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - Lydia van Dyck
- 26556University of Veterinary Medicine Hannover, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | | | - Andrea Springer
- 26556University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Sandra Ermel
- 26556University of Veterinary Medicine Hannover, Hannover, Germany
| | - Jürgen Rehage
- 26556University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Christina Strube
- 26556University of Veterinary Medicine Hannover, Hannover, Germany
| | - Jörg Hirzmann
- 221226Justus Liebig University Giessen, Giessen, Germany
| | | | - Wolfgang Baumgärtner
- 26556University of Veterinary Medicine Hannover, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | | | - Peter Wohlsein
- 26556University of Veterinary Medicine Hannover, Hannover, Germany
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19
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Abstract
INTRODUCTION Human babesiosis is reported throughout the world and is endemic in the northeastern and northern Midwestern United States and northeastern China. Transmission is primarily through hard bodied ticks. Most cases of severe disease occur in immunocompromised individuals and may result in prolonged relapsing disease or death. AREAS COVERED We provide a summary of evidence supporting current treatment recommendations for immunocompetent and immunocompromised individuals experiencing babesiosis. EXPERT OPINION Most cases of human babesiosis are successfully treated with atovaquone and azithromycin or clindamycin and quinine. Severe disease may require prolonged treatment.
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Affiliation(s)
- Robert P Smith
- Division of Infectious Diseases, Maine Medical Center, Portland, Maine; Tufts University School of Medicine , Boston, MA, USA
| | - Klaus-Peter Hunfeld
- Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Medical Faculty, Goethe University , Frankfurt/Main, Germany
| | - Peter J Krause
- Yale School of Public Health and Yale School of Medicine , New Haven, CT, USA
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20
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Wilhelmsson P, Lövmar M, Krogfelt KA, Nielsen HV, Forsberg P, Lindgren PE. Clinical/serological outcome in humans bitten by Babesia species positive Ixodes ricinus ticks in Sweden and on the Åland Islands. Ticks Tick Borne Dis 2020; 11:101455. [PMID: 32386909 DOI: 10.1016/j.ttbdis.2020.101455] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/25/2022]
Abstract
The risk of contracting babesiosis after a tick bite in Sweden and on the Åland Islands, Finland, is unknown. We investigated clinical and serological outcomes in people bitten by Ixodes ricinus ticks positive for Babesia species. Ticks, blood and questionnaires were obtained from study participants in Sweden and on the Åland Islands. Sixty-five of 2098 (3.1 %) ticks were positive by real-time PCR. Three Babesia species were detected, Babesia microti (n = 33), B. venatorum (n = 27) and B. capreoli (n = 5), the latter species not known to cause human infection. Half (46 %) of the Babesia PCR-positive ticks also contained Borrelia spp. Fifty-three participants bitten by a Babesia PCR-positive tick and a control group bitten by a Babesia PCR-negative tick were tested for B. microti IgG antibodies by IFA. The overall seroprevalence was 4.4 %, but there was no significant difference between the groups. None of the participants seroconverted and no participant with a Babesia PCR-positive tick sought medical care or reported symptoms suggestive of babesiosis. Given the prevalence of Babesia in I. ricinus ticks in southern Sweden and on the Åland Islands, babesiosis should be considered a possible diagnosis in symptomatic residents who seek medical care following tick exposure.
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Affiliation(s)
- P Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
| | - M Lövmar
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - K A Krogfelt
- Department of Bacteria Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark; Department of Science and Environmental, Roskilde University, Denmark.
| | - H V Nielsen
- Department of Bacteria Parasites and Fungi, Statens Serum Institute, Copenhagen, Denmark.
| | - P Forsberg
- Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | - P E Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden.
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21
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Azagi T, Hoornstra D, Kremer K, Hovius JWR, Sprong H. Evaluation of Disease Causality of Rare Ixodes ricinus-Borne Infections in Europe. Pathogens 2020; 9:pathogens9020150. [PMID: 32102367 PMCID: PMC7168666 DOI: 10.3390/pathogens9020150] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 12/13/2022] Open
Abstract
In Europe, Ixodes ricinus ticks transmit pathogens such as Borrelia burgdorferi sensu lato and tick-borne encephalitis virus (TBEV). In addition, there is evidence for transmission to humans from I. ricinus of Anaplasma phagocytophilum, Babesia divergens, Babesia microti, Babesia venatorum, Borrelia miyamotoi, Neoehrlichia mikurensis, Rickettsia helvetica and Rickettsia monacensis. However, whether infection with these potential tick-borne pathogens results in human disease has not been fully demonstrated for all of these tick-borne microorganisms. To evaluate the available evidence for a causative relation between infection and disease, the current study analyses European case reports published from 2008 to 2018, supplemented with information derived from epidemiological and experimental studies. The evidence for human disease causality in Europe found in this review appeared to be strongest for A. phagocytophilum and B. divergens. Nonetheless, some knowledge gaps still exist. Importantly, comprehensive evidence for pathogenicity is lacking for the remaining tick-borne microorganisms. Such evidence could be gathered best through prospective studies, for example, studies enrolling patients with a fever after a tick bite, the development of specific new serological tools, isolation of these microorganisms from ticks and patients and propagation in vitro, and through experimental studies.
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Affiliation(s)
- Tal Azagi
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
- Correspondence:
| | - Dieuwertje Hoornstra
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Kristin Kremer
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
| | - Joppe W. R. Hovius
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers Location Academic Medical Center, Amsterdam 1105 AZ, The Netherlands; (D.H.); (J.W.R.H.)
| | - Hein Sprong
- Centre for Infectious Diseases Research, National Institute for Public Health and the Environment, P.O. Box 1, Bilthoven 3720 BA, The Netherlands; (K.K.); (H.S.)
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Abstract
Increases in tick-borne disease prevalence and transmission are important public health issues. Efforts to control these emerging diseases are frustrated by the struggle to control tick populations and to detect and treat infections caused by the pathogens that they transmit. This review covers tick-borne infectious diseases of nonrickettsial bacterial, parasitic, and viral origins. While tick surveillance and tracking inform our understanding of the importance of the spread and ecology of ticks and help identify areas of risk for disease transmission, the vectors are not the focus of this document. Here, we emphasize the most significant pathogens that infect humans as well as the epidemiology, clinical features, diagnosis, and treatment of diseases that they cause. Although detection via molecular or immunological methods has improved, tick-borne diseases continue to remain underdiagnosed, making the scope of the problem difficult to assess. Our current understanding of the incidence of tick-borne diseases is discussed in this review. An awareness of the diseases that can be transmitted by ticks in specific locations is key to detection and selection of appropriate treatment. As tick-transmitted pathogens are discovered and emerge in new geographic regions, our ability to detect, describe, and understand the growing public health threat must also grow to meet the challenge.
