11 : Emerging Perspectives on Human Babesiosis

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Emerging Perspectives on Human Babesiosis, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816988/9781555812164_Chap11-1.gif /docserver/preview/fulltext/10.1128/9781555816988/9781555812164_Chap11-2.gif


Babesial parasites have special historical significance because the babesial agent of Texas cattle fever, characterized by Smith and Kilborne in 1893, was the first arthropod-transmitted pathogen described in vertebrates. The first case of human babesiosis in an individual from the eastern United States was reported in 1969 and attracted the interest of the medical community because it was a fulminating case in a spleen-intact patient. The first clinical studies of human babesiosis described erythema chronicum migrans-like lesions in the early stages of disease. Awareness of human babesiosis has prompted the identification of new human cases worldwide. Reports of human babesiosis around the world underscore the likelihood that many such cases go undetected, possibly because of unfamiliarity of physicians with the disease. Similarly, in South Africa, two human cases initially diagnosed as malaria were later recognized as cases of human babesiosis after reexamination of blood smears revealed merozoites in erythrocytes without pigment but with nonstaining vacuoles and many multiply infected erythrocytes, all of which are charactersitic of babesial infections. An increasing population of immunocompromised individuals will result in an increase in the number of human babesiosis cases. Parasitemias in human infection with range from 1 to 50% of the erythrocytes. In chronically infected individuals, the sensitivity of the PCR technique targeting the 18S ss rRNA gene would be low due to the small number of parasites in a sample and the small number of target genes present in spp.

Citation: Kjemtrup A, Conrad P. 2001. Emerging Perspectives on Human Babesiosis, p 175-196. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch11

Key Concept Ranking

Rocky Mountain Spotted Fever
Tumor Necrosis Factor alpha
Human Lyme Disease
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of Figure 1
Figure 1

Phylogenetic tree inferred from neighbor-joining analysis of piroplasm species using an alignment of the entire 18S ss rRNA gene sequence. Numbers above the lines represent the percentage of replicates out of 500 bootstrap samplings in which the given branching pattcrn was obtained. GenBank accession numbers for the sequences used are noted in parentheses after the isolate name.

Citation: Kjemtrup A, Conrad P. 2001. Emerging Perspectives on Human Babesiosis, p 175-196. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 5. ASM Press, Washington, DC. doi: 10.1128/9781555816988.ch11
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Anderson, J. F.,, R. C. Johnson,, I. A. Magnarelli,, F. W. Hyde,, and J. E. Myers. 1986. Peromyscus leucopus and Microtus pennsylvanicus simultaneously infected with Borrelia burgdorferi and Babesia microti. J. Clin. Microbial. 23:135137.
2. Anderson, J. F.,, E. D. Mintz,, J. J. Gadbaw,, and L. A. Magnarelli. 1991. Babesia microti, human babesiosis, and Borrelia burgdorferi in Connecticut. J. Clin. Microbial. 29:27792783.
3. Babès, V. 1888. Sur I'hémoglobinurie bactèrienne du boeuf. C. R. Acad. Sci. 107:692694.
4. Benach, J. 1.., J. L. Coleman, G. S. Habicht, A. MacDonald, E. Grunwaldt, and J. A. Giron. 1985. Serological evidence for simultaneous occurrences of Lyme disease and babesiosis. J. Infect. Dis. 152:473477.
5. Benach, J.L., , and G. S. Habicht. 1981. Clinical characteristics of human babesiosis. J. Infect. Dis. 144:481.
6. Benach, J. 1.., D. J. White, and J. P. McGovern. 1978. Babesiosis in Long Island. Host-parasite relationships of rodent- and human-derived Babesia micrati isolates in hamsters. Am. J. Trap. Med. Hyg. 27:10731078.
7. Benezra, D.,, A. E. Brown,, B. Polsky,, J. W. Gold, and D, Armstrong. 1987. Babesiosis and infection with human immunodeficiency virus (HIV). Ann. Intern. Med. 107:944.
8. Bonoan, J. T.,, D. H. Johnson,, and B. A. Cunha. 1998. Life-threatening babesiosis in an asplenic patient treated with exchange transfusion, azithromycin, and atovaquone. Heart Lung 27:424428.
9. Böse, R.,, W. K. Jorgensen,, R. J. Dalgliesh,, K. T. Friedhoff,, and A. J. de Vos. 1995. Current state and future trends in the diagnosis of babesiosis. Vet. Parasitol. 57:6174.
10. Boustani, M. R.,, and J. A. Gelfand. 1996. Babesiosis. Clin. Infect. Dis. 22:611615.
11. Boustani, M. R.,, T. J. Lepore,, J. A. Gelfand, and D. S. Lazarus. 1994. Acute respiratory failure in patients treated for babesiosis. Am. J. Respir. Cnt. Care. Med. 149:16891691.
