First Documented Case of Human Babesiosis in Sweden

Uhnoo, Ingrid; Cars, Otto; Christensson, Dan; Nyström-Rosander, Christina

doi:10.3109/00365549209052642

Cited by 53 publications

(33 citation statements)

References 21 publications

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“…The seroprevalence of B. divergens antibodies in our study was comparable to the results of the few other seroepidemiologic studies carried out in Europe (Uhnoo et al, 1992;Gorenflot et al, 1998;Hunfeld et al, 2002). B. divergens IgG X1:128 were found in 4.9% of the participants exposed to tick bites in Germany (Hunfeld et al, 2002), B. divergens IgG X1:40 were present in 13.3% of the patients with Lyme borreliosis in Sweden (Uhnoo et al, 1992), and B. divergens IgG X1:80 were established in 1% of the asymptomatic blood donors with tick bite in France (Gorenflot et al, 1998).…”

Section: Discussionsupporting

confidence: 90%

“…B. divergens IgG X1:128 were found in 4.9% of the participants exposed to tick bites in Germany (Hunfeld et al, 2002), B. divergens IgG X1:40 were present in 13.3% of the patients with Lyme borreliosis in Sweden (Uhnoo et al, 1992), and B. divergens IgG X1:80 were established in 1% of the asymptomatic blood donors with tick bite in France (Gorenflot et al, 1998). Because of the observed serologic cross-reactivity between Babesia EU1 and B. divergens, however, a part of the determined prevalence in our study could be attributed to the Babesia EU1, the causative agent of 3 recent human babesiosis cases in Europe (Herwaldt et al, 2003;Ha¨selbarth et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

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Seroprevalence of Babesia divergens infection among forestry workers in Slovenia

Rojko

Duh

̆upanc

et al. 2008

International Journal of Medical Microbiology

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Babesia divergens infection among forestry workers in Slovenia

Rojko

Duh

̆upanc

et al. 2008

International Journal of Medical Microbiology

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“…Interestingly, titers of Ն1:256, possibly indicating a more recent infection with the pathogen, were found with significantly greater frequency (9 versus 1; P Ͻ 0.05) in patients exposed to ticks than in the control groups. The seroprevalences of Babesia infections in the German population examined here correlate well with those in a study of Swedish Lyme borreliosis patients, in which 13% of the individuals were found to be seropositive for B. divergens (30), and with those in a study in western France that indicated 0.5% asymptomatic seropositive individuals out of 408 investigated when a more conservative cutoff titer of Ͼ1:80 was used (A. Gorenflot, M. Marjolet, L. Hostis, A. Coutarmanac'h, and A. Marchand, Abstr. 3rd Int.…”

Section: Discussionsupporting

confidence: 81%

Seroprevalence ofBabesiaInfections in Humans Exposed to Ticks in Midwestern Germany

et al. 2002

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Babesiosis is considered to be an emerging tick-borne disease in humans worldwide. However, most studies on the epidemiology of human babesiosis to date have been carried out in North America, and there is little knowledge on the prevalence of infection and frequency of disease in other areas. The aim of this study was to investigate the prevalence of Babesia infections in a human population in Germany. A total of 467 sera collected between May and October 1999 from individuals living in the Rhein-Main area were tested for the presence of immunoglobulin G (IgG) and IgM antibodies to antigens of Babesia microti and Babesia divergens by indirect fluorescent-antibody (IFA) tests. These sera were derived from 84 Lyme borreliosis patients suffering from erythema migrans, 60 asymptomatic individuals with positive borreliosis serology, and 81 individuals with a history of tick bite. Cutoff values for discrimination between seronegative and seropositive results in the IFA tests were determined using sera from 120 healthy blood donors and 122 patients suffering from conditions other than tick-borne diseases (malaria, n ‫؍‬ 40; toxoplasmosis, n ‫؍‬ 22; syphilis, n ‫؍‬ 20; Epstein-Barr virus infection, n ‫؍‬ 20; and presence of antinuclear antibodies, n ‫؍‬ 20). The overall specificities of the IFA tests for B. microti and B. divergens were estimated to be >97.5%. Positive IgG reactivity against B. microti antigen (titer, >1:64) or B. divergens antigen (titer, >1:128) was detected significantly more often (P < 0.05) in the group of patients exposed to ticks (26 of 225 individuals; 11.5%) than in the group of healthy blood donors (2 of 120 individuals; 1.7%). IgG antibody titers of >1:256 against at least one of the babesial antigens were found significantly more often (P < 0.05) in patients exposed to ticks (9 of 225) than in the control groups (1 of 242). In the human population investigated here, the overall seroprevalences for B. microti and B. divergens were 5.4% (25 of 467) and 3.6% (17 of 467), respectively. The results obtained here provide evidence for concurrent infections with Borrelia burgdorferi and Babesia species in humans exposed to ticks in midwestern Germany. They also suggest that infections with Babesia species in the German human population are more frequent than believed previously and should be considered in the differential diagnosis of febrile illness occurring after exposure to ticks or blood transfusions, in particular in immunocompromised patients.

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“…Seroepidemiological investigations from Germany, performed in healthy blood donors, show a prevalence of 1.7% (Hunfeld et al 2002). In persons with tick exposure, prevalences of 10% and 15% were determined in Germany and Sweden (Hunfeld et al 1998(Hunfeld et al , 2002Uhnoo et al 1992). These results coincide with the prevalence in ticks.…”

Section: Resultsmentioning

confidence: 86%

Spread of ticks and tick-borne diseases in Germany due to global warming

Hartelt¹,

Pluta

Oehme³

et al. 2008

Parasitol Res

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Tick-transmitted diseases like tick-borne encephalitis and Lyme Borreliosis have been well known in Germany for decades. Global climate changes may influence the emergence and reemergence of diseases. Ongoing research now gives an additional focus on other tick-borne pathogens such as Coxiella burnetii, Rickettsia conorii, Anaplasma phagocytophilum and Babesia spp., the causative agents of Q-fever, Mediterranean spotted fever, Anaplasmosis and Babesiosis, respectively. The epidemiology of these pathogens was investigated on ticks as well as on rodents, the main hosts. Therefore adults of Dermacentor spp. (n = 862) and rodents (n = 119) were collected and examined for the existence of C. burnetii and Rickettsia spp. by polymerase chain reaction (PCR). In none of the ticks and rodents C. burnetii could be detected, in contrast to Rickettsia spp. where the infection rate in ticks was about 20%. Over and above that, nymphs and adults of Ixodes ricinus were also collected and investigated by PCR for A. phagocytophilum (n = 5,424), Rickettsia helvetica (n = 1,187) and Babesia spp. (n = 3,113). Thereby infection rates of 1%, 8.9% and 1%, respectively, could be determined. The prevalence in rodents was 5.3% for A. phagocytophilum and 0.8% for Babesia microti. None of the rodents was R. helvetica positive.

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First Documented Case of Human Babesiosis in Sweden

Cited by 53 publications

References 21 publications

Seroprevalence of Babesia divergens infection among forestry workers in Slovenia

Seroprevalence of Babesia divergens infection among forestry workers in Slovenia

Seroprevalence ofBabesiaInfections in Humans Exposed to Ticks in Midwestern Germany

Spread of ticks and tick-borne diseases in Germany due to global warming

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