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23
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Kukina IV, Zelya OP, Guzeeva TM, Karan LS, Perkovskaya IA, Tymoshenko NI, Guzeeva MV. Severe babesiosis caused by Babesia divergens in a host with intact spleen, Russia, 2018. Ticks Tick Borne Dis 2019; 10:101262. [DOI: 10.1016/j.ttbdis.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 06/17/2019] [Accepted: 07/14/2019] [Indexed: 10/26/2022]
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Debierre-Grockiego F, Smith TK, Delbecq S, Ducournau C, Lantier L, Schmidt J, Brès V, Dimier-Poisson I, Schwarz RT, Cornillot E. Babesia divergens glycosylphosphatidylinositols modulate blood coagulation and induce Th2-biased cytokine profiles in antigen presenting cells. Biochimie 2019; 167:135-144. [PMID: 31585151 PMCID: PMC7079338 DOI: 10.1016/j.biochi.2019.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/29/2019] [Indexed: 01/08/2023]
Abstract
Glycosylphosphatidylinositols (GPIs) are glycolipids described as toxins of protozoan parasites due to their inflammatory properties in mammalian hosts characterized by the production of interleukin (IL)-1, IL-12 and tumor necrosis factor (TNF)-α. In the present work, we studied the cytokines produced by antigen presenting cells in response to ten different GPI species extracted from Babesia divergens, responsible for babesiosis. Interestingly, B. divergens GPIs induced the production of anti-inflammatory cytokines (IL-2, IL-5) and of the regulatory cytokine IL-10 by macrophages and dendritic cells. In contrast to all protozoan GPIs studied until now, GPIs from B. divergens did not stimulate the production of TNF-α and IL-12, leading to a unique Th1/Th2 profile. Analysis of the carbohydrate composition of the B. divergens GPIs indicated that the di-mannose structure was different from the evolutionary conserved tri-mannose structure, which might explain the particular cytokine profile they induce. Expression of major histocompatibility complex (MHC) molecules on dendritic cells and apoptosis of mouse peritoneal cells were also analysed. B. divergens GPIs did not change expression of MHC class I, but decreased expression of MHC class II at the cell surface, while GPIs slightly increased the percentages of apoptotic cells. During pathogenesis of babesiosis, the inflammation-coagulation auto-amplification loop can lead to thrombosis and the effect of GPIs on coagulation parameters was investigated. Incubation of B. divergens GPIs with rat plasma ex vivo led to increase of fibrinogen levels and to prolonged activated partial thromboplastin time, suggesting a direct modulation of the extrinsic coagulation pathway by GPIs.
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Affiliation(s)
| | - Terry K Smith
- Biomedical Sciences Research Complex, University of St Andrews, St Andrews, Fife, Scotland, KY16 9ST, UK
| | - Stéphane Delbecq
- Vaccination Antiparasitaire, Université de Montpellier, 34093, Montpellier, France
| | | | | | - Jörg Schmidt
- Institut für Virologie, AG Parasitologie, Philipps-Universität Marburg, 35043, Marburg, Germany
| | - Virginie Brès
- Vaccination Antiparasitaire, Université de Montpellier, 34093, Montpellier, France
| | | | - Ralph T Schwarz
- Institut für Virologie, AG Parasitologie, Philipps-Universität Marburg, 35043, Marburg, Germany; Univ. Lille, CNRS, UMR 8576, Unité de Glycobiologie Structurale et Fonctionnelle, 59655, Villeneuve d'Ascq, France
| | - Emmanuel Cornillot
- Institut de Biologie Computationnelle, 34095, Montpellier, France; Institut de Recherche en Cancérologie de Montpellier (IRCM - INSERM U1194), Institut Régional du Cancer de Montpellier (ICM), Université de Montpellier, 34095, Montpellier, France
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25
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Paleau A, Candolfi E, Souply L, De Briel D, Delarbre JM, Lipsker D, Jouglin M, Malandrin L, Hansmann Y, Martinot M. Human babesiosis in Alsace. Med Mal Infect 2019; 50:486-491. [PMID: 31548143 DOI: 10.1016/j.medmal.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/02/2018] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Human babesiosis is a rare parasitic anthropozoonosis transmitted to humans by tick bites. Fifty-six cases of human babesiosis have been recorded in Europe. Two cases of babesiosis were reported in Alsace, France, in 2009. We performed a retrospective observational descriptive study to assess the epidemiology of the disease in Alsace. METHODS Patients were included if they had a positive serology result for Babesia and/or a positive blood smear and/or a positive PCR result. The tests were performed in the microbiology laboratories of the university hospitals of Strasbourg, the civil hospitals of Colmar, and the hospital of Mulhouse between January 1, 2005 and December 31, 2015. Included patients were divided into three groups: definite case group (positive PCR or positive blood smear or seroconversion), possible case group (positive serology results without seroconversion with a compatible clinical picture and without other confirmed diagnoses), and incompatible case group (positive serology results without seroconversion, without compatible clinical picture and/or with other confirmed diagnoses). The compatible clinical picture was defined by the presence of flu-like symptoms and fever (≥38°C). RESULTS Fifty-one patients had at least one positive result. Three cases were excluded (missing files). There were six definite cases, 12 possible cases, and 30 incompatible cases. All patients in the definite case group were immunocompetent. No deaths occurred. CONCLUSIONS Human babesiosis is probably underdiagnosed due to its non-specific symptoms, lack of awareness about the disease, and the difficulty in making a diagnosis.
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Affiliation(s)
- A Paleau
- Service de maladies infectieuses, boulevard Louis-Escande, 71018 Mâcon cedex, France.
| | - E Candolfi
- Laboratoire de parasitologie et de mycologie médicale, plateau technique de microbiologie, hôpitaux universitaires de Strasbourg, 1, place de l'hôpital, BP 426, 67091 Strasbourg, France.
| | - L Souply
- Laboratoire de microbiologie, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue Liberté, 68024 Colmar cedex, France.
| | - D De Briel
- Laboratoire de microbiologie, hôpital Pasteur, hôpitaux civils de Colmar, 39, avenue Liberté, 68024 Colmar cedex, France.
| | - J M Delarbre
- Laboratoire de microbiologie, centre hospitalier de Mulhouse, site Emile-Muller, 20, avenue Docteur René-Laennec, 68100 Mulhouse, France.
| | - D Lipsker
- Service de dermatologie, consultation dermatologie, oncodermatologien, CHU de Strasbourg, hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
| | - M Jouglin
- BIOEPAR, Inra, Oniris, 44307 Nantes, France.
| | - L Malandrin
- BIOEPAR, Inra, Oniris, 44307 Nantes, France.
| | - Y Hansmann
- Service des maladies infectieuses et tropicales, 1, place de l'Hôpital, NHC BP 426, 67091 Strasbourg cedex, France.
| | - M Martinot
- Unité d'infectiologie, centre hospitalier de Colmar, 39, avenue de la Liberté, 68024 Colmar, France.