12. Brandt, F.,, G. R. Healy,, and M. WeIch. 1977. Human babesiosis: the isolation of Babesia microti in golden hamsters. J. Parasitol. 63:934937.
13. Bredt, A. B.,, W. M. Weinstein,, and S. Cohen. 1981. Treatment of babesiosis in asplenic patients. JAMA 245:19381939.
14. Bush, J. B.,, M. Isaäcson,, A. S. Mohamed,, F. T. Potgieter,, and D. T. de Waal. 1990. Human babesiosis-a preliminary report of 2 suspected cases in South Africa. S. Afr. Med. J. 78:699.
15.California Department of Health Services. 1994. Babesiosis in California-a Two Part Series, p. 710. California Department of Health Services, Berkeley.
16. Calvo de Mora, A.,, J. M. García Castellano,, C. Herrera,, and J. Jimenez-Alonso. 1985. Human babesiosis: report of a case with fatal outcome. Med. Clin. (Barcelona). 85:515516.
17. Canas, E.,, A. de Alarcon,, C. Regordan,, and P. Viciana. 1992. Babesiosis in an immunocompetent patient. Rev. Clin. Espan. 190:45. (In Spanish.)
18. Chauvin, A.,, M. L'Hostis,, A. Valentin,, E. Precigout,, N. Cesbron-Zeggane,, and A. Gorenflot. 1995. Babesia diver gens: an ELISA with soluble parasite antigen for monitoring the epidemiology of bovine babesiosis. Parasite 2:257262.
19. Clark, I. A.,, and L. S. Jacobson. 1998. Do babesiosis and malaria share a common disease process? Ann. Trop. Med. Parasitol. 92:483488.
20. Conrad, P.,, J. Thomford,, I. Yamane,, J. Whiting,, L. Bosma,, T. Uno,, H. J. Holshuh,, and S. Shelly. 1991. Hemolytic anemia caused by Babesia gibsoni infection in dogs. J. Am. Vet. Med. Assoc. 199:601605.
21. Cox, F. E.,, and F. Y. Liew. 1992. T-cell subsets and cytokines in parasitic infections. Immunol. Today 13:445448.
22. Cullen, J. M.,, and J. F. Levine. 1987. Pathology of experimental Babesia microti infection in the Syrian hamster. Lab. Anim. Sci. 37:640643.
23. Dalrymple, B. P.,, C. M. Dimmock,, F. Parrodi,, and I. G. Wright. 1992. Babesia bovis, Babesia bigemina, Babesia canis, Babesia microti and Babesia rodhaini: comparison of ribosomal RNA gene organization. Int. J. Parasitol. 22:851855.
24. Damrow, T.,, H. Freedman,, R. S. Lane,, and K. L. Preston. 1989. Is Ixodes (Ixodiopsis) angustus a vector of Lyme disease in Washington state? West. J. Med. 150:580582.
25. Dao, A. H.,, and M. L. Eberhard. 1996. Pathology of acute fatal babesiosis in hamsters experimentally infected with the WA-l strain of Babesia. Lab. Investig. 74:853859.
26. Daszak, P.,, A. A. Cunningham,, and A. D. Hyatt. 2000. Emerging infectious diseases of wildlifethreats to biodiversity and human health. Science 287:443449.
27. Denes, E.,, J. P. Rogez,, M. L. Dardé,, and P. Weinbreck. 1999. Management of Babesia diver gens babesiosis without a complete course of quinine treatment. Eur. J. Clin. Microbiol. Infect. Dis. 18: 672673.
28. Dobroszycki, J.,, B. L. Herwaldt,, F. Boctor,, J. R. Miller,, J. Linden,, M. L. Eberhard,, J. J. Yoon,, N. M. Ali,, H. B. Tanowitz,, F. Graham,, L. M. Weiss,, and M. Wittner. 1999. A cluster of transfusion- associated babesiosis cases traced to a single asymptomatic donor. J. Am. Med. Assoc. 281:927930.
29. Esernio-Jenssen, D.,, P. G. Scimeca,, J. L. Benach,, and M. J. Tenenbaum. 1987. Transplacental! perinatal babesiosis. J. Pediatr. 110:570572.
30. Eskow, E. S.,, P. J. Krause,, A. Spielman,, K. Freeman,, and J. Aslanzadeh. 1999. Southern extension of the range of human babesiosis in the eastern United States. J. Clin. Microbiol. 37:20512052.
31. Etkind, P.,, J. Piesman,, T. K. Ruebush II,, A. Spielman,, and D. D. Juranek. 1980. Methods for detecting Babesia microti infection in wild rodents. J. Parasitol. 66:107110.
