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Hoeve-Bakker BJA, Çelik G, van den Berg OE, van den Wijngaard CC, Hofhuis A, Reimerink JHJ, Thijsen SFT, Kerkhof K. Seropositivity to tick-borne pathogens in nature management workers in the Netherlands. Ticks Tick Borne Dis 2025; 16:102397. [PMID: 39277996 DOI: 10.1016/j.ttbdis.2024.102397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 09/01/2024] [Accepted: 09/09/2024] [Indexed: 09/17/2024]
Abstract
The incidence of tick-borne infections other than Lyme borreliosis and tick-borne encephalitis is rising in Europe, including the Netherlands. Nature management workers, being highly exposed to ticks, serve as valuable sentinels for seroprevalence studies on tick-borne pathogens (TBPs). This study assessed nature management workers' seropositivity to TBPs including Anaplasma phagocytophilum, Babesia divergens, B. microti, Borrelia burgdorferi s.l., Rickettsia conorii and R. typhi in the Netherlands. In addition, the study examined coexposure to multiple TBPs and identified risk factors for B. burgdorferi s.l.- and A. phagocytophilum-seropositivity. The study included 525 nature management workers who donated serum and completed a questionnaire. Sera were analysed for exposure to A. phagocytophilum, B. divergens, B. microti, R. conorii and R. typhi using immunofluorescence assays. For B. burgdorferi s.l. antibody detection, the recommended two-tier testing strategy was used. Risk factor analysis was performed using logistic regression modelling. Seropositivity was 30.9 % for B. burgdorferi s.l.; 16.4 % for A. phagocytophilum; 6.5 % for R. conorii; 2.3 % for R. typhi; 4.2 % for B. divergens; and 0.4 % for B. microti. Almost half (49.3 %) of the participants demonstrated seropositivity for one or more pathogens. Risk factors for B. burgdorferi s.l.-seropositivity included being male, increasing age and tick bite frequency. For A. phagocytophilum-seropositivity, increasing age and working in North Holland province were significant risk factors. This study illustrates the exposure to TBPs in the Netherlands, emphasizing the need for ongoing vigilance and international collaborations to better understand and address the growing threat of TBPs in regions with demonstrated environmental TBP circulation.
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Affiliation(s)
- B J A Hoeve-Bakker
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Department of Medical Microbiology and Immunology, Diakonessenhuis Hospital, Utrecht, the Netherlands.
| | - G Çelik
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - O E van den Berg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - C C van den Wijngaard
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - A Hofhuis
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - J H J Reimerink
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S F T Thijsen
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - K Kerkhof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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ZAMOTO-NIIKURA A, HAGIWARA K, IMAOKA K, MORIKAWA S, HANAKI KI. Genetic investigation of glycosylphosphatidylinositol (GPI) anchored Bd37 orthologs in Babesia divergens group and potential use of recombinant protein for ecological survey in deer. J Vet Med Sci 2024; 86:1185-1197. [PMID: 39370271 PMCID: PMC11569874 DOI: 10.1292/jvms.24-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 09/24/2024] [Indexed: 10/08/2024] Open
Abstract
The Babesia divergens/B. capreoli group includes parasites with confirmed or possible zoonotic potential to cause human babesiosis. Currently, diagnostic antigen of the group has not been established. In this study, we investigated the ortholog of Bd37, a glycosylphosphatidylinositol (GPI)-anchored major merozoite surface protein of B. divergens sensu stricto, in the Asia lineage of the group. From two genomic isolates from sporozoite/sporoblast stages, three Bd37 gene variants, namely Bd37 JP-A, JP-B, and JP-C, were isolated with 62.3-64.1% amino acid sequence identity. Discriminative blood direct PCR revealed that Bd37 JP-A was encoded in all parasites infecting wild sika deer examined (n=22). While Bd37 JP-B and JP-C genes were randomly detected in 12 and 11 specimens, respectively. Sequencing of all JP-A variants revealed that the gene was polymorphic, with a low ratio of non-synonymous to synonymous substitutions (dN/dS) and that a highly polymorphic region was not related to predicted B-cell epitopes. A recombinant JP-A-based ELISA showed an overall positive rate of 13.9% in sika deer in Japan from north (Hokkaido) to south (Kyushu island) across 24 prefectures (n=360). This positive rate was twice as high as that examined by 18S rRNA-based PCR (6.6%). The geographical trends in infection rates were consistent. This study demonstrated that direct examination was informative for revealing genetic background and selecting antigen candidates. Bd37 orthologs may serve diagnostic purposes in combination with indirect fluorescence assay, which requires biological isolates.
