Thanks for posting this, Carina.
After a quick survey of the internet, I learned that vertical transmission of Babesiosis is something that has been considered and studied for a number of years -- and especially by veterinarians. This is probably the most concise summary of Babesiosis I came across (even though some of the information may now be slightly out of date):
http://emedicine.medscape.com/article/996610-overview
Pediatric Babesiosis
Updated: Jul 29, 2010
Human babesiosis is an emerging tick-borne zoonotic disease caused by the protozoan parasites of the genus Babesia.[1] Babesial parasites and those of the closely related genus Theileria have worldwide distribution, parasitizing the erythrocytes of wild and domestic animals. These parasites are commonly called piroplasms because of the pear-shaped forms found within infected RBCs. Babesial infections in humans are infrequent and occur in limited geographic locations. Disease manifestations range from asymptomatic infection in healthy individuals to severe illness and death in those who are asplenic, elderly, or immunocompromised.
Babes first described babesiosis in Romanian cattle in 1888. Skrabalo was the first to identify a human infection caused by Babesia in 1957 in the former Yugoslavia. Earlier reports involved splenectomized patients with fulminant babesiosis. In 1969, infection with Babesia microti was described in a patient with an intact spleen from Nantucket Island off the coast of Massachusetts. Babesiosis is endemic in the Northeast, particularly in the areas of Nantucket Island, Martha's Vineyard, Shelter Island, and parts of Long Island. Cases have been reported from the Midwest and West Coast of the United States.
Of the more than 70 species worldwide in the genus Babesia, human infections are largely due to the rodent strain B microti (found only in the United States) and the cattle strains Babesia divergens and Babesia bovis (found only in Europe). Sporadic cases of babesiosis due to Babesia duncani (isolates WA-1 and CA-5) have been reported in Washington and northern California. Genetic sequence analysis of WA-1 strain has revealed piroplasm-specific, small-subunit ribosomal DNA. Phylogenetically, WA-1 strain Babesia is closely related to Babesia gibsoni, a canine pathogen. A fatal case of babesiosis was recently described in Missouri from a strain (MO-1) that was closely related to B divergens. Serologic studies that test for B microti do not detect infections due to these other strains of Babesia.
Babesia species in the host erythrocyte vary in size from 1-5 mm in length. B microti measures 2 X 1.5 mm, B divergens measures 4 X 1.5 mm, and B bovis measures 2.4 X 1.5 mm. They are pear-shaped, oval, or round. Their ring form and peripheral location in the erythrocyte frequently lead to their being mistaken for Plasmodium falciparum.
Babesiosis is a zoonotic disease and requires transmission from an animal reservoir to humans via a tick vector.[2] In the northeastern United States, the black-legged deer tick Ixodes scapularis, also called Ixodes dammini (see the image below), is the principal vector for transmitting the etiologic agent B microti. I scapularis is the same vector that transmits Lyme disease.
Babesia species from rodents, primarily the white-footed deer mouse but also the field mouse, vole, rat, and chipmunk, are transmitted to humans during tick bites in endemic areas. Babesiosis is understandably more prevalent during the periods of tick activity such as spring and summer.
The tick I scapularis has 3 developmental stages, the larva, the nymph, and the adult, with each stage requiring a blood meal for development into the next stage. As a larva and nymph, the tick feeds on rodents; however, as an adult, the tick prefers to feed on the white-tailed deer. Female ticks are impregnated while obtaining their blood meal on the deer, with the formation of up to 20,000 eggs.
Although rodents are infected with Babesia (60% on Nantucket Island), the white-tailed deer does not carry the organism. B microti is transmitted from the larval phase of the tick to the nymphal phase (transstadial transmission) but not transovarially. Human infection is primarily produced by the bite of an infected nymph during a blood meal. Restocking of deer populations and curtailment of hunting has increased deer herds in certain areas. The proximity of deer, mouse, and tick create the conditions for human infection. Babesiosis is rarely acquired through blood transfusion.[3] In transfusion-associated cases, sources of babesiosis have included platelets and frozen erythrocytes. The incubation period in transfusion-associated disease appears to be 6-9 weeks. Transplacental transmission has also occurred rarely.
The hard-bodied cattle tick Ixodes ricinus is thought to transmit bovine babesiosis from the cattle reservoir to humans in Europe.
Babesiosis has been getting a lot of attention lately, and especially when it concerns possible transmission by blood transfusion.