32. Euzeby, J. 1989. Epidemiology of human babesiosis in Europe. Prophylactic results. Bull. Acad. Natl. Med. 173:3137.
33. Evenson, D. A.,, E. Perry,, B. Kloster,, R. Hurley,, and D. F. Stroncek. 1998. Therapeutic apheresis for babesiosis. J. Clin. Apheresis 13:3236.
34. Falagas, M. E.,, and M. S. Klempner. 1996. Babesiosis in patients with AIDS: a chronic infection presenting as fever of unknown origin. Clin. Infect. Dis. 22:809812.
35. Fay, F. H.,, and R. L. Rausch. 1969. Parasitic organisms in the blood of arvicoline rodents in Alaska. J. Parasitol. 55:12581265.
36. Fritz, C. L.,, A. M. Kjemtrup,, P. A. Conrad,, G. R. Flores,, G. L. Campbell,, M. E. Schriefer,, D. Gallo,, and D. J. Vugia. 1997. Seroepidemiology of emerging tickborne infectious diseases in a Northern California community. J. Infect. Dis. 175:14321439.
37. Furman, D. P.,, and E. C. Loomis. 1984. The Ticks of California (Acari: Ixodida). University of California Press, Berkeley.
38. Gerber, M. A.,, E. D. Shapiro,, P. J. Krause,, R. G. Cable,, S. J. Badon,, and R. W. Ryan. 1994. The risk of acquiring Lyme disease or babesiosis from a blood transfusion. J. Infect. Dis. 170:231234.
39. Gleason, N. N.,, G. R. Healy,, K. A. Western,, G. D. Benson,, and M. G. Schultz. 1970. The "Gray" strain of Babesia microti from a human case established in laboratory animals. J. Parasitol. 56:12561257.
40. Goethert, H. K.,, E. W. Lance,, J. A. Cook,, and S. R. Telford. 1999. Prevalence and genetic diversity of Babesia microti in Beringian microtine populations. Am. J. Trop. Med. Hyg. 61(Supp1.): 355.
41. Goff, W. L.,, D. A. Jessup,, K. A. Waldrup,, J. W. Thomford,, P. A. Conrad,, W. M. Boyce,, J. R. Gorham,, and G. G. Wagner. 1993. The isolation and partial characterization of a Babesia sp. from desert bighorn sheep (Ovis canadensis nelsoni). J. Eukaryot. Microbiol. 40:237243.
42. Gorenflot, A.,, P. Brasseur,, E. Precigout,, M. L'Hostis,, A. Marchand,, and J. Schrevel. 1991. Cytological and immunological responses to Babesia divergens in different hosts: ox, gerbil, man. Parasitol. Res. 77:312.
43. Gorenflot, A.,, M. Marjolet,, M. L'Hostis,, A. Couatarmanc'h,, and A. Marchand. 1987. Existence probable en France de babesioses humaines asymptomatiques, p. 134. In Proceedings of the Third International Conference on Malaria and Babesiosis. Fondation Marcel Merieux, Lyon, France.
44. Gorenflot, A.,, K. Moubri,, E. Precigout,, B. Carey,, and T. P. Schetters. 1998. Human babesiosis. Ann. Trop. Med. Parasitol. 92:489501.
45. Gupta, P.,, R. W. Hurley,, P. H. Helseth,, J. L. Goodman,, and D. E. Hammerschmidt. 1995. Pancytopenia due to hemophagocytic syndrome as the presenting manifestation of babesiosis. Am. J. Hematol. 50:6062.
46. Healy, G. R.,, P. D. Walzer,, and A. J. Sulzer. 1976. A case of asymptomatic babesiosis in Georgia. Am. J. Trop. Med. Hyg. 25:376378.
47. Hemmer, R. H.,, D. A. Ferrick,, and P. A. Conrad. 2000. Role of T cells and cytokines in fatal and resolving experimental babesiosis: protection in the TNFRp55-/- mice infected with the human Babesia WAI parasite. J. Parasitol. 86:736742.
48. Hemmer, R. M.,, D. A. Ferrick,, and P. A. Conrad. 2000. Up-regulation of tumor necrosis factoralpha and interferon-gamma expression in the spleen and lungs of mice infected with the human Babesia isolate WA1. Parasitol. Res. 86:121128.
49. Hemmer, R. M.,, E. J. Wozniak,, L. J. Lowenstine,, C. G. Plopper,, V. Wong,, and P. A. Conrad. 1999. Endothelial cell changes are associated with pulmonary edema and respiratory distress in mice infected with the WAI human Babesia parasite. J. Parasitol. 85:479489.
50. Herwaldt, B.,, D. H. Persing,, E. A. Precigout,, W. L. Goff,, D. A. Mathiesen,, P. W. Taylor,, M. L. Eberhard,, and A. F. Gorenflot. 1996. A fatal case of babesiosis in Missouri: identification of another piroplasm that infects humans. Ann. Intern. Med. 124:643650.