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Debierre-Grockiego F, Smith TK, Delbecq S, Ducournau C, Lantier L, Schmidt J, Brès V, Dimier-Poisson I, Schwarz RT, Cornillot E. WITHDRAWN: Babesia divergens glycosylphosphatidylinositols modulate blood coagulation and induce Th2-biased cytokine profiles in antigen presenting cells. BIOCHIMIE OPEN 2019. [DOI: 10.1016/j.biopen.2019.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Antoszczak M, Steverding D, Huczyński A. Anti-parasitic activity of polyether ionophores. Eur J Med Chem 2019; 166:32-47. [DOI: 10.1016/j.ejmech.2019.01.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/08/2019] [Accepted: 01/15/2019] [Indexed: 02/04/2023]
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28
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Human Babesiosis in China: a systematic review. Parasitol Res 2019; 118:1103-1112. [DOI: 10.1007/s00436-019-06250-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
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Abstract
Ticks are a major group of arthropod vectors, characterized by the diversity of pathogens they transmit, by their impact on human and animal health, and by their socioeconomic implication especially in countries of the Southern Hemisphere. In Europe, Ixodes is the most important tick due to its wide distribution in the ecosystems and the variety of transmitted pathogens, in particular Borrelia (responsible for Lyme borreliosis), but also the tick-borne encephalitis virus. Their increased presence in the environment since the beginning of the 20th century is undeniable, because of major modifications in the biodiversity caused by humans. Increasing the awareness of health professionals and the general population is required to achieve better control of these infections. Thus, "a better understanding of these tick-borne diseases for a better control" is a simple but effective approach, considering their ubiquity in the environment and their particular mode of pathogen transmission (long-lasting blood meal for hard ticks and delayed transmission for bacteria and parasites). Finally, these ectoparasites are problematic due to the potential allergic reactions and other damages caused by their saliva, in humans and animals.
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30
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Krause PJ. Human babesiosis. Int J Parasitol 2019; 49:165-174. [PMID: 30690090 DOI: 10.1016/j.ijpara.2018.11.007] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/31/2018] [Accepted: 11/13/2018] [Indexed: 10/27/2022]
Abstract
Babesiosis is a worldwide emerging tick-borne disease that is increasing in frequency and geographic range. It imposes a significant health burden, especially on those who are immunocompromised and those who acquire the infection through blood transfusion. Death from babesiosis occurs in up to 20 percent of these groups. Diagnosis is confirmed with identification of typical intraerythrocytic parasites on a thin blood smear or Babesia DNA using PCR. Treatment consists of atovaquone and azithromycin or clindamycin and quinine, and exchange transfusion in severe cases. Personal and communal protective measures can limit the burden of infection but it is important to recognize that none of these measures are likely to prevent the continued expansion of Babesia into non-endemic areas.
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Affiliation(s)
- Peter J Krause
- Yale School of Public Health and Yale School of Medicine, New Haven, CT, USA.
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31
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Razanske I, Rosef O, Radzijevskaja J, Bratchikov M, Griciuviene L, Paulauskas A. Prevalence and co-infection with tick-borne Anaplasma phagocytophilum and Babesia spp. in red deer ( Cervus elaphus) and roe deer ( Capreolus capreolus) in Southern Norway. INTERNATIONAL JOURNAL FOR PARASITOLOGY-PARASITES AND WILDLIFE 2019; 8:127-134. [PMID: 30766793 PMCID: PMC6360459 DOI: 10.1016/j.ijppaw.2019.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 01/19/2023]
Abstract
Anaplasma phagocytophilum and Babesia spp. are causative agents of tick-borne infections that are increasingly considered as a threat to animal and public health. To assess the role of cervids in the maintenance of zoonotic pathogens in Norway, we investigated the prevalence of A. phagocytophilum and Babesia spp. in free-ranging roe deer and red deer. Initial screening of spleen samples of 104 animals by multiplex real-time PCR targeting the major surface protein (msp2) gene and 18S rRNA revealed the presence of A. phagocytophilum infection in 81.1% red deer (Cervus elaphus) and 88.1% roe deer (Capreolus capreolus), and Babesia spp. parasites in 64.9% red deer and 83.6% roe deer, respectively. Co-infections were found in 62.2% red deer and 79.9% roe deer. Nested PCR and sequence analysis of partial msp4 and 18S rRNA genes were performed for molecular characterization of A. phagocytophilum strains and Babesia species. A total of eleven A. phagocytophilum msp4 gene sequence variants were identified: five different variants were 100% identical to corresponding A. phagocytophilum sequences deposited in the GenBank database, while other six sequence variants had unique nucleotide polymorphisms. Sequence analysis of the 18S rRNA gene demonstrated the presence of multiple Babesia species, including Babesia capreoli, Babesia divergens, Babesia venatorum and Babesia odocoilei/Babesia cf. odocoilei. This study is the first report demonstrating the prevalence and molecular characterization of A. phagocytophilum strains and Babesia species in roe deer and red deer in Norway. The high infection and co-infection rates with A. phagocytophilum and Babesia spp. in red deer and roe deer suggest that these cervids may play an important role in the transmission of single and multiple pathogens.