Here are a few abstracts that demonstrate how important it is for people in various professions to work together when it comes to Babesiosis and other tick-borne diseases:
http://www.ncbi.nlm.nih.gov/pubmed/9664092
N Engl J Med. 1998 Jul 16;339(3):160-5.
Persistent parasitemia after acute babesiosis.
Krause PJ, Spielman A, Telford SR 3rd, Sikand VK, McKay K, Christianson D, Pollack RJ, Brassard P, Magera J, Ryan R, Persing DH.
Source
Department of Pediatrics, Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford 06106, USA.
Abstract
BACKGROUND:
Babesiosis, a zoonosis caused by the protozoan Babesia microti, is usually not treated when the symptoms are mild, because the parasitemia appears to be transient. However, the microscopical methods used to diagnose this infection are insensitive, and few infected people have been followed longitudinally. We compared the duration of parasitemia in people who had received specific antibabesial therapy with that in silently infected people who had not been treated.
METHODS:
Forty-six babesia-infected subjects were identified from 1991 through 1996 in a prospective, community-based study designed to detect episodes of illness and of seroconversion among the residents of southeastern Connecticut and Block Island, Rhode Island. Subjects with acute babesial illness were monitored every 3 months for up to 27 months by means of thin blood smears, Bab. microti polymerase-chain-reaction assays, serologic tests, and questionnaires.
RESULTS:
Babesial DNA persisted in the blood for a mean of 82 days in 24 infected subjects without specific symptoms who received no specific therapy. Babesial DNA persisted for 16 days in 22 acutely ill subjects who received clindamycin and quinine therapy (P=0.03), of whom 9 had side effects from the treatment. Among the subjects who did not receive specific therapy, symptoms of babesiosis persisted for a mean of 114 days in five subjects with babesial DNA present for 3 or more months and for only 15 days in seven others in whom the DNA was detectable for less than 3 months (P<0.05); one subject had recrudescent disease after two years.
CONCLUSIONS:
When left untreated, silent babesial infection may persist for months or even years. Although treatment with clindamycin and quinine reduces the duration of parasitemia, infection may still persist and recrudesce and side effects are common. Improved treatments are needed.
PMID:
9664092
[PubMed - indexed for MEDLINE]
Free full text
http://www.ncbi.nlm.nih.gov/pubmed/15200851
Emerg Infect Dis. 2004 Apr;10(4):622-9.
Babesia divergens-like infection, Washington State.
Herwaldt BL, de Bruyn G, Pieniazek NJ, Homer M, Lofy KH, Slemenda SB, Fritsche TR, Persing DH, Limaye AP.
Source
Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
Most reported U.S. zoonotic cases of babesiosis have occurred in the Northeast and been caused by Babesia microti. In Washington State, three cases of babesiosis have been reported previously, which were caused by WA1 (for "Washington 1")-type parasites. We investigated a case of babesiosis in Washington in an 82-year-old man whose spleen had been removed and whose parasitemia level was 41.4%. The complete 18S ribosomal RNA gene of the parasite was amplified from specimens of his whole blood by polymerase chain reaction. Phylogenetic analysis showed the parasite is most closely related, but not identical, to B. divergens (similarity score, 99.5%), a bovine parasite in Europe. By indirect fluorescent-antibody testing, his serum reacted to B. divergens but not to B. microti or WA1 antigens. This case demonstrates that babesiosis can be caused by novel parasites detectable by manual examination of blood smears but not by serologic or molecular testing for B. microti or WA1-type parasites.
PMID:
15200851
[PubMed - indexed for MEDLINE]
PMCID:
PMC3323086
Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/19727410
Interdiscip Perspect Infect Dis. 2009;2009:984568. Epub 2009 Aug 27.
Update on babesiosis.
Vannier E, Krause PJ.
Source
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, 800 Washington Street, Box 041, Boston, MA 02111, USA.