51. Herwaldt, B. L.,, A. M. Kjemtrup,, P. A. Conrad,, R. C. Barnes,, M. Wilson,, M. G. McCarthy,, M. H. Sayers,, and M. L. Eberhard. 1997. Transfusion-transmitted babesiosis in Washington State: first reported case caused by a WA1-type parasite. J. Infect. Dis. 175:12591262.
52. Herwaldt, B. L.,, F. E. Springs,, P. P. Roberts,, M. L. Eberhard,, K. Case,, D. H. Persing,, and W. A. Agger. 1995. Babesiosis in Wisconsin: a potentially fatal disease. Am. J. Trop. Med. Hyg. 53:146151.
53. Homer, M. J.,, E. S. Bruinsma,, M. J. Lodes,, M. H. Moro,, S. R. Telford III,, P. J. Krause,, L. D. Reynolds,, R. Mohamath,, D. R. Benson,, R. L. Houghton,, S. G. Reed,, and D. H. Persing. 2000. A polymorphic multigene family encoding an immunodominant protein from Babesia microti. J. Clin. Microbiol. 38:362368.
54. Hsu, N. H.,, and J. H. Cross. 1977. Serologic survey for human babesiosis on Taiwan. Taiwan I Hsueh Hui Tsa Chih 76:950954.
55. Hu, R.,, and K. E. Hyland. 1997. Human babesiosis in the United States: a review with emphasis on its tick vector. Syst. Appl. Acarol. 2:316.
56.Institute of Medicine Committee on Emerging Microbial Threats to Health ( J. Lederberg,, R. E. Shope,, and S. C. Oaks [ed.]). 1992. Emerging Infections: Microbial Threats to Health in the United States. National Academy Press, Washington, D.C.
57. Jacoby, G. A.,, J. V. Hunt,, K. S. Kosinski,, Z. N. Demirjian,, C. Huggins,, P. Etkind,, L. C. Marcus,, and A. Spielman. 1980. Treatment of transfusion-transmitted babesiosis by exchange transfusion. N. Engl. J. Med. 303:10981100.
58. Jacquemin, L.,, C. Bazin,, C. Lamy,, C. Chubilleau,, T. Barale,, P. Daoudal,, and C. Duhamel. 1980. Babèsiose (ou piroplasmose) humaine: 11 propos de trois observations récentes en France. Maghreb Inform. Med. 2:3138.
59. Jerant, A. F.,, and A. D. Arline. 1993. Babesiosis in California. West. J. Med. 158:622625.
60. Kim, N.,, G. S. Rosenbaum,, and B. A. Cunha. 1998. Relative bradycardia and lymphopenia in patients with babesiosis. Clin. Infect. Dis. 26:12181219.
61. Kjemtrup, A. M.,, A. A. Kocan,, L. Whitworth,, J. Meinkoth,, A. J. Birkenheuer,, J. Cummings,, M. K. Boudreaux,, S. L. Stockham,, A. Irizarry-Rovira,, and P. A. Conrad. 2001. There are at least three genetically distinct small piroplasms from dogs. Int. J. Parasitol. 30:15011505.
62. Kjemtrup, A. M.,, T. Robinson,, and P. A. Conrad. 2001. Description and epidemiology of Theileria youngi sp. n. from a northern Californian dusky-footed woodrat (Neotoma juscipes) population. J. Parasitol. 87:373378.
63. Kjemtrup, A. M.,, J. Thomford,, T. Robinson,, and P. A. Conrad. 2000. Phylogenetic relationships of human and wildlife piroplasm isolates in the western United States inferred from the 18S nuclear small subunit RNA gene. Parasitology 120:487493.
64. Kjemtrup, A. M.,, J. T. Thomford,, I. A. Gardner,, and P. A. Conrad. 1995. Seroprevalence of two Babesia spp. isolates in selected bighorn sheep (Ovis canadensis) and mule deer (Odocoileus hemionus) populations in California. J. Wildl. Dis. 31:467471.
65. Krause, P. J.,, and H. M. Feder, Jr. 1994. Lyme disease and babesiosis. Adv. Pediatr. Infect. Dis. 9:183209.
66. Krause, P. J.,, T. Lepore,, V. K. Sikand,, J. Gadbaw,, G. Burke,, S. R. Telford,, P. Brassard,, D. Pearl,, J. Azlanzadeh,, D. Christianson,, D. McGrath,, and A. Spielman. 2000. Atovaquone and azithromycin for the treatment of babesiosis. N. Engl. J. Med. 343:14541458.
67. Krause, P. J.,, R. Ryan,, S. R. Telford III,, D. Persing,, and A. Spielman. 1996. Efficacy of immunoglobulin M serodiagnostic test for rapid diagnosis of acute babesiosis. J. Clin. Microbiol. 34:20142016.
