Ahead of Print -Human Babesiosis, Maine, USA, 1995–2011 - Volume 20, Number 10—October 2014 - Emerging Infectious Disease journal - CDC

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Ahead of Print -Human Babesiosis, Maine, USA, 1995–2011 - Volume 20, Number 10—October 2014 - Emerging Infectious Disease journal - CDC

Volume 20, Number 10—October 2014

Dispatch

Human Babesiosis, Maine, USA, 1995–2011

On This Page

• The Study
• Conclusions
• Suggested Citation

Figures

• Figure 1
• Figure 2

Tables

• Table 1
• Table 2

Robert P. Smith, Susan P. Elias , Timothy J. Borelli, Bayan Missaghi, Brian J. York, Robert A. Kessler, Charles B. Lubelczyk, Eleanor H. Lacombe, Catherine M. Hayes, Michael S. Coulter, and Peter W. Rand

Author affiliations: Maine Medical Center Research Institute, South Portland, Maine, USA (R.P. Smith Jr,, S.P. Elias, C.B. Lubelczyk, E.H. Lacombe, P.W. Rand); Maine General Medical Center, Augusta, Maine (T.J. Borelli);University of Calgary, Department of Medicine, Calgary, Alberta, Canada (B. Missaghi); Alberta Health Services (Calgary Zone), Calgary (B. Missaghi); Kadlec Regional Medical Center, Richland, Washington, USA (B.J. York);University of Maryland, Baltimore, Maryland, USA (R.A. Kessler); University of Vermont College of Medicine, Burlington, VT, USA (C. M. Hayes); Denver Health and Hospital Authority, Denver, Colorado, USA (M.S. Coulter)

Suggested citation for this article

Abstract

We observed an increase in the ratio of pathogenic Babesia microti to B. odocoilei in adult Ixodes scapularis ticks in Maine. Risk for babesiosis was associated with adult tick abundance, Borrelia burgdorferi infection prevalence, and Lyme disease incidence. Our findings may help track risk and increase the focus on blood supply screening.

Babesiosis caused by Babesia microti is a potentially life-threatening parasitic infection transmitted by Ixodes scapularis, the deer, or black-legged, tick; it is of increasing concern as a transfusion-acquired illness (1,2). Since its recognition on Nantucket Island and Cape Cod, Massachusetts, USA, during the 1970s (3), human babesiosis from B. microti infection has become a public health threat in an increasing number of foci in the northeastern and upper midwestern United States (1). Risk for infection by B. microti remains geographically more localized than for other pathogens transmitted by I. scapularis ticks, such as Borrelia burgdorferi (4–6). This localization may be associated with dense populations of I. scapularis ticks and high prevalence of B. burgdorferi in ticks (6,7). Therefore, entomologic data may help predict risk for human babesiosis (6).

The presence of B. microti–infected ticks in Maine was first documented in 1995 from a town in which Lyme disease was endemic (7,8). The first case of human babesiosis reported in Maine occurred in 2001, 15 years after the first case of Lyme disease occurred in the state (8,9). A transfusion-associated case of babesiosis in2007 originated from a blood donor in Maine (10). We report on the geographic and temporal expansion of babesiosis in Maine, entomologic correlates of its emergence, and the seroprevalence of Babesia spp. in blood donors from the 2 southernmost coastal counties.

Dr Smith is Program Director of Infectious Disease at the Maine Medical Center, co-director and co-principal pnvestigator of the Vector-borne Disease Laboratory at the Maine Medical Center Research Institute, and Clinical Professor of Medicine at Tufts University School of Medicine. He has a long-standing interest in the epidemiology and ecology of vectorborne diseases.