Abstract
Human babesiosis is an emerging tick-borne infectious disease caused by intraerythrocytic protozoan species of the genus Babesia with many clinical features similar to those of malaria. Over the last 50 years, the epidemiology of human babesiosis has changed from a few isolated cases to the establishment of endemic areas in the northeastern and midwestern United States. Episodic cases are reported in Europe, Asia, Africa, and South America. The severity of infection ranges from asymptomatic infection to fulminant disease resulting in death, although the majority of healthy adults experience a mild-to-moderate illness. People over the age of 50 years and immunocompromised individuals are at the highest risk of severe disease, including those with malignancy, HIV, lacking a spleen, or receiving immunosuppressive drugs. Asymptomatic carriers present a blood safety risk when they donate blood. Definitive diagnosis of babesial infection generally is made by microscopic identification of the organism on thin blood smear, amplification of Babesia DNA using PCR, and detection of Babesia antibody in acute and convalescent sera. Specific antimicrobial therapy consists of atovaquone and azithromycin or clindamycin and quinine. Exchange transfusion is used in severe cases. The use of multiple prevention strategies is recommended and consists of personal, residential, and community approaches.
PMID:
19727410
[PubMed - in process]
PMCID:
PMC2734943
Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/21233506
Clin Microbiol Rev. 2011 Jan;24(1):14-28.
Transfusion-transmitted Babesia spp.: bull's-eye on Babesia microti.
Leiby DA.
Source
Transmissible Diseases Department, American Red Cross Holland Laboratory, 15601 Crabbs Branch Way, Rockville, MD 20855, USA.
leibyd@usa.redcross.org
Abstract
Babesia spp. are intraerythrocytic protozoan parasites of animals and humans that cause babesiosis, a zoonotic disease transmitted primarily by tick vectors. Although a variety of species or types of Babesia have been described in the literature as causing infection in humans, the rodent parasite Babesia microti has emerged as the focal point of human disease, especially in the United States. Not only has B. microti become established as a public health concern, this agent is increasingly being transmitted by blood transfusion: estimates suggest that between 70 and 100 cases of transfusion-transmitted Babesia (TTB) have occurred over the last 30 years.
A recent upsurge in TTB cases attributable to B. microti, coupled with at least 12 fatalities in transfusion recipients diagnosed with babesiosis, has elevated TTB to a key policy issue in transfusion medicine. Despite clarity on a need to mitigate transmission risk, few options are currently available to prevent the transmission of B. microti by blood transfusion. Future mitigation efforts may stress serological screening of blood donors in regionalized areas of endemicity, with adjunct nucleic acid testing during the summer months, when acute infections are prevalent. However, several hurdles remain, including the absence of a licensed blood screening assay and a thorough cost-benefit analysis of proposed interventions.
Despite current obstacles, continued discussion of TTB without proactive intervention is no longer a viable alternative.
PMID:
21233506
[PubMed - indexed for MEDLINE]
PMCID:
PMC3021205
Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/21192869
Emerg Infect Dis. 2011 Jan;17(1):114-6.
Babesiosis in immunocompetent patients, Europe.
Martinot M, Zadeh MM, Hansmann Y, Grawey I, Christmann D, Aguillon S, Jouglin M, Chauvin A, De Briel D.
Source
Service de Médecine Interne et Rhumatologie, Hôpitaux Civils De Colmar, Colmar, France.
martin.martinot@ch-colmar.fr
Abstract
We report 2 cases of babesiosis in immunocompetent patients in France. A severe influenza-like disease developed in both patients 2 weeks after they had been bitten by ticks. Diagnosis was obtained from blood smears, and Babesia divergens was identified by PCR in 1 case.
Babesiosis in Europe occurs in healthy patients, not only in splenectomized patients.
PMID:
21192869
[PubMed - indexed for MEDLINE]
PMCID:
PMC3204631
Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/21310036
Parasit Vectors. 2011 Feb 10;4:17.
Small risk of developing symptomatic tick-borne diseases following a tick bite in The Netherlands.
Tijsse-Klasen E, Jacobs JJ, Swart A, Fonville M, Reimerink JH, Brandenburg AH, van der Giessen JW, Hofhuis A, Sprong H.
Source
Laboratory for Zoonoses and Environmental Microbiology, Centre for Infectious Disease Control Netherlands, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.
Abstract
BACKGROUND:
In The Netherlands, the incidence of Lyme borreliosis is on the rise. Besides its causative agent, Borrelia burgdorferi s.l., other potential pathogens like Rickettsia, Babesia and Ehrlichia species are present in Ixodes ricinus ticks. The risk of disease associated with these microorganisms after tick-bites remains, however, largely unclear. A prospective study was performed to investigate how many persons with tick-bites develop localized or systemic symptoms and whether these are associated with tick-borne microorganisms.