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Affiliation(s)
- Irma Razanske
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania
| | - Olav Rosef
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania.,Rosef Field Research Station, Frolandsveien 2667, 4828, Mjåvatn, Norway
| | - Jana Radzijevskaja
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania
| | - Maksim Bratchikov
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania.,Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, LT-03101, Vilnius, Lithuania
| | - Loreta Griciuviene
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania
| | - Algimantas Paulauskas
- Department of Biology, Vytautas Magnus University, Vileikos 8, LT -444404, Kaunas, Lithuania
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Blackwood B, Binder W. Unusual Complications From Babesia Infection: Splenic Infarction and Splenic Rupture in Two Separate Patients. J Emerg Med 2018; 55:e113-e117. [DOI: 10.1016/j.jemermed.2018.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/16/2018] [Accepted: 08/03/2018] [Indexed: 12/15/2022]
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Xie Y, Visconte V, Duan L, Rogers HJ. The first concurrent diagnosis of acute symptomatic Babesiosis and chronic myeloid leukemia in a healthy young adult. Blood Res 2018; 53:163-166. [PMID: 29963524 PMCID: PMC6021575 DOI: 10.5045/br.2018.53.2.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 11/24/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Yan Xie
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Valeria Visconte
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Lei Duan
- Department of Pathology, Southern New Hampshire Medical Center, Nashua, NH, USA
| | - Heesun J Rogers
- Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH, USA
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Li S, Goyal B, Cooper JD, Abdelbaki A, Gupta N, Kumar Y. Splenic rupture from babesiosis, an emerging concern? A systematic review of current literature. Ticks Tick Borne Dis 2018; 9:1377-1382. [PMID: 29954722 DOI: 10.1016/j.ttbdis.2018.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 01/17/2023]
Abstract
Babesiosis is a relatively common tick-borne parasitic infection of erythrocytes primarily affecting the northeastern United States. Babesiosis' prevalence and presentation have earned it the monikers "malaria of the northeast" and "Nantucket fever". Clinical presentation ranges from asymptomatic infection to severe infection including acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulopathy (DIC) or death. Since 2008, there have been a number of reports of splenic rupture in patients with the disease. We seek to provide a further understanding of this process, with the report of a case of splenic rupture followed by a systematic review of the current literature. We found that 87% of splenic rupture secondary to babesiosis occurred in male patients who are otherwise healthy, with an average of 56 years. Computed tomography is a reliable mode of diagnosis, and hemoperitoneum is the most common imaging finding. Patients with splenic rupture due to human babesiosis were successfully treated by various management strategies, such as conservative non-operative approach, splenic artery embolization, and splenectomy. The modality of treatment depends on patient's clinical course and hemodynamic stability, although spleen conserving strategy should be considered first whenever possible.
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Affiliation(s)
- Shuo Li
- Department of Radiology, Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, United States.
| | - Bobby Goyal
- St. George's University School of Medicine, Grenada, West Indies.
| | - Joseph D Cooper
- Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th Street, The Bronx, NY, 10467, United States.
| | - Ahmed Abdelbaki
- Department of Radiology, Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, United States.
| | - Nishant Gupta
- Department of Radiology, Columbia University Medical Center, 630 W 168th St, New York, NY, 10032, United States.
| | - Yogesh Kumar
- Department of Radiology, Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, United States.
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The Babesia divergens Asia Lineage Is Maintained through Enzootic Cycles between Ixodes persulcatus and Sika Deer in Hokkaido, Japan. Appl Environ Microbiol 2018; 84:AEM.02491-17. [PMID: 29374041 DOI: 10.1128/aem.02491-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/24/2018] [Indexed: 12/20/2022] Open
Abstract
Parasites of the Babesiadivergens Asia lineage, which are closely related to B. divergens in Europe and Babesia sp. strain MO1 in the United States, were recently reported in sika deer (Cervus nippon) in eastern Japan. To identify the tick vector(s) for this parasite, we conducted a field survey in Hokkaido, Japan, where the infection rate in sika deer is the highest in the country. A specific PCR system which detects and discriminates between lineages within B. divergens and between those lineages and Babesia venatorum showed that Ixodes persulcatus (11/822), but not sympatric Ixodes ovatus (0/595) or Haemaphysalis sp. (0/163) ticks, carried B. divergens Asia lineage. Genomic DNA was archived from salivary glands of partially engorged I. persulcatus females and three isolates of B. divergens Asia lineage were newly described. The 18S rRNA gene sequence of the isolates formed the Asia lineage cluster with those previously described in sika deer isolates. One salivary gland also contained parasites of Babesia microti U.S. lineage, which were subsequently isolated in a hamster in vivoB. venatorum (strain Etb5) was also detected in one I. persulcatus tick. The 18S rRNA sequence of Etb5 was 99.7% identical to that of B. venatorum (AY046575) and was phylogenetically positioned in a taxon composed of B. venatorum isolates from Europe, China, and Russia. The geographical distribution of I. persulcatus is consistent with that of B. divergens in sika deer in Japan. These results suggest that I. persulcatus is a principal vector for B. divergens in Japan and Eurasia, where I. persulcatus is predominantly distributed.IMPORTANCE The Babesiadivergens Asia lineage of parasites closely related to B. divergens in Europe and Babesia sp. MO1 in the United States was recently reported in Cervus nippon in eastern Japan. In this study, specific PCR for the Asia lineage identified 11 positives in 822 host-seeking Ixodes persulcatus ticks, a principal vector for many tick-borne disease agents. Gene sequences of three isolates obtained from DNA in salivary glands of female ticks were identical to each other and to those in C. nippon We also demonstrate the coinfection of B. divergens Asia lineage with Babesia microti U.S. lineage in a tick salivary gland and, furthermore, isolated the latter in a hamster. These results suggest that I. persulcatus is the principal vector for B. divergens as well as for B. microti, and both parasites may be occasionally cotransmitted by I. persulcatus This report will be important for public health, since infection may occur through transfusion.
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Dunaj J, Moniuszko-Malinowska A, Swiecicka I, Andersson M, Czupryna P, Rutkowski K, Zambrowski G, Zajkowska J, Grygorczuk S, Kondrusik M, Świerzbińska R, Pancewicz S. Tick-borne infections and co-infections in patients with non-specific symptoms in Poland. Adv Med Sci 2018; 63:167-172. [PMID: 29120859 DOI: 10.1016/j.advms.2017.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/28/2017] [Accepted: 09/26/2017] [Indexed: 11/26/2022]
Abstract
AIM The aim of the study was the evaluation of the frequency of infections and co-infections among patients hospitalized because of non-specific symptoms after a tick bite. MATERIALS AND METHODS Whole blood, serum and cerebrospinal fluid samples from 118 patients hospitalised for non-specific symptoms up to 8 weeks after tick bite from 2010 to 2013 were examined for tick-borne infections. ELISA, Western blot and/or molecular biology (PCR; fla gene; 16S rRNA; sequencing) and thin blood smears (MDD) were used. Control group included 50 healthy blood donors. All controls were tested with PCR and serology according to the same procedure as in patients. RESULTS Out of 118 patients 85 (72%) experienced headaches, 15 (13%) vertigo, 32 (27%) nausea, 17 (14%) vomiting, 37 (31%) muscle pain, 73 (62%) fever and 26 (22%) meningeal signs. 47.5% were infected with at least one tick-borne pathogen. Borrelia burgdorferi sensu lato infection was confirmed with ELISA, Western blot in serum and/or (PCR (fla gene) in whole blood in 29.7% cases. In blood of 11.9% patients Anaplasma phagocytophilum DNA (16S rRNA gene) was detected; in 0.9% patients 1/118 Babesia spp. DNA (18S rRNA gene) was also detected. Co-infections were observed in 5.1% of patients with non-specific symptoms. B. burgdorferi s.l. - A. phagocytophilum co-infection (5/118; 4.2%) was most common. In 1/118 (0.8%) A. phagocytophilum - Babesia spp. co-infection was detected. All controls were negative for examined pathogens. CONCLUSIONS Non-specific symptoms after tick bite may be caused by uncommon pathogens or co-infection, therefore it should be considered in differential diagnosis after tick bite.