68. Krause, P. J.,, A. Spielman,, S. R. Telford III,, V. K. Sikand,, K. McKay,, D. Christianson,, R. J. Pollack,, P. Brassard,, J. Magera,, R. Ryan,, and D. H. Persing. 1998. Persistent parasitemia after acute babesiosis. N. Engl. J. Med. 339:160165.
69. Krause, P. J.,, S. R. Telford III,, R. Ryan,, P. A. Conrad,, M. Wilson,, J. W. Thomford,, and A. Spielman. 1994. Diagnosis of babesiosis: evaluation of a serologic test for the detection of Babesia microti antibody. J. Infect. Dis. 169:923926.
70. Krause, P. J.,, S. R. Telford III,, A. Spielman,, R. Ryan,, J. Magera,, T. V. Rajan,, D. Christianson,, T. V. Alberghini,, L. Bow,, and D. Persing. 1996. Comparison of PCR with blood smear and inoculation of small animals for diagnosis of Babesia microti parasitemia. J. Clin. Microbiol. 34:27912794.
71. Krause, P. J.,, S. R. Telford III,, A. Spielman,, V. Sikand,, R. Ryan,, D. Christianson,, G. Burke,, P. Brassard,, R. Pollack,, J. Peck,, and D. H. Persing. 1996. Concurrent Lyme disease and babesiosis. Evidence for increased severity and duration of illness. JAMA 275:16571660.
72. Krause, P. J.,, S. R. Telford,, R. Ryan,, A. B. Hurta,, I. Kwasnik,, S. Luger,, J. Niederman,, M. Gerber,, and A. Spielman. 1991. Geographical and temporal distribution of babesial infection in Connecticut. J. Clin. Microbiol. 29:14.
73. Lane, R. S. 1990. Seasonal activity of two human-biting ticks. Calif. Agric. 44:2325.
74. Lane, R. S. 1994. Ticks of California and their public health significance. J. Spirochet. Tick-Borne Dis. 1:7476.
75. Lodes, M. J.,, R. L. Houghton,, E. S. Bruinsma,, R. Mohamath,, L. D. Reynolds,, D. R. Benson,, P. J. Krause,, S. G. Reed,, and D. H. Persing. 2000. Serological expression cloning of novel immunoreactive antigens of Babesia microti. Infect. Immun. 68:27832790.
76. Loutan, L.,, J. Rossier,, G. ZutTerey,, D. Cuenod,, C. Hatz,, H. P. Marti,, and L. Geru. 1993. Imported babesiosis diagnosed as malaria. Lancet 342:749.
77. Machtinger, L.,, S. R. Telford ill,, C. Inducil,, E. Klapper,, S. H. Pepkowitz,, and D. Goldfinger. 1993. Treatment of babesiosis by red blood cell exchange in an HIV-positive, splenectomized patient. J. Clin. Apheresis 8:7881.
78. Magnarelli, L. A.,, J. F. Anderson,, K. C. I. Stafford,, and J. S. Dumler. 1997. Antibodies to multiple tick-borne pathogens of babesiosis, ehrlichiosis, and Lyme borreliosis in white-footed mice. J. Wildl. Dis. 33:466473.
79. Magnarelli, L. A.,, J. W. Ijdo,, J. F. Anderson,, S. J. Padula,, R. A. Flavell,, and E. Fikrig. 1998. Human exposure to a granulocytic Ehrlichia and other tick-borne agents in Connecticut. J. Clin. Microbiol. 36:28232827.
80. Marcus, L. c.,, A. C. Steere,, P. H. Duray,, A. E. Anderson,, and E. B. Mahoney. 1985. Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis. Demonstration of spirochetes in the myocardium. Ann. Intern. Med. 103:374376.
81. Marsaudon, E.,, M. F. Barrault,, D. Testou, and M. Cahiez. 1997. Human babesiosis or pseudo malaria. Med. Mal. Infect. 27:8487.
82. Marsaudon, E.,, J. Camenen,, D. Testou,, P. Bourree,, P. Samson,, and F. Luneau. 1995. Human babesiosis-Babesia canis causing a 40-day period of anuria. Ann. Med. Intern. 146:451452.
83. Mather, T. N.,, M. C. Nicholson,, R. Hu,, and N. J. Miller. 1996. Entomological correlates of Babesia microti prevalence in an area where Ixodes scapularis (Acari:Ixodidae) is endemic. J. Med. Entomol. 33:866870.
84. McQuistion, J. H.,, J. E. Childs,, M. E. Chamberland,, and E. Tabor. 2000. Transmission of tickborne agents of disease by blood transfusion: a review of known and potential risks in the United States. Transfusion 40:274284.
