Human Babesiosis in Europe: what clinicians need to know

Hildebrandt, Anke; Gray, Jeremy; Hunfeld, Klaus-Peter

doi:10.1007/s15010-013-0526-8

Cited by 156 publications

(233 citation statements)

References 130 publications

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“…It primarily occurs in the USA [Vannier and Krause 2012]. In Europe however, severe cases of human babesiosis have mainly been caused by Babesia divergens-like parasites in immunocompromised patients, but cases have also been reported in immunocompetent patients [Hildebrandt et al 2013, Mathis et al 2006, Martinot et al 2011.…”

Section: Introductionmentioning

confidence: 99%

Molecular examinations of Babesia microti in rodents and rodent-attached ticks from urban and sylvatic habitats in Germany

Obiegala

Pfeffer

Pfister

et al. 2015

Ticks and Tick-borne Diseases

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Small mammals serve as reservoir hosts for tick-borne pathogens, especially for those which are not transmitted transovarially in ticks -such as Babesia microti. Molecular investigations on the prevalence of B. microti in wild small mammals and on attached ticks from differently structured areas may provide information on the circulation of B. microti in different ecological niches. In 2012 and 2013, 622 rodents (396 Myodes glareolus, 178 Apodemus flavicollis, 36 Apodemus sylvaticus, 4 Apodemus agrarius, 7 Microtus arvalis, 1 Microtus agrestis) were captured from three differently structured habitats (urban, sylvatic, recultivated) in Germany. Attached ticks were collected from 449 small mammals (3250 Ixodes ricinus, 7 Ixodes trianguliceps, 133 Dermacentor reticulatus). A representative selection of a maximum of 5 ticks per developmental stage and species per 30 rodents of each species, location and year resulting in 965 ticks was further investigated. DNA was extracted from tick, blood and spleen samples, and tested by PCR for the partial 18S rRNA gene of B. microti with subsequent sequencing. The prevalence was significantly higher in rodents from the sylvatic site (4.6%) than in rodents captured at both other sites (0-0.6%) (2= 11.95; p= 0.00125). Body and spleen weight of infected M. glareolus from the sylvatic site were significantly higher compared to those from non-infected individuals from that site (p = 0.00288 and p = 0.00017, respectively). Babesia microti DNA was detected in 3 out of 965 attached ticks (0.3%; 95%CI: 0-1) from all sites, but they derived exclusively from rodents captured at the sylvatic site. At the same site, I. ricinus nymphs (7.7%; 95%CI: 1-25.3) were significantly more often infected than I. ricinus larvae (0%; 95%CI: 0-1.3)(2 = 26.72; p <0.0001). The majority of positive rodents was also found at that site. I. trianguliceps occurred exclusively and the majority of M. glareolus at that site. Thus, it may be assumed that the circulation of B. microti is more efficient where this tick species and voles exist sympatrically than in areas with a predominant occurrence of Apodemus species. microti with subsequent sequencing. The prevalence was significantly higher in rodents from the sylvatic site (4.6%) than in rodents captured at both other sites (0-0.6%) (χ²= 11.95; p= 0.00125).Body and spleen weight of infected M. glareolus from the sylvatic site were significantly higher compared to those from non-infected individuals from that site (p=0.00288 and p=0.00017, respectively). Babesia microti DNA was detected in 3 out of 965 attached ticks (0.3%; 95%CI: 0-1) from all sites, but they derived exclusively from rodents captured at the sylvatic site. At the same site, I. ricinus nymphs (7.7%; 95%CI: 1-25.3) were significantly more often infected than I. ricinus larvae (0%; 95%CI: 0-1.3)(χ²=26.72; p <0.0001). The majority of positive rodents was also found at that site. I. trianguliceps occurred exclusively and the majority of M. glareolus at that site. Thus, it may be assumed that...

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Section: Introductionmentioning

confidence: 99%

Molecular examinations of Babesia microti in rodents and rodent-attached ticks from urban and sylvatic habitats in Germany

Obiegala

Pfeffer

Pfister

et al. 2015

Ticks and Tick-borne Diseases

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“…Human babesiosis, an emerging zoonosis caused by the hemoparasites of the genus Babesia, the second most common blood-borne parasites of mammals after trypanosomes [1,2]. Infection of the human host is being diagnosed more often, probably due to increasing number of travelers, immunocompromised individuals, blood transfusions, and better diagnostic methods.…”

Section: Introductionmentioning

confidence: 99%

“…The main species of Babesia that are thought to cause the majority of human babesiosis are B. microti, B. divergens, and B. venatorum. [2,4]. In the northeastern part of the US, babesiosis is usually caused by the rodent species B. microti, which is transmitted by the tick, Ixodes scapularis, the same tick vector responsible for the transmission of anaplasmosis and Lyme disease; and thus co-infection with Anaplasma phagocytophilum and Borrelia burgdorferi should always be considered and tested [5].…”

Section: Introductionmentioning

confidence: 99%

“…A study of 1000 patients who are seropositive for Borrelia burgdorferi found that 10% of them had antibodies to B. microti [6]. In Europe, human babesiosis is mainly caused by the cattle species B. divergens which is also transmitted by the Ixodes tick (I. ricinus being the most important) [2]. The incubation period for babesiosis is somewhere between 5 to 30 days [7].…”

Section: Introductionmentioning

confidence: 99%

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Hematologic Manifestations of Babesiosis

Akel

Mobarakai

2018

Ann Clin Lab Res

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Background: Babesiosis, a zoonotic parasitic infection transmitted by the Ixodes tick, has become an emerging health problem in the human host 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 ruture, disseminated intravascular coagulopathy (DIC), or even hemophagocytic lymphohistiocytosis (HLH).

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“…Other bacterial pathogens such as Francisella tularensis, causing tularemia, and the Q fever agent Coxiella burnetii have also been detected in I. ricinus, but the direct role of this tick species in the epidemiology of these diseases is probably not significant [11,12]. Humans may develop babesiosis following tick-borne transmission of protozoans belonging to the genus Babesia, mainly B. divergens, however, the virulence of additional members of this genus, such as B. venatorum, have recently been confirmed [13]. Babesia microti, an emerging human tick-borne pathogen in USA, has also been identified in ticks in Europe, with one single human case to date [14].…”

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confidence: 99%

Emerging Horizons for Tick-Borne Pathogens: From the ‘One Pathogen–one Disease’ Vision to the Pathobiome Paradigm

et al. 2015

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Ticks, as vectors of several notorious zoonotic pathogens, represent an important and increasing threat for human and animal health in Europe. Recent applications of new technology revealed the complexity of the tick microbiome, which may affect its vectorial capacity. Appreciation of these complex systems is expanding our understanding of tick-borne pathogens, leading us to evolve a more integrated view that embraces the 'pathobiome'; the pathogenic agent integrated within its abiotic and biotic environments. In this review, we will explore how this new vision will revolutionize our understanding of tickborne diseases. We will discuss the implications in terms of future research approaches that will enable us to efficiently prevent and control the threat posed by ticks.

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Human Babesiosis in Europe: what clinicians need to know

Cited by 156 publications

References 130 publications

Molecular examinations of Babesia microti in rodents and rodent-attached ticks from urban and sylvatic habitats in Germany

Molecular examinations of Babesia microti in rodents and rodent-attached ticks from urban and sylvatic habitats in Germany

Hematologic Manifestations of Babesiosis

Emerging Horizons for Tick-Borne Pathogens: From the ‘One Pathogen–one Disease’ Vision to the Pathobiome Paradigm

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