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Affiliation(s)
- Aya ZAMOTO-NIIKURA
- Research Center for Biosafety, Laboratory Animal and Pathogen Bank, National Institute of Infectious Diseases, Tokyo, Japan
| | - Katsuro HAGIWARA
- School of Veterinary Medicine, Rakuno-Gakuen University, Hokkaido, Japan
| | - Koichi IMAOKA
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shigeru MORIKAWA
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Veterinary Medicine, Okayama University of Science, Okayama, Japan
| | - Ken-Ichi HANAKI
- Research Center for Biosafety, Laboratory Animal and Pathogen Bank, National Institute of Infectious Diseases, Tokyo, Japan
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Tijani MK, Svensson J, Adlerborn P, Danielsson L, Teleka A, Lövmar ML, Lindgren PE, Forsberg P, Persson KEM. How to Detect Antibodies Against Babesia divergens in Human Blood Samples. Open Forum Infect Dis 2024; 11:ofae028. [PMID: 38328497 PMCID: PMC10849114 DOI: 10.1093/ofid/ofae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
Background Today only indirect fluorescent antibody assays (IFAs) are commercially available to detect antibodies against Babesia divergens in humans. IFA is subjective and requires highly experienced staff. We have therefore developed an enzyme-linked immunosorbent assay (ELISA)-based method for measuring anti-B. divergens immunoglobulin G antibodies in human blood samples. Methods Crude merozoite extract from in vitro cultures of a new B. divergens isolate was used in ELISA to detect antibodies in different sets of samples: Borrelia burgdorferi-positive samples, healthy individuals, tick-bitten individuals including follow-up samples 3 months later, positive control samples from patients with an active Babesia infection, and samples from malaria-endemic regions. As a reference, IFA was used to detect antibodies in the tick-bitten samples. Western blot was used to evaluate reactions against specific bands in extracts with/without parasites. Results Using IFA as the reference method, the sensitivity and specificity of the ELISA were 86% (12/14) and 100% (52/52). There was a very high correlation (r = -0.84; P = .0004) between IFA dilution factors and ELISA absorbances among the samples classified as positive. Five percent of the B. burgdorferi-positive samples were judged as weakly positive and 5% as strongly positive in our ELISA. Western blot showed that the immunodominant antigens (∼120 kDa) were from merozoites and not from erythrocytes. Conclusions This ELISA can detect antibodies directed against B. divergens, and it can be a useful and easy assay to handle compared with IFA. The ELISA can also measure high and low levels of antibodies, which could give insight into the recency of a B. divergens infection.
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Affiliation(s)
| | - Joel Svensson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
- Laboratory Medicine, Unilabs, Skaraborg Hospital Skövde, Skövde, Sweden
| | - Paula Adlerborn
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
| | - Lena Danielsson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
| | - Alexandra Teleka
- Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Matilda Ljungqvist Lövmar
- Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per-Eric Lindgren
- Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Pia Forsberg
- Division of Infectious Diseases, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina E M Persson
- Department of Laboratory Medicine, Lund University, Lund, Sweden
- Clinical Chemistry and Pharmacology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
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Gandy S, Medlock J, Cull B, Smith R, Gibney Z, Sewgobind S, Parekh I, Harding S, Johnson N, Hansford K. Detection of Babesia species in questing Ixodes ricinus ticks in England and Wales. Ticks Tick Borne Dis 2024; 15:102291. [PMID: 38061320 DOI: 10.1016/j.ttbdis.2023.102291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023]
Abstract
Babesiosis, a disease in humans and animals is caused by piroplasms from the genus Babesia and is transmitted by ixodid ticks. Bovine babesiosis, commonly called redwater fever, is reported in cattle from many regions of the British Isles. The presence of Babesia in questing ticks in the United Kingdom (UK) and its potential impact on public and animal health has not been widely studied. Therefore, this study aimed to assess the presence of Babesia spp. in England and Wales using ticks collected over a six-year period. Questing Ixodes ricinus nymphs were collected at 20 recreational areas between 2014 and 2019 and screened for Babesia. Of 3912 nymphs tested, Babesia spp. were detected in 15, giving an overall prevalence of 0.38% [95%CI: 0.21-0.63%]. A number of Babesia species were identified including B. venatorum (n = 9), B. divergens/capreoli (n = 5) and B. odocoilei-like species (n = 1). Based on the low prevalence of Babesia detected in questing I. ricinus nymphs in the recreational areas studied, the likelihood of exposure to Babesia-infected ticks is lower compared to other pathogens more widely studied in the UK (e.g. Borrelia burgdorferi s.l.). However, localized areas of elevated risk may occur in pockets in England and Wales.
