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Babesia microti. Marcus Williamson Katie Hofkes Kayla Jenness. General Information. Hemoprotozoan infection of the red blood cells Babesiids are pyriform, round, or oval parasites Spread to humans by a tick bite, Ixodes scapularis . General Information.

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babesia microti

Babesia microti

Marcus Williamson

Katie Hofkes

Kayla Jenness

general information
General Information
  • Hemoprotozoan infection of the red blood cells
  • Babesiids are pyriform, round, or oval parasites
  • Spread to humans by a tick bite, Ixodes scapularis .
general information3
General Information
  • The disease mostly effects people who are immunocompromised, elderly, or have undergone a splenectomy
  • Approximately 20% of patients diagnosed with Babesiosis also have Lyme disease from the same deer tick bite.
  • While more than 100 species of Babesia have been reported, only a few have been identified as causing human infections.
general information4
General Information
  • Their apical complex is reduced to a polar ring, rhoptries, micronemes, and subpellicular microtubules
geographic distribution
Geographic Distribution
  • Is found worldwide
  • Babesia microti is most commonly found in the Northeast and Midwest in the United States and often in nonsplenectomized patients
  • In the Northeast: Martha’s Vineyard, Nantucket Island, Cape Cod, Long Island are the most common places
  • In the Western US, the causative agent of Babesiosis is Babesia gibsoni
  • There have been cases in Minnesota and Wisconsin as well.
geographic distribution cont d
Geographic Distribution Cont’d
  • Not much is known about Babesia in Malaria-endemic countries
  • In Europe, most reported cases are from Babesia divergens and is found in splenectomized patients
  • In the Southern United States, the infection is called Babesia bigemina, which is a disease of cattle
    • Also called Texas red-water fever
mortality morbidity
Mortality/Morbidity
  • Death in the US is uncommon
  • Most infections are asymptomatic and improve spontaneously without treatment
  • About 25% of patients with Babesiosis also have Lyme disease
  • In Europe, Babesiosis is more serious
    • 84% are asplenic and 53% become comatose and die
  • Male to Female ratio is 1:1 and it affects all age groups
hosts
Hosts
  • Definitive Host- White footed mouse (Peromyscus leucopus)
  • Intermediate Host- Deer Tick (Ixodes scapularis)
  • Accidental Host – Humans (Dead end host)
  • Deer are the hosts which adult ticks feed on but are indirectly part of the life cycle.
life cycle cont d
Life Cycle Cont’d.
  • During a blood meal, a Babesia infected tick introduces sporozoites into the mouse host
  • Sporozoites enter the erythrocytes and undergo asexual reproduction
  • In the blood, some parasites differentiate into male and female gametes
  • Once ingested by a tick, the gametes unite and undergo a sporogenic cycle resulting in sporozoites
life cylce cont d
Life Cylce (Cont’d.)
  • Humans become a part of the cycle when bitten by infected ticks
  • During a blood meal, the Babesia infected tick gives sporozoites to the human host
  • Sporozoites enter the erythrocytes and undergo asexual reproduction
  • Humans are dead end hosts and there is little, if any more transmission that occurs from ticks feeding on infected humans
pathogenesis clinical signs
Pathogenesis/Clinical Signs
  • Majority of people have no visible symptoms
  • Fever, chills, sweating, fatigue
  • Flu-like, tiredness, loss of appetite, muscle pain, nausea, vomiting, headache, shaking chills, blood in urine, and depression can occur.
  • Hepatosplenomegaly
  • Hemolytic Anemia
  • These can occur for several weeks after an incubation period of 1-4 weeks
  • Those over 40 who have had spleen taken out or have serious disease may end up with 85% blood cells infected which leads to possibly death.
diagnosis
Diagnosis
  • Early diagnosis can reduce the severity of the illness.
  • Some people may be infected with more than one tick-borne infection which will make diagnosis more difficult.
  • Examining thick and thin blood smear samples stained with Giesma is the most common way for diagnosis.
  • Antibody detection by indirect fluorescent antibody (IFA) test is a diagnostic test.
  • Isolation of Babesia by inoculation of patients blood into hamsters and gerbils assists in diagnosis also.
treatment
Treatment
  • Treated with antimicrobial drugs.
  • Combination of clindamycin, quinine, atovaquone, and/or azithromycin
  • Clindamycin is by injection and quinine given orally 3-4 times a day for 4-7 days.
  • Exchange transfusions have been used for the severely ill patients.
control measure
Control Measure
  • Avoid tick habitats during the peak time of the year (when deer populations increase)
  • Stay on trails when walking through the woods.
  • Avoid tall grasses.
  • Wear long sleeved shirts and tuck pant legs into socks.
  • Wear insect repellent.
  • Check for ticks after an outing.
tick removal
Tick Removal
  • Use pair of tweezers to grasp the head of the tick.
  • Grasp tick close to the skin.
  • Pull tick outward slowly, gently, steadily.
  • Do not squeeze the tick.
  • Use antiseptic on the tick bite.
pictures
Pictures

Giemsa-stained thin smear

pictures cont d
Pictures Cont’d.

Note: the absence of pigment, variation in the rings, and the tetrad on the left, which is helpful for diagnosis of B. microti

references
References
  • http://www.itg.be/itg/DistanceLearning/LectureNotesVandenEndenE/imagehtml/ppages/kabisa_1396.htm
  • http://www.medterms.com/script/main/art.asp?articlekey=15257
  • http://www.dpd.cdc.gov/dpdx/html/Babesiosis.asp?body=Frames/A-F/Babesiosis/body_Babesiosis_page1.htm
  • http://www.health.state.mn.us/divs/idepc/diseases/babesiosis/basics.html
  • www.healthatoz.com