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A Model for Experimental Exposure of Humans to Larval Ixodes scapularis Ticks
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Update on babesiosis.

Edouard Vannier1, Peter J Krause

  • 1Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, 800 Washington Street, Box 041, Boston, MA 02111, USA.

Interdisciplinary Perspectives on Infectious Diseases
|September 4, 2009
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Human babesiosis, a tick-borne illness, is spreading globally and poses risks, especially to older or immunocompromised individuals. Early diagnosis and prevention are key to managing this malaria-like disease.

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Area of Science:

  • Infectious Diseases
  • Parasitology
  • Epidemiology

Background:

  • Human babesiosis is an emerging tick-borne infectious disease caused by *Babesia* protozoa.
  • It shares clinical similarities with malaria and has seen epidemiological shifts, with endemic areas in the US and sporadic cases worldwide.
  • Infection severity varies from asymptomatic to fatal, with higher risks for individuals over 50 and the immunocompromised.

Purpose of the Study:

  • To review the epidemiology, clinical presentation, diagnosis, treatment, and prevention of human babesiosis.
  • To highlight the evolving geographic distribution and risk factors associated with *Babesia* infection.
  • To underscore the public health implications, including blood safety concerns from asymptomatic carriers.

Main Methods:

  • Diagnosis relies on microscopic identification of *Babesia* in blood smears.
  • Molecular methods include PCR amplification of *Babesia* DNA.
  • Serological tests detect antibodies in acute and convalescent sera.

Main Results:

  • Human babesiosis epidemiology has evolved, with established endemic regions and global spread.
  • High-risk groups include the elderly, asplenic individuals, and those with HIV, malignancy, or immunosuppressive therapy.
  • Asymptomatic carriers represent a potential risk for blood transfusion safety.

Conclusions:

  • Effective management involves prompt diagnosis through microscopy, PCR, and serology.
  • Treatment regimens include atovaquone with azithromycin or clindamycin with quinine; exchange transfusion for severe cases.
  • A multi-pronged prevention strategy encompassing personal, residential, and community measures is recommended.