Acknowledgment

We thank numerous volunteers and technicians who collected ticks in the field, and scientists who tested ticks in several laboratories. We thank Jacquelyn Hedlund of Maine Center for Cancer Medicine and Bruce Cahill of the Maine Medical Center; the staff of Coral Blood Services, Inc. (formerly of Scarborough, Maine); Anne Breggia, Elizabeth McMenamin, and Ellen McMonagle of the Maine Medical Center Research Institute Research Laboratory Services Core Facility; Diane Caporale of the University of Wisconsin-Stevens Point; Peter Krause and Lindsay Rollend of the Yale University School of Public Health, and Carol Mariani of the DNA Analysis Facility at Yale University. We thank the Maine Center for Disease Control for data and Linda B. Turcotte for administrative support. We also thank the numerous private landowners, land trusts, and town governments, and the Wells National Estuarine Reserve and the State of Maine for access to private and public lands for field collections. The Mentored Research Committee of the Maine Medical Center Research Institute provided financial support for portions of this study.

References

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2. Vannier E, Krause PJ. Human babesiosis. N Engl J Med. 2012;366:2397–407 . DOIPubMed
3. Ruebush TK, Juranek DD, Spielman A, Piesman J, Healy GR. Epidemiology of human babesiosis on Nantucket Island. Am J Trop Med Hyg.1981;30:937–41 http://www.ajtmh.org/content/30/5/937.long.PubMed
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7. Armstrong PM, Katavolos P, Caporale DA, Smith RP, Spielman A, Telford SR. Diversity of Babesia infecting deer ticks (Ixodes dammini). Am J Trop Med Hyg. 1998;58:739–42 and http://www.ajtmh.org/content/58/6/739.long.PubMed
8. Holman MS, Caporale DA, Goldberg J, Lacombe E, Lubelczyk C, Rand PW, Anaplasma phagocytophilum, Babesia microti, and Borrelia burgdorferiin Ixodes scapularis, southern coastal Maine. Emerg Infect Dis. 2004;10:744–6 . DOIPubMed
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10. Ngo V, Civen R. Babesiosis acquired through blood transfusion, California, USA. Emerg Infect Dis. 2009;15:785–7. DOIPubMed
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12. Rand PW, Lubelczyk C, Holman MS, Lacombe EH, Smith RP. Abundance of Ixodes scapularis (Acari:Ixodidae) after the complete removal of deer from an isolated offshore island, endemic for Lyme disease. J Med Entomol. 2004;41:779–84 . DOIPubMed
13. Rand PW, Lacombe EH, Dearborn R, Cahill B, Elias S, Lubelczyk CB, Passive surveillance in Maine, an area emergent for tick-borne disease. J Med Entomol. 2007;44:1118–29 . DOIPubMed
14. Krause PJ, Telford SR, Ryan R, Conrad PA, Wilson M, Thomford JW, Diagnosis of babesiosis: evaluation of a serologic test for the detection ofBabesia microti antibody. J Infect Dis. 1994;169:923–6 . DOIPubMed
15. Johnson ST, Cable RG, Tonnetti L, Spencer B, Rios J, Leiby DA. Seroprevalence of Babesia microti in blood donors from Babesia-endemic areas of the northeastern United States: 2000 through 2007. Transfusion. 2009;49:2574–82 . DOIPubMed

Figures

• Figure 1. Human babesiosis cases reported by county, Maine, 2001–2011.
• Figure 2. Distribution of towns sampled for questing adult Ixodes scapularis ticks, Maine, 1995–2011.

Tables

• Table 1. Prevalence of Borrelia burgdorferi in Ixodes scapularis ticks and incidence of Lyme disease and human babesiosis, Maine, 1995–2011
• Table 2. Emergence of Babesia microti in Ixodes scapularis ticks, Maine, 1995–2011

Suggested citation for this article: Smith RP Jr, Elias SP, Borelli TJ, Missaghi B, York BJ, Kessler RA, et al. Human babesiosis, 1995–2011, Maine, USA. Emerg Infect Dis. 2014 Oct [date cited]. http://dx.doi.org/10.3201/eid2010.130938

DOI: 10.3201/eid2010.130938