Background Spontaneous splenic rupture is an increasingly reported complication of babesiosis and has been described as a severe complication. Methods We performed a retrospective chart review in a high-prevalence area to identify 7 cases of babesiosis-related splenic rupture between 2014 and 2016. Results Splenic rupture occurred in approximately 1% of babesiosis cases. Compared to cases without splenic rupture, these patients were younger (by >10 years), healthier (most with ≤1 comorbidity), had a lower degree of parasitemia (<10%), and were less likely to have end-organ dysfunction other than their splenic involvement. Conclusions Younger, healthier patients may be more prone to develop splenic rupture, as splenic histiocytes engage in more robust erythrophagocytosis, leading to pathological mechanical strain and rupture.

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What is already known on this topic?No national research has been published on the physical or mental health of childcare professionals during the COVID-19 pandemic.What is added by this report?Childcare professionals had a higher rate of depression during the pandemic than before the pandemic; rates of asthma, depression, and stress were greater among childcare professionals than among US adults overall during the pandemic. We found disparities in chronic disease rates by race, ethnicity, and sex/gender. What are the implications for public health practice?Efforts should be directed toward developing effective and scalable interventions for improving the physical and mental health of childcare professionals and addressing stressors that may undermine their well-being.