85. Mehlhorn, H.,, and E. Shein. 1984. The piroplasms: life cycle and sexual stages. Adv. Parasitol. 23:37103.
86. Meldrum, S. c.,, G. S. Birkhead,, D. J. White,, J. L. Benach,, and D. L. Morse. 1992. Human babesiosis in New York State: an epidemiological description of 136 cases. Clin. Infect. Dis. 15:10191023.
87. Michael, S. A.,, T. A. Morsy,, and M. F. Montasser. 1987. A case of human babesiosis. J. Egypt. Soc. Parasitol. 17:409410.
88. Mintz, E. D.,, J. F. Anderson,, R. G. Cable,, and J. L. Hadler. 1991. Transfusion-transmitted babesiosis: a case report from a new endemic area. Transfusion 31:365368.
89. Mitchell, P. D.,, K. D. Reed,, and J. M. Hofkes. 1996. Immunoserologic evidence of coinfection with Borrelia burgdorferi, Babesia microti, and human granulocytic Ehrlichia species in residents of Wisconsin and Minnesota. J. Clin. Microbiol. 34:724727.
90. New, D. L.,, J. B. Quinn,, M. Z. Qureshi,, and S. J. Sigler. 1997. Vertically transmitted babesiosis. J. Pediatr. 131:163164.
91. Oliver, J. H., Jr.,, M. R. Owsley,, H. J. Hutcheson,, A. M. James,, C. Chen,, W. S. Irby,, E. M. Dotson,, and D. K. McLain. 1993. Conspecificity of the ticks Ixodes scapularis and I. dammini (Acari: Ixodidae). J. Med. Entomol. 30:5463.
92. Olmeda, A. S.,, P. M. Armstrong,, B. M. Rosenthal,, B. Valladares,, A. del Castillo,, F. de Armas,, M. Miguelez,, A. Gonz31ez,, J. A. Rodríguez Rodríguez,, A. Spielman,, and S. R. Telford III. 1997. A subtropical case of human babesiosis. Acta Trop. 67:229234.
93. Ong, K. R.,, C. Stavropoulos,, and Y. Inada. 1990. Babesiosis, asplenia, and AIDS. Lancet 336:112.
94. Osorno, B. M.,, C. Vega,, M. Ristic,, C. Robles, and S. Ibarra. 1976. Isolation of Babesia spp. from asymptomatic human beings. Vet. Parasitol. 2:111120.
95. Persing, D. H.,, T. F. Smith,, F. C. Tenover,, and T. J. White (ed.). 1993. Diagnostic Molecular Microbiology: Principles and Applications. American Society for Microbiology, Washington, D.C.
96. Persing, D. H.,, and P. A. Conrad. 1995. Babesiosis: new insights from phylogenetic analysis. Infect. Agents Dis. 4:182195.
97. Persing, D. H.,, B. L. Herwaldt,, C. Glaser,, R. S. Lane,, J. W. Thomford,, D. Mathiesen,, P. J. Krause,, D. F. Phillip,, and P. A. Conrad. 1995. Infection with a Babesia-like organism in northern California. N. Engl. J. Med. 332:298303.
98. Persing, D. H.,, D. Mathiesen,, W. F. Marshall,, S. R. Telford III,, A. Spielman,, J. W. Thomford,, and P. A. Conrad. 1992. Detection of Babesia microti by polymerase chain reaction. J. Clin. Microbiol. 30:20972103.
99. Piesman, J.,, and A. Spielman. 1980. Human babesiosis on Nantucket Island: prevalence of Babesia microti in ticks. Am. J. Trop. Med. Hyg. 29:742746.
100. Piesman, J.,, A. Spielman,, P. Etkind,, T. K. Ruebush II,, and D. D. Juranek. 1979. Role of deer in the epizootiology of Babesia microti in Massachusetts, USA. J. Med. Entomol. 15:537540.
101. Prowse, C. V. 1999. Alternatives to standard blood transfusion: availability and promise. Transfus. Med. 9:287299.
102. Pruthi, R. K.,, W. F. Marshall,, J. C. Wiltsie,, and D. H. Persing. 1995. Human babesiosis. Mayo Clin Proc. 70:853862.
103. Quick, R. E.,, B. L. Herwaldt,, J. W. Thomford,, M. E. Garnett,, M. L. Eberhard,, M. Wilson,, D. H. Spach,, J. W. Dickerson,, S. R. Telford III,, K. R. Steingart,, R. PoUock,, D. H. Persing,, J. M. Kobayashi,, D. D. Juranek,, and P. A. Conrad. 1993. Babesiosis in Washington State: a new species of Babesia? Ann. Intern. Med. 119:284290.
104. Raucher, H. S.,, H. Jaffin,, and J. L. Glass. 1984. Babesiosis in pregnancy. Obstet. Gynecol. 63:7S9S.
105. Rodriguez, O. N.,, M. Isabel,, R. T. Dias,, and P. Rodriguez. 1984. Report on infection with Babesia bovis (Babes, 1888) in the human population of the Popular Republic of Mozambique. Rev. Cub. Cienc. Vet. 15:4150.