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Affiliation(s)
- Sara Gandy
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down, United Kingdom.
| | - Jolyon Medlock
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down, United Kingdom; NIHR Health Protection Research Unit in Environmental Change and Health, United Kingdom
| | - Benjamin Cull
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down, United Kingdom
| | - Rob Smith
- Health Protection Division, Public Health Wales, Cardiff, United Kingdom
| | - Zoë Gibney
- Emerging Infections and Zoonoses Team, UK Health Security Agency, United Kingdom
| | | | - Insiyah Parekh
- Animal and Plant Health Agency, Addlestone, United Kingdom
| | - Sophie Harding
- Animal and Plant Health Agency, Addlestone, United Kingdom
| | - Nicholas Johnson
- Animal and Plant Health Agency, Addlestone, United Kingdom; Faculty of Health and Medicine, University of Surrey, Guildford, United Kingdom
| | - Kayleigh Hansford
- Medical Entomology and Zoonoses Ecology, UK Health Security Agency, Porton Down, United Kingdom
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Drews SJ, Kjemtrup AM, Krause PJ, Lambert G, Leiby DA, Lewin A, O'Brien SF, Renaud C, Tonnetti L, Bloch EM. Transfusion-transmitted Babesia spp.: a changing landscape of epidemiology, regulation, and risk mitigation. J Clin Microbiol 2023; 61:e0126822. [PMID: 37750699 PMCID: PMC10595070 DOI: 10.1128/jcm.01268-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Babesia spp. are tick-borne parasites with a global distribution and diversity of vertebrate hosts. Over the next several decades, climate change is expected to impact humans, vectors, and vertebrate hosts and change the epidemiology of Babesia. Although humans are dead-end hosts for tick-transmitted Babesia, human-to-human transmission of Babesia spp. from transfusion of red blood cells and whole blood-derived platelet concentrates has been reported. In most patients, transfusion-transmitted Babesia (TTB) results in a moderate-to-severe illness. Currently, in North America, most cases of TTB have been described in the United States. TTB cases outside North America are rare, but case numbers may change over time with increased recognition of babesiosis and as the epidemiology of Babesia is impacted by climate change. Therefore, TTB is a concern of microbiologists working in blood operator settings, as well as in clinical settings where transfusion occurs. Microbiologists play an important role in deploying blood donor screening assays in Babesia endemic regions, identifying changing risks for Babesia in non-endemic areas, investigating recipients of blood products for TTB, and drafting TTB policies and guidelines. In this review, we provide an overview of the clinical presentation and epidemiology of TTB. We identify approaches and technologies to reduce the risk of collecting blood products from Babesia-infected donors and describe how investigations of TTB are undertaken. We also describe how microbiologists in Babesia non-endemic regions can assess for changing risks of TTB and decide when to focus on laboratory-test-based approaches or pathogen reduction to reduce TTB risk.