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Asensi V, González LM, Fernández-Suárez J, Sevilla E, Navascués RÁ, Suárez ML, Lauret ME, Bernardo A, Carton JA, Montero E. A fatal case of Babesia divergens infection in Northwestern Spain. Ticks Tick Borne Dis 2018; 9:730-734. [PMID: 29496491 DOI: 10.1016/j.ttbdis.2018.02.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Víctor Asensi
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Luis Miguel González
- Parasitology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Jonathan Fernández-Suárez
- Microbiology and Parasitology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Elena Sevilla
- Parasitology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Rafael Álvarez Navascués
- Nephrology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - María Luisa Suárez
- Nephrology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - María Eugenia Lauret
- Gastroenterology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Angel Bernardo
- Hematology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - José Antonio Carton
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Estrella Montero
- Parasitology Service, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
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Hematologic Aspects of Parasitic Diseases. Hematology 2018. [DOI: 10.1016/b978-0-323-35762-3.00158-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
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39
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Oechslin CP, Heutschi D, Lenz N, Tischhauser W, Péter O, Rais O, Beuret CM, Leib SL, Bankoul S, Ackermann-Gäumann R. Prevalence of tick-borne pathogens in questing Ixodes ricinus ticks in urban and suburban areas of Switzerland. Parasit Vectors 2017; 10:558. [PMID: 29121976 PMCID: PMC5680829 DOI: 10.1186/s13071-017-2500-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 10/26/2017] [Indexed: 12/30/2022] Open
Abstract
Background Throughout Europe, Ixodes ricinus transmits numerous pathogens. Its widespread distribution is not limited to rural but also includes urbanized areas. To date, comprehensive data on pathogen carrier rates of I. ricinus ticks in urban areas of Switzerland is lacking. Results Ixodes ricinus ticks sampled at 18 (sub-) urban collection sites throughout Switzerland showed carrier rates of 0% for tick-borne encephalitis virus, 18.0% for Borrelia burgdorferi (sensu lato), 2.5% for Borrelia miyamotoi, 13.5% for Rickettsia spp., 1.4% for Anaplasma phagocytophilum, 6.2% for "Candidatus Neoehrlichia mikurensis", and 0.8% for Babesia venatorum (Babesia sp., EU1). Site-specific prevalence at collection sites with n > 45 ticks (n = 9) significantly differed for B. burgdorferi (s.l.), Rickettsia spp., and "Ca. N. mikurensis", but were not related to the habitat type. Three hundred fifty eight out of 1078 I. ricinus ticks (33.2%) tested positive for at least one pathogen. Thereof, about 20% (71/358) were carrying two or three different potentially disease-causing agents. Using next generation sequencing, we could detect true pathogens, tick symbionts and organisms of environmental or human origin in ten selected samples. Conclusions Our data document the presence of pathogens in the (sub-) urban I. ricinus tick population in Switzerland, with carrier rates as high as those in rural regions. Carriage of multiple pathogens was repeatedly observed, demonstrating the risk of acquiring multiple infections as a consequence of a tick bite. Electronic supplementary material The online version of this article (10.1186/s13071-017-2500-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Corinne P Oechslin
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland.,Institute for Infectious Diseases, University of Bern, Friedbühlstrasse, Bern, Switzerland.,Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Daniel Heutschi
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland
| | - Nicole Lenz
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland.,Institute for Infectious Diseases, University of Bern, Friedbühlstrasse, Bern, Switzerland
| | - Werner Tischhauser
- ZHAW Life Science and Facility Management, Grüental, Wädenswil, Switzerland
| | - Olivier Péter
- retired, Infectious Diseases, Central Institute of Valais Hospitals, Sion, Switzerland
| | - Olivier Rais
- Laboratory of Ecology and Evolution of Parasites, Institute of Biology, University of Neuchâtel, Emile Argand, Neuchâtel, Switzerland
| | - Christian M Beuret
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland
| | - Stephen L Leib
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland.,Institute for Infectious Diseases, University of Bern, Friedbühlstrasse, Bern, Switzerland
| | - Sergei Bankoul
- Medical Services Directorate, Swiss Armed Forces, Ittigen, Switzerland
| | - Rahel Ackermann-Gäumann
- Spiez Laboratory, Federal Office for Civil Protection, Austrasse, Spiez, Switzerland. .,Swiss National Reference Centre for tick-transmitted diseases, Spiez, Switzerland.
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40
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Pereira A, Parreira R, Cotão AJ, Nunes M, Vieira ML, Azevedo F, Campino L, Maia C. Tick-borne bacteria and protozoa detected in ticks collected from domestic animals and wildlife in central and southern Portugal. Ticks Tick Borne Dis 2017; 9:225-234. [PMID: 28958791 DOI: 10.1016/j.ttbdis.2017.09.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 09/15/2017] [Accepted: 09/15/2017] [Indexed: 12/18/2022]
Abstract
Ticks are vectors of many human and animal pathogens. The aim of this study was to screen bacteria and protozoa from ticks infesting domestic animals and wildlife collected in central and southern Portugal. A total of 593 ticks, comprising 465 (78.4%) adults, 122 (20.6%) nymphs, and six (1.0%) larvae, were collected from 283 hosts of 25 different species (4 domestic and 21 wild). Overall, the analysis of DNA extracts prepared from ticks collected from hosts of 11 different species in the districts of Castelo Branco, Portalegre, Lisboa, Setúbal, Beja and Faro, revealed the presence of genomic sequences from Anaplasma sp., A. ovis, Babesia sp., relapsing fever-like Borrelia sp., Ehrlichia spp., Rickettsia aeschlimannii, Ri. helvetica, Ri. massiliae, Ri. raoultii, Ri. slovaca, Candidatus Ri. barbariae, Theileria annulata and T. ovis, in specimens of Dermacentor marginatus, Hyalomma lusitanicum, Hy. marginatum, Rhipicephalus bursa and Rh. sanguineus sensu lato. The obtained results suggest the circulation of a wide variety of infectious agents, some of zoonotic concern, in hard ticks from Portugal. Further studies should be conducted to better characterize (both genetically and phenotypically) the putative novel microorganisms detected, both in what regards their potential pathogenity towards vertebrates, and to assist the implementation of effective control strategies for the management of ticks and human and animal tick-borne pathogens.