106. Rosner, F.,, M. H. Zarrabi,, J. L. Benach,, and G. S. Habicht. 1984. Babesiosis in splenectomized adults. Review of 22 reported cases. Am. J. Med. 76:696701.
107. Rothman, K. J.,, and S. Greenland. 1998. Modem Epidemiology. Lippincott-Raven, Philadelphia, Pa.
108. Ruebush, T. K., II,, P. B. Casaday,, H. J. Marsh,, S. A. Lisker,, D. B. Voorhees,, E. B. Mahoney,, and G. R. Healy. 1977. Human babesiosis in Nantucket Island. Clinical features. Ann. Intern. Med. 86:69.
109. Ruebush, T. K., II,, D. D. Juranek,, E. S. Chisholm,, P. C. Snow,, G. R. Healy,, and A. J. Sulzer. 1977. Human babesiosis on Nantucket Island. Evidence for self-limited and subclinical infections. N. Engl. J. Med. 297:825827.
1l0.. Ruebush, T. K., II,, D. D. Juranek,, A. Spielman,, J. Piesman,, and G. R. Healy. 1981. Epidemiology of human babesiosis on Nantucket Island. Am. J. Trop. Med. Hyg. 30:937941.
111. Scholtens, R. G.,, E. H. Braff,, G. A. Healey,, and N. Gleason. 1968. A case of babesiosis in man in the United States. Am. J. Trop. Med. Hyg. 17:810813.
112. Scimeca, P. G.,, M. E. Weinblatt,, G. Schonfeld,, M. H. Kaplan,, and J. H. Kochen. 1986. Babesiosis in two infants from Eastern Long Island, NY. Am. J. Dis. Child. 140:971.
113. Shapiro, E. D. 1997. Tick-borne diseases. Adv. Pediatr. Infect. Dis. 13:187218.
114. Shih, C. M.,, L. P. Liu,, W. C. Chung,, S. J. Ong,, and C. C. Wang. 1997. Human babesiosis in Taiwan: asymptomatic infection with a Babesia microti-like organism in a Taiwanese woman. J. Clin. Microbiol. 35:450454.
115. Shulman, I. A. 1994. Parasitic infections and their impact on blood donor selection and testing. Arch. Pathol. Lab. Med. 118:366370.
116. Skrabalo, Z.,, and Z. Deanovic. 1957. Piroplasmosis in man. Doc. Med. Geogr. Trop. 9:1116.
117. Slovut, D. P.,, E. Benedetti,, and A. J. Matas. 1996. Babesiosis and hemophagocytic syndrome in an asplenic renal transplant recipient. Transplantation 62:537539.
118. Smith, T.,, and F. L. Kilbourne. 1893. Investigation into the nature, causation and prevention of Texas or southern cattle fever, p. 177304. In Bureau of Animal Industries Bulletin, vol. 1. U.S. Department of Agriculture, Washington, D.C.
119. Spielman, A. 1994. The emergence of Lyme disease and human babesiosis in a changing environment. Ann. N. Y. Acad. Sci. 740:146156.
120. Spielman, A. 1976. Human babesiosis on Nantucket Island: transmission by nymphal Ixodes ticks. Am. J. Trop. Med. Hyg. 25:784787.
121. Spielman, A.,, C. M. Clifford,, J. Piesman,, and M. D. Corwin. 1979. Human babesiosis on Nantucket Island, USA: description of the vector, Ixodes (Ixodes) dammini, n. sp. (Acarina: Ixodidae). J. Med. Entomol. 15:218234.
122. Spielman, A.,, J. F. Levine,, and M. L. Wilson. 1984. Vectorial capacity of North American Ixodes ticks. Yale J. BioI. Med. 57:507513.
123. Spielman, A.,, M. L. Wilson,, J. F. Levine,, and J. Piesman. 1985. Ecology of Ixodes damminiborne human babesiosis and Lyme disease. Annu. Rev. Entomol. 30:439460.
124. Stahl, W.,, R. Jackson,, G. Turek,, and H. A. Gaafar. 1978. Babesiosis: malaria mimic. Am. J. Med. Technol. 44:572574.
125. Starcovici, C. 1893. Bemerkungen tiber den durch Babes entdeckten Blutparasiten und die durch denselben hervorgebrachten Krankheiten, die seuchenhafte Hämoglobinurie des Rindes (Babes) das Texasfieber (Th. Smith) und der Carceag der Schafe (Babes). Centbl. Bakteriol. I Orig. 14:18.
126. Steere, A. C.,, N. H. Bartenhagen,, J. E. Craft,, G. J. Hutchinson,, J. H. Newman,, D. W. Rahn,, L. H. Sigal,, P. N. Spieler,, K. S. Stenn,, and S. E. Malawista. 1983. The early clinical manifestations of Lyme disease. Ann. Intern. Med. 99:7682.