RESULTS:
In total, 297 Ixodes ricinus ticks were collected from 246 study participants who consulted a general practitioner on the island of Ameland for tick bites. Ticks were subjected to PCR to detect DNA of Borrelia burgdorferi s.l., Rickettsia spp., Babesia spp. or Ehrlichia/Anaplasma spp.. Sixteen percent of the collected ticks were positive for Borrelia burgdorferi s.l., 19% for Rickettsia spp., 12% for Ehrlichia/Anaplasma spp. and 10% for Babesia spp.. At least six months after the tick bite, study participants were interviewed on symptoms by means of a standard questionnaire. 14 out of 193 participants (8.3%) reported reddening at the bite site and 6 participants (4.1%) reported systemic symptoms. No association between symptoms and tick-borne microorganisms was found. Attachment duration ≥24 h was positively associated with reddening at the bite site and systemic symptoms. Using logistic regression techniques, reddening was positively correlated with presence of Borrelia afzelii, and having 'any symptoms' was positively associated with attachment duration.
CONCLUSION:
The risk of contracting acute Lyme borreliosis, rickettsiosis, babesiosis or ehrlichiosis from a single tick bite was <1% in this study population.
PMID:
21310036
[PubMed - indexed for MEDLINE]
PMCID:
PMC3050846
Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/21967706
Parasit Vectors. 2011 Oct 3;4:192.
Towards an integrated approach in surveillance of vector-borne diseases in Europe.
Braks M, van der Giessen J, Kretzschmar M, van Pelt W, Scholte EJ, Reusken C, Zeller H, van Bortel W, Sprong H.
Source
Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Antonie van Leeuwenhoeklaan 9, Bilthoven, the Netherlands.
marieta.braks@rivm.nl
Abstract
Vector borne disease (VBD) emergence is a complex and dynamic process. Interactions between multiple disciplines and responsible health and environmental authorities are often needed for an effective early warning, surveillance and control of vectors and the diseases they transmit. To fully appreciate this complexity, integrated knowledge about the human and the vector population is desirable. In the current paper, important parameters and terms of both public health and medical entomology are defined in order to establish a common language that facilitates collaboration between the two disciplines. Special focus is put on the different VBD contexts with respect to the current presence or absence of the disease, the pathogen and the vector in a given location.
Depending on the context, whether a VBD is endemic or not, surveillance activities are required to assess disease burden or threat, respectively. Following a decision for action, surveillance activities continue to assess trends.
PMID:
21967706
[PubMed - indexed for MEDLINE]
PMCID:
PMC3199249
Free PMC Article
It's very possible that Babesiosis will eventually be found in areas not currently considered endemic. Here is one example from North America:
http://www.journalofparasitology.org/do ... /GE-3083.1
Article Citation:
Kerry Clark, Kyla Savick, and Joseph Butler (2012) Babesia microti in rodents and raccoons from northeast Florida. Journal of Parasitology In-Press.
doi:
http://dx.doi.org/10.1645/GE-3083.1
Regular Article
Babesia microti in rodents and raccoons from northeast Florida
Kerry Clark, Ph.D.1, Kyla Savick2, and Joseph Butler3
a University of North Florida, Associate Professor, Public Health, University of North Florida
b Department of BiologyUniversity of North Florida
c Department of BiologyUniversity of North Florida
Abstract
ABSTRACT: Human babesiosis in the United States is caused most commonly by the intraerythrocytic protozoan parasite, Babesia microti.
Although a few reports have described evidence of Babesia species in animals in Florida, to date Babesia microti specifically has not been reported from Florida or most other southern states. To determine if the organism is present in vertebrates in the region, small mammals were trapped and sampled at 2 sites in northeastern Florida, and DNA extracts from blood samples were screened for B. microti DNA via PCR assays targeting portions of the nuclear small subunit rRNA (18S rDNA) and beta-tubulin genes. Amplified fragments from representative samples of PCR positive hosts were sequenced and compared phylogenetically to reference strains of Babesia species. The B. microti strains found in cotton rats most closely resembles B. microti sensu stricto strains that are pathogenic to humans, and strains found in raccoons most closely resemble previously described raccoon-related strains of B. microti sensu lato.
The results of this study suggest that B. microti is prevalent among cotton rats and raccoons at some sites in northeast Florida, and may pose a risk to humans in the region.
Received: January 6, 2012; Revised: May 18, 2012; Accepted: May 30, 2012