Faculty Mentor
David Jackson
Major/Area of Research
Physician Assistant Studies
Description
Background: Human babesiosis is a parasitic infection caused by species of the protozoan Babesia, most commonly B. microti. The organism invades the erythrocytes causing them to lyse. The infection is transmitted through the Ixodes tick, which is commonly found on white mice and white tailed deer. Outbreaks of this disease most commonly occur in the Northeastern region of the United States, specifically New England and Long Island, New York, during spring and summer months, due to the greater proximity of vectors to humans. Patients who are infected can have a range of symptoms from asymptomatic to severe manifestations, including hospitalizations and mortality.
Methods: Information was gathered through the use of the PubMed search engine. The search terms: (a) human babesiosis, (b) prevalence, (c) prevention, and (d) manifestations were used. To narrow the results the article types were limited to clinical trials and reviews. Other limitations included: (a) full text, (b) publication dates from 2008-2018, and (c) human species. This search provided 102 results.
Results: According to the Centers for Disease Control and Prevention, in 2014 the highest incidence of babesiosis was in the found in: (a) New Jersey (159), (b) Rhode Island (172), (c) Connecticut (205), (d) New York (437), and (e) Massachusetts (537). A total of 1,744 incidences reported in the United States in 2014. Between 2011 and 2014 it was reported that roughly 2,165 cases of babesiosis required hospitalization. The highest rates per state in 2014 were found in: (a) Rhode Island (16.3), (b) Massachusetts (8.0), (c) Connecticut (5.7), (d) Maine (3.2), (e) New Hampshire (3.2), (f) New York (2.4), and (g) New Jersey (1.8). Immunocompromised patients, such as those who are: (a) asplenic, (b) HIV-infected, or (c) fighting malignancy, are more likely to experience severe symptoms and death as a result of babesiosis. In a recent study, those with more than one immunosuppressive condition were more likely to experience a prolonged disease state and despite multiple rounds of therapy, 20% of those patients died.
Conclusions & Recommendations: It is recommended that those who detect a tick bite seek medical attention to remove the tick, and undergo lab testing. Most patients who are asymptomatic do not require treatment. Ill patients are treated for 7-10 days with a combination of two antibiotics. The two options include atovaquone and azithromycin or clindamycin and quinine for severely ill patients. Supportive treatment such as antipyretics and vasopressors may also be helpful. Preventative measures can be taken to lower the risk of babesiosis infection such as: (a) avoiding areas of high grass and shrubbery, (b) frequently mowing the lawn, (c) wearing long clothing when spending time outdoors, (d) checking oneself, children, and pets after spending times outdoors, (e) avoiding going off trails in wooded areas, and (f) wearing long pants that are tucked into socks if planning on spending time in areas where ticks are present. Additionally, many of the areas plagued with high incidence of infection are taking action by educating the public on ways to prevent further infections.
Included in
Tick-Talk: Human Babesiosis
Background: Human babesiosis is a parasitic infection caused by species of the protozoan Babesia, most commonly B. microti. The organism invades the erythrocytes causing them to lyse. The infection is transmitted through the Ixodes tick, which is commonly found on white mice and white tailed deer. Outbreaks of this disease most commonly occur in the Northeastern region of the United States, specifically New England and Long Island, New York, during spring and summer months, due to the greater proximity of vectors to humans. Patients who are infected can have a range of symptoms from asymptomatic to severe manifestations, including hospitalizations and mortality.
Methods: Information was gathered through the use of the PubMed search engine. The search terms: (a) human babesiosis, (b) prevalence, (c) prevention, and (d) manifestations were used. To narrow the results the article types were limited to clinical trials and reviews. Other limitations included: (a) full text, (b) publication dates from 2008-2018, and (c) human species. This search provided 102 results.
Results: According to the Centers for Disease Control and Prevention, in 2014 the highest incidence of babesiosis was in the found in: (a) New Jersey (159), (b) Rhode Island (172), (c) Connecticut (205), (d) New York (437), and (e) Massachusetts (537). A total of 1,744 incidences reported in the United States in 2014. Between 2011 and 2014 it was reported that roughly 2,165 cases of babesiosis required hospitalization. The highest rates per state in 2014 were found in: (a) Rhode Island (16.3), (b) Massachusetts (8.0), (c) Connecticut (5.7), (d) Maine (3.2), (e) New Hampshire (3.2), (f) New York (2.4), and (g) New Jersey (1.8). Immunocompromised patients, such as those who are: (a) asplenic, (b) HIV-infected, or (c) fighting malignancy, are more likely to experience severe symptoms and death as a result of babesiosis. In a recent study, those with more than one immunosuppressive condition were more likely to experience a prolonged disease state and despite multiple rounds of therapy, 20% of those patients died.
Conclusions & Recommendations: It is recommended that those who detect a tick bite seek medical attention to remove the tick, and undergo lab testing. Most patients who are asymptomatic do not require treatment. Ill patients are treated for 7-10 days with a combination of two antibiotics. The two options include atovaquone and azithromycin or clindamycin and quinine for severely ill patients. Supportive treatment such as antipyretics and vasopressors may also be helpful. Preventative measures can be taken to lower the risk of babesiosis infection such as: (a) avoiding areas of high grass and shrubbery, (b) frequently mowing the lawn, (c) wearing long clothing when spending time outdoors, (d) checking oneself, children, and pets after spending times outdoors, (e) avoiding going off trails in wooded areas, and (f) wearing long pants that are tucked into socks if planning on spending time in areas where ticks are present. Additionally, many of the areas plagued with high incidence of infection are taking action by educating the public on ways to prevent further infections.