127. Steketee, R. W.,, M. R. Eckman,, E. C. Burgess,, J. N. Kuritsky,, J. Dickerson,, W. L. Schell,, M. S. Godsey, Jr.,, and J. P. Davis. 1985. Babesiosis in Wisconsin. A new focus of disease transmission. JAMA 253:26752678.
128. Suliman, T.,, A. Abdoun,, and M. EI Tayeb. 1998. Babesia parasites described from patients bled for malaria. Saudi Med. J. 19:179181.
129. Sweeney, C. J.,, M. Ghassemi,, W. A. Agger,, and D. H. Persing. 1998. Coinfection with Bahesia microti and Borrelia burgdoiferi in a western Wisconsin resident. Mayo Clin. Proc. 73:338341.
130. Telford, S. R., III,, A. Gorenflot,, P. Brasseur,, and A. Spielman,. 1993. Babesial infections in humans and wildlife, p. 147. In J. P. Kreier (ed.), Parasitic Protozoa. Academic Press, Inc., San Diego, Calif.
131. Telford, S. R., III,, and A. Spielman,. 1997. Babesiosis of humans, p. 349359. In L. Collier,, A. Balows,, M. Sussman,, and J. P. Kreier (ed.), Topley and Wilson's Microbiology and Microbial Infections. Edward Arnold, London, United Kingdom.
132. Teutsch, S. M.,, P. Etkind,, E. L. Burwell,, K. Sato,, M. M. Dana,, P. R. Fleishman,, and D. D. Juranek. 1980. Babesiosis in post-splenectomy hosts. Am. l. Trop. Med. Hyg. 29:738741.
133. Thomford, J. W.,, P. A. Conrad,, W. M. Boyce,, P. J. Holman,, and D. A. Jessup. 1993. Isolation and in vitro cultivation of Babesia parasites from free-ranging desert bighorn sheep (avis canadensis nelsoni) and mule deer (Odocoileus hemionus) in California. J. Parasitol. 79:7784.
134. Thomford, J. W.,, P. A. Conrad,, S. R. Telford III,, D. Mathiesen,, B. H. Bowman,, A. Spielman,, M. L. Eberhard,, B. L. Herwaldt,, R. E. Quick,, and D. H. Persing. 1994. Cultivation and phylogenetic characterization of a newly recognized human pathogenic protozoan. J. Infect. Dis. 169: 10501056.
135. Van Peenen, P. F. D.,, S. J. Chang,, A. R. Bankneider,, and F. J. Santana. 1977. Piroplasms from Taiwanese rodents. J. Protozool. 24:310312.
136. Van Peenen, P. F. D.,, and J. F. Duncan. 1968. Piroplasms (Protozoa: Sarcodina) of wild mammals in California. Bull. Wildi. Dis. Assoc. 4:38.
137. Varde, S.,, J. Beckley,, and I. Schwartz. 1998. Prevalence of tick-borne pathogens in Ixodes scapularis in a rural New Jersey county. Emerg. Infect. Dis. 4:9799.
138. Vermeil, C.,, J. Menut,, M. Miegeville,, J. Cruziat,, F. Julienne,, O. Morin,, A. P. Roger,, M. Marjolet,, and C. Bouillard. 1983. Babesiosis, pediatric malaria: does confusion exist in Africa? Bull. Soc. Pafhol. Exot. Fil. 76:797804.
139. Western, K. A.,, G. D. Benson,, N. N. Gleason,, G. R. Healy,, and M. G. Schultz. 1970. Babesiosis in a Massachusetts resident. N. Engl. J. Med. 283:854856.
140. White, D. J.,, J. Talarico,, H. G. Chang,, G. S. Birkhead,, T. Heimberger,, and D. L. Morse. 1998. Human babesiosis in New York State: review of 139 hospitalized cases and analysis of prognostic factors. Arch. Intern. Med. 158:21492154.
141. Wilson, L. B.,, and W. M. Chowning. 1904. Studies in Pyroplasmosis hominis ('spotted fever' or 'tick fever' of the Rocky Mountains). J. Infect. Dis. 1:3157.
142. Wittner, M.,, K. S. Rowin,, H. B. Tanowitz,, J. F. Hobbs,, S. Saltzman,, B. Wenz,, R. Hirsch,, E. Chisholm,, and G. R. Healy. 1982. Successful chemotherapy of transfusion babesiosis. Ann. Intern. Med. 96:601604.
143. Wozniak, E. J.,, L. J. Lowenstine,, R. Hemmer,, T. Robinson,, and P. A. Conrad. 1996. Comparative pathogenesis of human WAI and Babesia microti isolates in a Syrian hamster model. Lab. Anim. Sci. 46:507515.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error