Babesiosis and Ehrlichiosis reports from US States

28/07/2010 08:46:00

Date: Sat 24 Jul 2010

Source: CIDRAP (Center for Infectious Disease Research & Policy) News [edited]

<http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/jul2110newsscan.html>First zoonotic babesiosis in Tennessee and new ehrlichiosis species in Minnesota and Wisconsin

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Among new tick-related infectious disease findings presented at the International Conference on Emerging Infectious Disease (ICEID), which ended 14 Jul 2010 in Atlanta, were a report on the 1st zoonotic babesiosis case documented in Tennessee and a report on ehrlichiosis infections in Minnesota and Wisconsin involving a species that had not previously been identified in North America [<http://www.iceid.org/images/stories/newsroom/wednesday_abstracts.pdf>].In the 1st report, a group from the Tennessee Department of Health, Vanderbilt University, and the CDC diagnosed babesiosis in an immunosuppressed patient who began to have fever, fatigue, and headache. He had not traveled outside Tennessee in several years and had been exposed to ticks during hunting trips._Babesia_ parasites were noted on the man's blood smear and molecular analysis revealed that it was a novel species, but attempts to isolate it were unsuccessful. The man's symptoms resolved after 10 days of treatment.The researchers said efforts to identify the animal host and tick vectors are ongoing and that the case serves as a reminder that patients can have babesiosis without exposure to known endemic areas and without testing positive to previously known species.In the 2nd report, local health officials and CDC and Mayo Clinic experts described the identification of _Ehrlichia_ DNA from Mayo Clinic blood samples of patients from the 2 states involving a species similar to _E. muris_ that had not been previously identified in North America.The organism was found in 2009 in the blood of 4 patients, 3 from Wisconsin, and 1 from Minnesota. All had reported fever and headache, and all had lymphopenia. All recovered with doxycycline treatment. Serological studies also suggested 40 more probable cases among Wisconsin residents. A survey of the patients found dog contact in 91 percent and possible tick exposure in 85 percent. The group concluded that more studies are needed to identify the epidemiologic and clinical features of infections with the _E. muris_-like organism and that better testing in the region could help identify the infections.==================[A history of tick bites cannot be used to assess risk of infections transmitted by ticks -- the bites can easily pass unnoticed. The report underlines that protozoan infections in ticks such as _Babesia_ and _Ehrlichia_ and probably also rickettsial organisms remain underdiagnosed and are likely to appear in new areas. Immunosuppressed patients are especially vulnerable as illustrated in this report. - ProMed Mod.EP][Ehrlichiosis [is caused by] a group of tick-borne zoonotic diseases that are due to rickettsia-like obligate intracellular bacteria and are usually named according to the host species and the type of white blood cell most often infected. In 2001, when the taxonomy of the ehrlichiae was changed, the name of _Ehrlichia phagocytophila_ was changed to _Anaplasma phagocytophilum_ and the name of the disease it caused was changed from human granulocytic ehrlichiosis to human granulocytic anaplasmosis (<http://riki-lb1.vet.ohio-state.edu/ehrlichia/background/ehrlichiaspp.php>).The name for human monocytic or monocytotropic ehrlichiosis and its pathogen, _Ehrlichia chaffeensis_ remain unchanged. _Ehrlichia muris_ has been found in rodents in Japan (Wen B, et al. _Ehrlichia muris_ p. nov. Identified on the Basis of 16s rRNA Base Sequences and Serological, Morphological, and Biological Characteristics. Internat J Syst Bacteriol 1998; 45: 250-254). Although not previously known to be associated with any human disease, it can cause murine monocytotropic ehrlichiosis.- ProMed Mod.ML][The states mentioned in this report can be located on theHealthMap/ProMED-mail interactive map of the US at<http://healthmap.org/r/01b_>. - ProMed Sr.Tech.Ed.MJ]

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Babesiosis and Ehrlichiosis reports from US States