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Affiliation(s)
- Steven J. Drews
- Microbiology, Donation Policy and Studies, Canadian Blood Services, Edmonton, Alberta, Canada
- Department of Laboratory Medicine and Pathology, Division of Diagnostic and Applied Microbiology, University of Alberta, Edmonton, Alberta, Canada
| | - Anne M. Kjemtrup
- California Department of Public Health, Vector-Borne Disease Section, Sacramento, California, USA
| | - Peter J. Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA
| | - Grayson Lambert
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health and Yale School of Medicine, New Haven, Connecticut, USA
| | - David A. Leiby
- Department of Microbiology, Immunology, and Tropical Medicine, George Washington University, Washington, USA
| | - Antoine Lewin
- Epidemiology, Surveillance and Biological Risk Assessment, Medical Affairs and Innovation, Héma-Québec, Montréal, Quebec, Canada
- Département d'Obstétrique et de Gynécologie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sheila F. O'Brien
- Epidemiology and Surveillance, Canadian Blood Services, Donation Policy and Studies, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Christian Renaud
- Department of Microbiology, CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Laura Tonnetti
- American Red Cross, Scientific Affairs, Holland Laboratories for the Biomedical Sciences, Rockville, Maryland, USA
| | - Evan M. Bloch
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Montero E, Folgueras M, Rodriguez-Pérez M, Pérez-Ls L, Díaz-Arias J, Meana M, Revuelta B, Haapasalo K, Collazos J, Asensi V, Gonzalez LM. Retrospective study of the epidemiological risk and serological diagnosis of human babesiosis in Asturias, Northwestern Spain. Parasit Vectors 2023; 16:195. [PMID: 37296439 DOI: 10.1186/s13071-023-05817-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Babesiosis is a globally growing tick-borne disease in humans. Severe babesiosis caused by Babesia divergens has been reported in two patients from Asturias (Northwestern Spain), suggesting an undetected risk for the disease. To analyze this risk, we retrospectively evaluated the seroprevalence of babesiosis in the Asturian population from 2015 through 2017, a period covering the intermediate years in which these two severe cases occurred. METHODS Indirect fluorescent assay (IFA) and Western blot (WB) were performed to detect B. divergens IgG antibodies in 120 serum samples from Asturian patients infected with the tick-transmitted spirochete Borrelia burgdorferi sensu lato, a condition that indicates exposure to tick bites. RESULTS This retrospective study confirmed a B. divergens seroprevalence rate of 39.2% according to IFA results. B. divergens incidence was 7.14 cases/100,000 population, exceeding previously reported seroprevalence rates. No differences in epidemiology and risk factors were found between patients infected solely with B. burgdorferi s.l. and those infected with B. burgdorferi s.l. and with IgG antibodies against B. divergens. This last group of patients lived in Central Asturias, had a milder clinical course and, according to WB results, developed different humoral responses against B. divergens. CONCLUSIONS Babesia divergens parasites have circulated for several years in Asturias. Epidemiological evidence of babesiosis makes Asturias an emerging risk area for this zoonosis. Human babesiosis could also be relevant in other Spanish and European regions affected by borreliosis. Hence, the potential risk of babesiosis on human health in Asturias and other European forest regions needs to be addressed by the health authorities.
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Affiliation(s)
- Estrella Montero
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain.