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Affiliation(s)
- André Pereira
- Faculty of Veterinary Medicine, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Parasitology Unit, IHMT, UNL, Portugal
| | - Ricardo Parreira
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Microbiology Unit, IHMT, UNL, Portugal
| | | | - Mónica Nunes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Microbiology Unit, IHMT, UNL, Portugal
| | - Maria Luísa Vieira
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Microbiology Unit, IHMT, UNL, Portugal
| | | | - Lenea Campino
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Parasitology Unit, IHMT, UNL, Portugal
| | - Carla Maia
- Faculty of Veterinary Medicine, Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal; Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisboa, Portugal; Medical Parasitology Unit, IHMT, UNL, Portugal.
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Cursino-Santos JR, Singh M, Pham P, Lobo CA. A novel flow cytometric application discriminates among the effects of chemical inhibitors on various phases ofBabesia divergensintraerythrocytic cycle. Cytometry A 2017; 91:216-231. [DOI: 10.1002/cyto.a.23062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/09/2016] [Accepted: 12/28/2016] [Indexed: 12/21/2022]
Affiliation(s)
| | - Manpreet Singh
- Department of Blood Borne Parasites; New York Blood Center; New York New York
| | - Petra Pham
- Flow Cytometry Core Facility; New York Blood Center; New York New York
| | - Cheryl A. Lobo
- Department of Blood Borne Parasites; New York Blood Center; New York New York
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42
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Akel T, Mobarakai N. Hematologic manifestations of babesiosis. Ann Clin Microbiol Antimicrob 2017; 16:6. [PMID: 28202022 PMCID: PMC5310009 DOI: 10.1186/s12941-017-0179-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/03/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Babesiosis, a zoonotic parasitic infection transmitted by the Ixodes tick, has become an emerging health problem in humans 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 rupture, 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 5 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.
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Affiliation(s)
- Tamer Akel
- Department of Internal Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305 USA
| | - Neville Mobarakai
- Department of Infectious Diseases, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305 USA
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43
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Zintl A, Moutailler S, Stuart P, Paredis L, Dutraive J, Gonzalez E, O'Connor J, Devillers E, Good B, OMuireagain C, De Waal T, Morris F, Gray J. Ticks and Tick-borne diseases in Ireland. Ir Vet J 2017; 70:4. [PMID: 28163889 PMCID: PMC5282849 DOI: 10.1186/s13620-017-0084-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/19/2017] [Indexed: 11/12/2022] Open
Abstract
Throughout Europe interest in tick-borne agents is increasing, particularly with regard to those that can cause human disease. The reason for this is the apparent rise in the incidence of many tick-borne diseases (TBD’s). While there has never been a national survey of ticks or TBD’s in Ireland, the trend here appears to be the reverse with a decline in the incidence of some agents seemingly associated with decreasing tick numbers particularly on agricultural land. In the absence of robust baseline data, however, this development cannot be confirmed. This review collates the limited information available from several dated published records on tick species and a small number of studies focused on certain TBD’s. Some pilot data on tick density and TBD agents collected in 2016 are also presented. The aim is to explore the particular situation in Ireland with regard to ticks and TBD’s and to provide a reference for future workers in the field.
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Affiliation(s)
- Annetta Zintl
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Ireland
| | - Sara Moutailler
- UMR BIPAR, ANSES, INRA, ENVA, Animal Health Laboratory, 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France
| | - Peter Stuart
- Department of Zoology, Trinity College Dublin, Dublin 2, Ireland
| | - Linda Paredis
- Department of Zoology, Trinity College Dublin, Dublin 2, Ireland
| | | | | | | | - Elodie Devillers
- UMR BIPAR, ANSES, INRA, ENVA, Animal Health Laboratory, 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France
| | - Barbara Good
- Animal & Grassland Research and Innovation Centre, Teagasc, Athenry, Co. Galway Ireland
| | - Colm OMuireagain
- Department of Agriculture, Food and the Marine, Sligo Regional Veterinary Laboratory, Sligo, Ireland
| | - Theo De Waal
- UCD School of Veterinary Medicine, University College Dublin, Belfield, Ireland
| | | | - Jeremy Gray
- School of Biology and Environmental Science (Emeritus Professor), University College Dublin, Belfield, Ireland
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Didyk YM, Blaňárová L, Pogrebnyak S, Akimov I, Peťko B, Víchová B. Emergence of tick-borne pathogens (Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Ricketsia raoultii and Babesia microti) in the Kyiv urban parks, Ukraine. Ticks Tick Borne Dis 2016; 8:219-225. [PMID: 27923669 DOI: 10.1016/j.ttbdis.2016.10.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 07/25/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
To date, only limited data about the presence of ticks and circulation of tick-borne pathogens in urban parks of Kyiv in northern Ukraine are available. In total, 767 ticks (696 Ixodes ricinus and 69 Dermacentor reticulatus) collected in seven urban parks and one suburban oak wood park in Kyiv were individually analyzed by the PCR assays. Tick-borne pathogens, namely spirochetes from Borrelia burgdorferi sensu lato complex, Anaplasma phagocytophilum, and Babesia microti, were detected in 11.1% of tested I. ricinus ticks. In total, 4% of I. ricinus ticks tested positive for the presence of B. burdorferi s.l. (Borrelia afzelii and Borrelia garinii), 5.2% for A. phagocytophilum, and Ba. microti was confirmed in 1.9% of examined ticks. Mixed infections were recorded in four DNA samples, representing the prevalence of 0.6%. One female and two I. ricinus nymphs were simultaneously infected with B. afzelii and A. phagocytophilum, and one female carried B. afzelii and Ba. microti. In addition, 10.1% of D. reticulatus ticks tested positive for Rickettsia raoultii. Identification of infectious agents and their diversity, assessment of the relative epidemiological importance and determination of the prevalence in questing ticks from central parts of the cities are crucial steps towards the tick-borne diseases surveillance in urban environment.
