Babesiosis in Immunocompetent Patients | CDC EID

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Volume 17, Number 1–January 2011
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Babesiosis in Immunocompetent Patients, Europe

Martin Martinot, Comments to Author Mahsa Mohseni Zadeh, Yves Hansmann, Isabelle Grawey, Daniel Christmann, Sarah Aguillon, Maggy Jouglin, Alain Chauvin, and Dominique De Briel

Author affiliations: Hôpitaux Civils De Colmar, Colmar, France (M. Martinot, M.M. Zadeh, I. Grawey, S. Aguillon, D. De Briel); Hôpitaux Universitaires de Strasbourg, Strasbourg, France (Y. Hansmann, D. Christmann); École Nationale Vétérinaire Agroalimentaire et de l'Alimentation Nantes-Atlantique, Nantes, France (M. Jouglin, A. Chauvin); and Institut National de la Recherche Agronomique, Nantes (M. Jouglin, A. Chauvin)

Suggested citation for this article

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.

Babesiosis, a tick-borne infectious disease that occurs worldwide, is caused by species of Babesia, an intraerythrocytic parasite (1). Babesia spp. parasites infect wild and domesticated animals and may cause a malaria-like syndrome. The first human case was described in 1957 in a splenectomized Yugoslavian farmer who died (2). More than 100 Babesia species infect animals, but human infection has been associated with only a few species, mainly B. microti and B. divergens (1–3). B. microti parasites are transmitted by Ixodes scapularis ticks and infect rodents. Since 1957, these parasites have caused hundreds of human babesiosis cases in the United States, the most affected country. Infections are found mainly in healthy persons and manifest as asymptomatic or mild to moderate illness; severe disease, even in immunocompromised or elderly patients, is seldom reported (2,3). B. divergens parasites are endemic to Europe; they are transmitted by I. ricinus ticks and infect bovines (4). In Europe, the disease is rare in humans; ≈40 cases have been reported (2,3,5–7). These cases are almost exclusively severe in immunocompromised patients, especially those whose spleens have been removed (2,3,8). B. divergens parasites are responsible for >70% of these cases (2,8), although the disease is not always confirmed by molecular-based methods.

We report 2 cases of human babesiosis in Colmar, Alsace, a northeastern region of France in which Lyme disease is endemic. The disease was diagnosed in spring 2009 in healthy young persons without history of travel abroad who experienced a marked influenza-like syndrome and recovered. These cases should change the classic description of babesiosis in Europe, in which the disease was thought to affect immunocompromised patients exclusively. Our study indicates that this disease also occurs in Europe among immunocompetent patients.

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Babesiosis in Immunocompetent Patients | CDC EID


Suggested Citation for this Article

Martinot M, Zadeh MM, Hansmann Y, Grawey I, Christmann D, Aguillon S, et al. Babesiosis in immunocompetent patients, Europe. Emerg Infect Dis [serial on the Internet]. 2011 Jan [date cited]. http://www.cdc.gov/EID/content/17/1/114.htm

DOI: 10.3201/eid1701.100737

Comments to the Authors

Please use the form below to submit correspondence to the authors or contact them at the following address:

Martin Martinot, Service de Médecine Interne et Rhumatologie, Hôpitaux Civils de Colmar, 39 Ave de la Liberté, 68024, Colmar, France; email: martin.martinot@ch-colmar.fr

Babesiosis in Immunocompetent Patients | CDC EID