| | - María Folgueras
- Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Mercedes Rodriguez-Pérez
- Microbiology Service, Hospital Universitario Central de Asturias, Oviedo University School of Medicine, Oviedo, Spain
| | - Laura Pérez-Ls
- Researcher, Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Javier Díaz-Arias
- Researcher, Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Maria Meana
- Internal Medicine, Hospital Alvarez-Buylla, Mieres, Asturias, Spain
| | - Belén Revuelta
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain
| | - Karita Haapasalo
- Department of Bacteriology and Immunology, Medicum, University of Helsinki, 00014, Helsinki, Finland
| | - Julio Collazos
- Infectious Diseases Unit, Hospital de Galdácano, Vizcaya, Spain
| | - Víctor Asensi
- Infectious Diseases Unit, Hospital Universitario Central de Asturias and Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Miguel Gonzalez
- Parasitology Reference and Research Laboratory, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, 28220, Madrid, Spain
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Karshima SN, Karshima MN, Ahmed MI. Global meta-analysis on Babesia infections in human population: prevalence, distribution and species diversity. Pathog Glob Health 2021; 116:220-235. [PMID: 34788196 DOI: 10.1080/20477724.2021.1989185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Human babesiosis is an emerging tick-borne protozoan zoonosis caused by parasites of the genus Babesia and transmitted by ixodid ticks. It was thought to be a public health problem mainly for the immunocompromised, however the increasing numbers of documented cases among immunocompetent individuals is a call for concern. In this systematic review and meta-analysis, we reported from 22 countries and 69 studies, an overall pooled estimate (PE) of 2.23% (95% CI: 1.46-3.39) for Babesia infections in humans. PEs for all sub-groups varied significantly (p < 0.05) with a continental range of 1.54% (95% CI: 0.89-2.65) in North America to 4.17% (95% CI: 2.11-8.06) in Europe. PEs for country income levels, methods of diagnosis, study period, sample sizes, Babesia species and targeted population ranged between 0.43% (95% CI: 0.41-0.44) and 7.41% (95% CI: 0.53-54.48). Babesia microti recorded the widest geographic distribution and was the predominant specie reported in North America while B. divergens was predominantly reported in Europe. Eight Babesia species; B. bigemina, B. bovis, B. crassa-like, B. divergens, B. duncani, B. microti, B. odocoilei and B. venatorum were reported in humans from different parts of the world with the highest prevalence in Europe, lower middle income countries and among individuals with history of tick bite and other tick-borne diseases. To control the increasing trend of this emerging public health threat, tick control in human settlements, the use of protective clothing by occupationally exposed people and the screening of transfusion blood in endemic countries are recommended.Abbreviations AJOL: African Journals OnLine, CI: Confidence interval, CIL: Country income level, df: Degree of freedom, HIC: Higher-income countries, HQ: High quality, I2: Inverse variance index, IFAT: Indirect fluorescent antibody test, ITBTBD: Individuals with tick-bite and tick-borne diseases, JBI: Joanna Briggs Institute, LIC: Lower-income countries, LMIC: Lower middle-income countries, MQ: Medium quality, NA: Not applicable, N/America: North America, OEI: Occupational exposed individuals, OR: Odds ratio, PE: Pooled estimates, PCR: Polymerase chain reaction, Prev: Prevalence, PRISMA: Preferred Reporting System for Systematic Reviews and Meta-Analyses, Q: Cochran's heterogeneity statistic, QA: Quality assessment, Q-p: Cochran's p-value, qPCR: Quantitative polymerase chain reaction, S/America: South America, Seq: Sequencing, UMIC: Upper middle-income countries, USA: United States of America.
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Affiliation(s)
- Solomon Ngutor Karshima
- Department of Veterinary Public Health and Preventive Medicine, University of Jos, Jos, Nigeria
| | | | - Musa Isiyaku Ahmed
- Department of Veterinary Parasitology and Entomology, Federal University of Agriculture, Zuru, Nigeria
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Bloch EM, Krause PJ, Tonnetti L. Preventing Transfusion-Transmitted Babesiosis. Pathogens 2021; 10:pathogens10091176. [PMID: 34578209 PMCID: PMC8468711 DOI: 10.3390/pathogens10091176] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Babesia are tick-borne intra-erythrocytic parasites and the causative agents of babesiosis. Babesia, which are readily transfusion transmissible, gained recognition as a major risk to the blood supply, particularly in the United States (US), where Babesia microti is endemic. Many of those infected with Babesia remain asymptomatic and parasitemia may persist for months or even years following infection, such that seemingly healthy blood donors are unaware of their infection. By contrast, transfusion recipients are at high risk of severe babesiosis, accounting for the high morbidity and mortality (~19%) observed in transfusion-transmitted babesiosis (TTB). An increase in cases of tick-borne babesiosis and TTB prompted over a decade-long investment in blood donor surveillance, research, and assay development to quantify and contend with TTB. This culminated in the adoption of regional blood donor testing in the US. We describe the evolution of the response to TTB in the US and offer some insight into the risk of TTB in other countries. Not only has this response advanced blood safety, it has accelerated the development of novel serological and molecular assays that may be applied broadly, affording insight into the global epidemiology and immunopathogenesis of human babesiosis.