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Affiliation(s)
- Yuliya M Didyk
- Schmalhausen Institute of Zoology NAS of Ukraine, B. Khmelnytsky, 15, 01030, Kyiv, Ukraine; Institute of Zoology SAS, Dúbravska cesta 9, 845 06, Bratislava, Slovakia
| | - Lucia Blaňárová
- Institute of Parasitology SAS, Hlinkova, 3, 040 01, Košice, Slovakia
| | - Svyatoslav Pogrebnyak
- National Museum of Natural History NAS of Ukraine, B. Khmelnytsky, 15, 01030, Kyiv, Ukraine
| | - Igor Akimov
- Schmalhausen Institute of Zoology NAS of Ukraine, B. Khmelnytsky, 15, 01030, Kyiv, Ukraine
| | - Branislav Peťko
- Institute of Parasitology SAS, Hlinkova, 3, 040 01, Košice, Slovakia
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45
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Jahfari S, Hofhuis A, Fonville M, van der Giessen J, van Pelt W, Sprong H. Molecular Detection of Tick-Borne Pathogens in Humans with Tick Bites and Erythema Migrans, in the Netherlands. PLoS Negl Trop Dis 2016; 10:e0005042. [PMID: 27706159 PMCID: PMC5051699 DOI: 10.1371/journal.pntd.0005042] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 09/14/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Tick-borne diseases are the most prevalent vector-borne diseases in Europe. Knowledge on the incidence and clinical presentation of other tick-borne diseases than Lyme borreliosis and tick-borne encephalitis is minimal, despite the high human exposure to these pathogens through tick bites. Using molecular detection techniques, the frequency of tick-borne infections after exposure through tick bites was estimated. METHODS Ticks, blood samples and questionnaires on health status were collected from patients that visited their general practitioner with a tick bite or erythema migrans in 2007 and 2008. The presence of several tick-borne pathogens in 314 ticks and 626 blood samples of this cohort were analyzed using PCR-based methods. Using multivariate logistic regression, associations were explored between pathogens detected in blood and self-reported symptoms at enrolment and during a three-month follow-up period. RESULTS Half of the ticks removed from humans tested positive for Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis, Rickettsia helvetica, Rickettsia monacensis, Borrelia miyamotoi and several Babesia species. Among 92 Borrelia burgdorferi s. l. positive ticks, 33% carried another pathogen from a different genus. In blood of sixteen out of 626 persons with tick bites or erythema migrans, DNA was detected from Candidatus Neoehrlichia mikurensis (n = 7), Anaplasma phagocytophilum (n = 5), Babesia divergens (n = 3), Borrelia miyamotoi (n = 1) and Borrelia burgdorferi s. l. (n = 1). None of these sixteen individuals reported any overt symptoms that would indicate a corresponding illness during the three-month follow-up period. No associations were found between the presence of pathogen DNA in blood and; self-reported symptoms, with pathogen DNA in the corresponding ticks (n = 8), reported tick attachment duration, tick engorgement, or antibiotic treatment at enrolment. CONCLUSIONS Based on molecular detection techniques, the probability of infection with a tick-borne pathogen other than Lyme spirochetes after a tick bite is roughly 2.4%, in the Netherlands. Similarly, among patients with erythema migrans, the probability of a co-infection with another tick-borne pathogen is approximately 2.7%. How often these infections cause disease symptoms or to what extend co-infections affect the course of Lyme borreliosis needs further investigations.
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Affiliation(s)
- Setareh Jahfari
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Agnetha Hofhuis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Manoj Fonville
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Joke van der Giessen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Wilfrid van Pelt
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hein Sprong
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Rigaud E, Jaulhac B, Garcia-Bonnet N, Hunfeld KP, Féménia F, Huet D, Goulvestre C, Vaillant V, Deffontaines G, Abadia-Benoist G. Seroprevalence of seven pathogens transmitted by the Ixodes ricinus tick in forestry workers in France. Clin Microbiol Infect 2016; 22:735.e1-9. [PMID: 27237545 DOI: 10.1016/j.cmi.2016.05.014] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/13/2016] [Accepted: 05/14/2016] [Indexed: 12/30/2022]
Abstract
In order to assess the level of occupational exposure to the main pathogens transmitted by the Ixodes ricinus tick, a seroprevalence study was performed on serum samples collected in 2003 from 2975 forestry workers of northeastern France. The global seroprevalence estimated for the seven pathogens studied was 14.1% (419/2975) for Borrelia burgdorferi sl, 5.7% (164/2908) for Francisella tularensis, 2.3% (68/2941) for tick-borne encephalitis virus, 1.7% (50/2908) for Anaplasma phagocytophilum and 1.7% (48/2908) for Bartonella henselae. The seroprevalences of Babesia divergens and Babesia microti studied in a subgroup of participants seropositive for at least one of these latter pathogens were 0.1% (1/810) and 2.5% (20/810), respectively. Borrelia burgdorferi sl seroprevalence was significantly higher in Alsace and Lorraine and F. tularensis seroprevalence was significantly higher in Champagne-Ardenne and Franche-Comté. The results of this survey also suggest low rates of transmission of Bartonella henselae and F. tularensis by ticks and a different west/east distribution of Babesia species in France. The frequency and potential severity of these diseases justify continued promotion of methods of prevention of I. ricinus bites.
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Affiliation(s)
- E Rigaud
- Caisse Centrale de la Mutualité Sociale Agricole, Direction santé sécurité au travail, Bagnolet, France.
