Emergence of human babesiosis along the border of China with Myanmar: detection by PCR and confirmation by sequencing

Abstract

Babesiosis is a tick-borne, zoonotic disease caused by Babesia spp. Two cases of babesiosis were detected by nested polymerase chain reaction (PCR) in Yunnan province, China, and further confirmed by molecular assay. The blood smears showed intraerythrocytic ring form and tetrads typical of small B. microti. In both cases, the rapid diagnostic test (RDT) ruled out the possibility of co-infections with malaria. Neither case was initially diagnosed because of the low Babesia parasitemia. These two cases of babesiosis in areas along the Myanmar–China border pose the question of the emergence of this under recognized infection in countries or areas where malaria is endemic.

A pilot serosurvey of Babesia microti in Chinese blood donors

“…There is plausible evidence that Babesia is endemic in the PRC (Fig. ) . Our findings from a pilot serosurvey in Chinese blood donors demonstrate comparable rates of seroreactivity against B. microti to those that have been reported in areas of the United States that are highly endemic for B. microti .…”

“…tick‐borne) as well as transfusion‐transmitted Babesia infection is being underreported or misdiagnosed. This is particularly the case in malaria‐endemic areas such as in Yunnan province along the Myanmar–China border , where both Plasmodium and Babesia are endemic; Plasmodium and Babesia parasites are morphologically similar (almost indistinguishable) on blood smear and have similar clinical presentations .…”

“…However, Babesia is globally ubiquitous . Recent studies suggest that both B. microti and B. venatorum are endemic in the People's Republic of China (PRC) . Other Babesia species (e.g.…”

Human Babesiosis: Pathogens, Prevalence, Diagnosis, and Treatment

“…Firstly, the China–Myanmar border is highly endemic area for malaria. Reports of human babesiosis due to B. microti from this region [58, 61, 62], show that in areas where co-infections with other tick-borne infections and malaria occur, differential diagnoses are essential to determine whether the causative agents of disease are Babesia or Plasmodium spp. This is especially important as the therapeutic regimes for these parasites are different, and Babesia parasites are not known to respond to anti-malarials.…”

Regional Features and National Differences in Population Distribution in China’s Border Regions (2000–2015)

“…Given their special geographic locations and settlements of ethnic minorities, the border regions are becoming very sensitive areas for China in terms of maintaining foreign and ethnic relations. Domestic and international research on China's borders has mainly focused on social and economic development [1][2][3][4], resources and environmental problems [5][6][7][8][9][10], border management [11,12], trade and cooperation with neighboring countries [13][14][15][16][17][18][19], and security issues [20][21][22][23][24][25][26].…”