Monitoring Human Babesiosis Emergence through Vector Surveillance New England, USA

Diuk‐Wasser, Maria A.; Liu, Yuchen; Steeves, Tanner K.; Folsom-O'Keefe, Corrine M.; Dardick, Kenneth R.; Lepore, Timothy J.; Bent, Stephen J.; Usmani‐Brown, Sahar; Telford, Sam R.; Fish, Durland; Krause, Peter J.

doi:10.3201/eid1302/130644

Cited by 34 publications

(43 citation statements)

References 38 publications

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“…Although there is a close association between human disease and tick infection ratios in long-established babesiosis-endemic areas, babesiosis at emerging sites is likely to be under-reported. [42] …”

Section: Discussionmentioning

confidence: 97%

Infection withBabesia microtiin humans with non-specific symptoms in North East Poland

Moniuszko

Święcicka

Dunaj

et al. 2016

Infectious Diseases

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Section: Discussionmentioning

confidence: 97%

Infection withBabesia microtiin humans with non-specific symptoms in North East Poland

Moniuszko

Święcicka

Dunaj

et al. 2016

Infectious Diseases

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“…4 The primary vector is Ixodes scapularis , which also transmits Borrelia burgdorferi, the etiologic agent of Lyme disease, Anaplasma phagocytophilum , Borrelia miyamotoi , Ehrlichia muris -like agent, and Powassan virus. 4,7 Humans can be infected with two or more of these pathogens. The prevalence of B. microti infection in nymphal I. scapularis ticks ranges from 1% in newly endemic areas to 20% in some well-established endemic areas.…”

Section: Epidemiologymentioning

confidence: 99%

“…The prevalence of B. microti infection in nymphal I. scapularis ticks ranges from 1% in newly endemic areas to 20% in some well-established endemic areas. 7 Initially identified on the coastal islands of southern New England, B. microti has spread north, west, and south to encompass much of the northeastern United States. This geographic expansion mimics that of Lyme disease but has proceeded more slowly.…”

Section: Epidemiologymentioning

confidence: 99%

“…This geographic expansion mimics that of Lyme disease but has proceeded more slowly. The reported incidence of babesiosis is lower than that of Lyme disease due to a more restricted geographic range, lower tick infection rate, greater proportion of asymptomatic infection, insufficient physician awareness, and greater difficulty in diagnosis 2,7 Carefully designed epidemiologic studies have shown that differences in the incidence of babesiosis and Lyme disease are small at certain sites that have long been endemic for both diseases. 7-8 …”

Section: Epidemiologymentioning

confidence: 99%

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Babesiosis

Vannier¹,

Diuk‐Wasser²,

Mamoun³

et al. 2015

Infectious Disease Clinics of North America

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286

345

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Summary Babesiosis is a worldwide tick-borne zoonosis caused by hemoprotozoan parasites of the genus Babesia. Babesia microti is the main etiologic agent of human babesiosis and is endemic in the northeastern and the upper Midwestern United States. The geographic expansion of babesiosis has followed that of Lyme disease, but has remained more restricted. The emergence of human babesiosis poses a serious health threat in highly endemic areas. Fever is the salient feature of babesiosis and often is accompanied by a series of non-specific symptoms, explaining why diagnosis may be delayed or missed. The diagnosis is confirmed by identification of babesia organisms on Giemsa stained blood smears, detection of babesia DNA by PCR, or a four-fold rise in anti-babesia antibody titers in acute and convalescent sera. The disease may be severe or fatal, particularly in patients who are otherwise healthy but older than 50 years of age, and in patients who are immunocompromised regardless of age. Most patients have complete recovery following a standard 7 to 10 day course of antimicrobial therapy.

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“…Two strain types of A. phagocytophilum were identified, the human pathogenic strain (AP-ha), which is most often associated with clinical cases of HGA, and a variant strain (AP-variant 1); their relative prevalence appears to vary geographically (Krakowetz et al 2014). B. microti has rarely been detected in ticks in Ontario; however, it occurs nearby in the northeastern United States, and the geographic range of human babesiosis is expanding (Diuk-Wasser et al 2014). Information about the occurrence of tick-associated pathogens in different geographical areas is useful for informing physicians and public health practitioners about the disease risks associated with ticks in their area.…”

Section: Introductionmentioning

confidence: 98%

Prevalence ofAnaplasma phagocytophilumandBabesia microtiinIxodes scapularisfrom a Newly Established Lyme Disease Endemic Area, the Thousand Islands Region of Ontario, Canada

Werden

Lindsay

et al. 2015

Vector-Borne and Zoonotic Diseases

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Blacklegged ticks (Ixodes scapularis) are vectors for several important human diseases, including Lyme disease, human granulocytic anaplasmosis (HGA), and human babesiosis, caused by Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti, respectively. The continued northward range expansion of blacklegged ticks and associated pathogens is an increasing public health concern in Canada. The Thousand Islands region of eastern Ontario has recently been identified as a new endemic area for Lyme disease in Canada, but the occurrence of other pathogens in ticks in this area has not been fully described. Our objectives were to determine the prevalence of A. phagocytophilum and B. microti in small mammals and questing ticks in the Thousand Islands area and identify the strains of A. phagocytophilum circulating in ticks in the area. Serum and larval ticks were collected from trapped small mammals, and questing ticks were collected via drag sampling from up to 12 island and mainland sites in 2006, 2009, and 2010. A. phagocytophilum was identified by PCR in 3.4% (47/1388) ticks from eight of 12 sites; the prevalence ranged from 8.9% in 2006 to 3% in 2009. All 365 ticks tested for B. microti were negative. Antibodies to A. phagocytophilum were detected in 2.8% (17/611) of white-footed mice (Peromyscus leucopus) at two of 11 sites in 2006, 2009, or 2010. All 34 A. phagocytophilum-positive ticks submitted for strain identification using single-nucleotide polymorphism genotyping assays targeting the 16S rRNA gene were identified as a variant strain (Ap variant-1), which is not commonly associated with human disease. Our findings suggest that people are at low risk of contracting HGA or human babesiosis due to locally acquired tick bites in the Thousand Islands area. However, continued surveillance is warranted as these pathogens continue to expand their ranges in North America.

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Monitoring Human Babesiosis Emergence through Vector Surveillance New England, USA

Abstract: Such surveillance can provide an early warning for emergence of this disease and measure disease underreporting.

Cited by 34 publications

References 38 publications

Infection withBabesia microtiin humans with non-specific symptoms in North East Poland

Infection withBabesia microtiin humans with non-specific symptoms in North East Poland

Babesiosis

Prevalence ofAnaplasma phagocytophilumandBabesia microtiinIxodes scapularisfrom a Newly Established Lyme Disease Endemic Area, the Thousand Islands Region of Ontario, Canada

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