| | - B Jaulhac
- EA7290 Virulence Bactérienne Précoce, Centre National de Référence des Borrelia, Groupe d'Etude de la Borréliose de Lyme (GEBLY), Fédération de Médecine Translationnelle de Strasbourg, Institut de Bactériologie, Université de Strasbourg, CHRU Strasbourg, France
| | - N Garcia-Bonnet
- Hôpital Avicenne, Maladies Infectieuses et Tropicales, formerly Caisse Centrale de la Mutualité Sociale Agricole, Bobigny, France
| | - K-P Hunfeld
- Institute for Laboratory Medicine, Northwest Medical Center, Academic Teaching Hospital, School of Medicine, The Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - F Féménia
- INRA, UMR BIPAR, INRA, Anses, ENVA, Maisons-Alfort, France
| | - D Huet
- INRA, UMR BIPAR, INRA, Anses, ENVA, Maisons-Alfort, France
| | - C Goulvestre
- INRA, UMR BIPAR, INRA, Anses, ENVA, Maisons-Alfort, France
| | - V Vaillant
- Institut de Veille Sanitaire, Saint-Maurice, France
| | - G Deffontaines
- Caisse Centrale de la Mutualité Sociale Agricole, Direction santé sécurité au travail, Bagnolet, France
| | - G Abadia-Benoist
- AFOMETRA, formerly Caisse Centrale de la Mutualité Sociale Agricole, Paris, France
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47
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Moniuszko-Malinowska A, Swiecicka I, Dunaj J, Zajkowska J, Czupryna P, Zambrowski G, Chmielewska-Badora J, Żukiewicz-Sobczak W, Swierzbinska R, Rutkowski K, Garkowski A, Pancewicz S. Infection with Babesia microti in humans with non-specific symptoms in North East Poland. Infect Dis (Lond) 2016; 48:537-43. [PMID: 27118086 DOI: 10.3109/23744235.2016.1164339] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM The aim of the study was to evaluate the clinical course and effectiveness of diagnostics tools for Babesia spp. infection in patients bitten by ticks. MATERIALS AND METHODS Five hundred and forty-eight patients hospitalised or seen in outpatients department because of various symptoms after a tick bite were included in the study. PCR, nucleotide sequencing of Babesia 18S rRNA gene fragment, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi were performed in all patients. Six patients infected with Babesia were included in the final analysis. They had PCR, Babesia 18S rRNA gene fragment nucleotide sequencing, blood smears and serological tests for Babesia spp., TBEV, A. phagocytophilum and B. burgdorferi performed twice. RESULTS Tick-borne infection with Babesia microti in six immunocompetent patients with non-specific symptoms was confirmed for the first time in Poland. No severe course of the disease was seen. No piroplasm forms were noticed within erythrocytes on blood smear. Three patients developed a serological response. CONCLUSIONS Immunocompetent patients may be unaware of infection with Babesia microti after a tick bite. It must be included in the differential diagnosis after the tick bite. In patients with low parasitaemia PCR and serology seem useful when blood smear is negative. Self-elimination of Babesia spp. is possible, especially in cases with low parasitaemia.
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Affiliation(s)
| | - Izabela Swiecicka
- b Department of Microbiology, Faculty of Biology and Chemistry , University of Białystok , Bialystok , Poland
| | - Justyna Dunaj
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
| | - Joanna Zajkowska
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
| | - Piotr Czupryna
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
| | - Grzegorz Zambrowski
- b Department of Microbiology, Faculty of Biology and Chemistry , University of Białystok , Bialystok , Poland
| | | | | | - Renata Swierzbinska
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
| | - Krzysztof Rutkowski
- d Department of Allergy , Guy's and St Thomas' NHS Foundation Trust , London , UK
| | - Adam Garkowski
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
| | - Sławomir Pancewicz
- a Department of Infectious Diseases and Neuroinfections , Medical University of Bialystok , Poland
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48
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Babesia in a Nonsplenectomized Patient Requiring Exchange Transfusion. Case Rep Infect Dis 2015; 2015:405263. [PMID: 26693364 PMCID: PMC4677028 DOI: 10.1155/2015/405263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 11/17/2022] Open
Abstract
Babesiosis is a tick born zoonosis caused by red blood cell parasites of the genus Babesia. It is caused predominantly by B. microti and B. divergens, microti being more common in the US. The parasites are transmitted by Ixodes tick to their host but infection can also spread by blood transfusion and perinatally. Clinical manifestations vary from subclinical infection to fulminating disease depending upon the immune status of the patient. About half of patients, hospitalized with babesiosis, develop complication with fatality rates of 6 to 9% which increase up to 21% among those with immunosuppression. A case of 58-year-old previously healthy man, infected by B. microti, was reported on 2000 who presented with severe disease characterized by severe anemia, DIC, and renal and respiratory failure. First case of overwhelming septic shock without respiratory involvement due to babesiosis in a healthy patient with an intact spleen was published in a case report on 2011. Since our patient here is an immunocompetent healthy male with intact spleen presenting with severe babesiosis requiring exchange transfusion, this presentation of Babesia is rare and warrants further study.
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49
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Surgers L, Belkadi G, Foucard A, Lalande V, Girard PM, Hennequin C. Babesiosis and Lyme disease co-infection in a female patient returning from the United States. Med Mal Infect 2015; 45:490-2. [PMID: 26525187 DOI: 10.1016/j.medmal.2015.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/02/2015] [Accepted: 10/01/2015] [Indexed: 11/29/2022]
Affiliation(s)
- L Surgers
- Service de maladies infectieuses et tropicales, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Sorbonne universités, UPMC université Paris 06 CR7, 75013 Paris, France; Inserm U1135, CIMI, Team E13, Paris, France.
| | - G Belkadi
- Service de parasitologie-mycologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France
| | - A Foucard
- Service de parasitologie-mycologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France
| | - V Lalande
- Service de bactériologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France
| | - P-M Girard
- Service de maladies infectieuses et tropicales, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Sorbonne universités, UPMC université Paris 06, UMR_S 1136, institut Pierre-Louis d'épidémiologie et de santé publique, 75013 Paris, France; Inserm, UMR_S 1136, institut Pierre-Louis d'épidémiologie et de santé publique, 75013 Paris, France
| | - C Hennequin
- Service de parasitologie-mycologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Inserm, U945, 75013 Paris, France; Université Pierre-et-Marie-Curie-Paris 6, UMR S945, 75013 Paris, France
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50
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Eshoo MW, Crowder CD, Carolan HE, Rounds MA, Ecker DJ, Haag H, Mothes B, Nolte O. Broad-range survey of tick-borne pathogens in Southern Germany reveals a high prevalence of Babesia microti and a diversity of other tick-borne pathogens. Vector Borne Zoonotic Dis 2015; 14:584-91. [PMID: 25072989 DOI: 10.1089/vbz.2013.1498] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract Ticks harbor numerous pathogens of significance to human and animal health. A better understanding of the pathogens carried by ticks in a given geographic area can alert health care providers of specific health risks leading to better diagnosis and treatments. In this study, we tested 226 Ixodes ricinis ticks from Southern Germany using a broad-range PCR and electrospray ionization mass spectrometry assay (PCR/ESI-MS) designed to identify tick-borne bacterial and protozoan pathogens in a single test. We found 21.2% of the ticks tested carried Borrelia burgdorferi sensu lato consisting of diverse genospecies; a surprisingly high percentage of ticks were infected with Babesia microti (3.5%). Other organisms found included Borrelia miyamotoi, Rickettsia helvetica, Rickettsia monacensis, and Anaplasma phagocytophilum. Of further significance was our finding that more than 7% of ticks were infected with more than one pathogen or putative pathogen.
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Affiliation(s)
- Mark W Eshoo
- 1 Ibis Biosciences an Abbott company , Carlsbad, California
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