Human Coinfection withBorrelia burgdorferiandBabesia microtiin the United States

Abstract

Borrelia burgdorferi, the causative agent of Lyme disease, and Babesia microti, a causative agent of babesiosis, are increasingly implicated in the growing tick-borne disease burden in the northeastern United States. These pathogens are transmitted via the bite of an infected tick vector, Ixodes scapularis, which is capable of harboring and inoculating a host with multiple pathogens simultaneously. Clinical presentation of the diseases is heterogeneous and ranges from mild flu-like symptoms to near-fatal cardiac arrhythmias. While the reason for the variability is not known, the possibility exists that concomitant infection with both B. burgdorferi and B. microti may synergistically increase disease severity. In an effort to clarify the current state of understanding regarding coinfection with B. burgdorferi and B. microti, in this review, we discuss the geographical distribution and pathogenesis of Lyme disease and babesiosis in the United States, the immunological response of humans to B. burgdorferi or B. microti infection, the existing knowledge regarding coinfection disease pathology, and critical factors that have led to ambiguity in the literature regarding coinfection, in order to eliminate confusion in future experimental design and investigation.

Empirical validation of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for suspected Lyme disease

“… 74 Any patient who complains of unexplained fevers, day and night sweats, chills, flushing, an unexplained cough, and shortness of breath (air hunger), which are questions number 1 and number 22 (Section 1 of the HMQ), may also have a concomitant infection with babesiosis. 75 – 77 A Babesia panel approach with a Giemsa stain, Babesia titers (IFA) for multiple species of Babesia ( Babesia microti , Babesia duncani [WA-1, Babesia divergens and Babesia sp. EU1 ]), with PCR [61] and FISH testing, may help to establish the diagnosis 78 in the United States and Europe, 78 while ruling out other causes of these symptoms.…”

Extended-spectrum antiprotozoal bumped kinase inhibitors: A review

“…There, B. microti shares its vector host with Borrelia sp., the causative agent of Lyme disease. Thus, it has been reported that some Lyme disease patients also suffer from human babesisosis (Diuk-Wasser, et al, 2016, Knapp and Rice, 2015). …”

Microbial Pre-exposure and Vectorial Competence of Anopheles Mosquitoes

“…A large panel of tick-borne diseases, which affect both humans and wild mammals, can result from the transmission of several pathogens including bacteria, viruses, and protists. It is known that ticks can harbor and co-transmit multiple pathogens (Knapp and Rice, 2015 ). Malaria and tick-borne diseases overlap in many African regions, therefore co-infections in Anopheles mosquitoes may be possible after successive or concomitant infectious blood meals on hosts carrying both micro-organisms.…”