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Affiliation(s)
- Evan M. Bloch
- Division of Transfusion Medicine, Department of Pathology, Johns Hopkins University, Baltimore, MD 21287, USA
- Correspondence: ; Tel.: +1-410-614-4246
| | - Peter J. Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT 06520, USA;
| | - Laura Tonnetti
- Scientific Affairs, American Red Cross, Holland Laboratories, Rockville, MD 21287, USA;
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9
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Zamoto-Niikura A, Hagiwara K, Imaoka K, Morikawa S, Ishihara C, Hanaki KI. Epidemiological Survey of Babesia divergens Asia Lineage in Wild Sika Deer (Cervus nippon) by Using Direct PCR in Japan. Jpn J Infect Dis 2019; 73:68-71. [PMID: 31564691 DOI: 10.7883/yoken.jjid.2019.096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Babesia divergens is the major causal agent of zoonotic human babesiosis across Europe. Previously, we reported the detection of a B. divergens Asia lineage in wild sika deer (Cervus nippon) in Japan which was genetically closely related to the European B. divergens. To further elucidate its etiology, we conducted a large epidemiological survey by combining lineage-specific PCR system and blood direct PCR. The infection rate of the Asia lineage was 6.6% (116/1,747) throughout Japan, where Hokkaido (45%), Nagano (17%), Iwate (12%), Gunma (11%), and Yamanashi (11%) were highly enzootic (> 10%) among the 30 prefectures examined. European B. divergens was not detected. A geographical information system (GIS) map revealed dense populations of PCR-positive deer in the mountains including the Japanese Alps in eastern Honshu, and Hokkaido. These areas markedly overlapped with the major habitats of Ixodes persulcatus, a principal tick vector responsible for the transmission of the Asia lineage. Other areas in southern Japan including Miyazaki, Kagoshima, and Shimane Prefectures, where positive sika deer were sporadically detected, may be habitats for other tick species involved in the enzootic cycle as I. persulcatus were scarce. The rise in human babesiosis cases is occasionally attributed to healthy blood donors who were unaware of tick bites and Babesia infection. Therefore, there is an urgent need to investigate whether infections in humans have occurred in Japan.
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Affiliation(s)
- Aya Zamoto-Niikura
- Division of Experimental Animal Research, National Institute of Infectious Diseases
| | | | - Koichi Imaoka
- Department of Veterinary Science, National Institute of Infectious Diseases
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases
| | | | - Ken-Ichi Hanaki
- Division of Experimental Animal Research, National Institute of Infectious Diseases
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Pawełczyk A, Bednarska M, Kowalska JD, Uszyńska-Kałuża B, Radkowski M, Welc-Falęciak R. Seroprevalence of six pathogens transmitted by the Ixodes ricinus ticks in asymptomatic individuals with HIV infection and in blood donors. Sci Rep 2019; 9:2117. [PMID: 30765826 PMCID: PMC6376038 DOI: 10.1038/s41598-019-38755-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/07/2019] [Indexed: 11/24/2022] Open
Abstract
The objective of our study was to estimate the seroprevalence of six pathogens transmitted by ticks in HIV-infected persons and blood donors in Poland (B. burgdorferi s.l., A. phagocytophilum, Ehrlichia spp., Babesia spp., Rickettsia spp. Bartonella henselae) to assess the frequency of exposure to such microorganisms in immunocompetent and immunocompromised individuals in endemic regions for I. ricinus ticks. Serum samples were collected from 227 HIV-infected patients and 199 blood donors. All samples were analyzed for antibodies against six tick-borne pathogens and seroprevalence rates were statistically compared between two tested group as well as age, sex and lymphocyte T CD4+ level in HIV infected patients. The seroprevalence of tick-borne infections in HIV-infected patients is higher than that of the healthy population in Poland, although no association between serological status of patients and lymphocyte CD4+ T cell level has been observed. The frequency of tick-borne coinfections and doubtful results of serological tests were significantly higher in HIV-positive individuals. In Poland, the possibility of tick-borne diseases transmission with blood is rather negligible.
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Affiliation(s)
- Agnieszka Pawełczyk
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, 3C Pawińskiego Street, 02-106, Warsaw, Poland.,AmerLab Ltd. Diagnostic Laboratory of Parasitic Diseases and Zoonotic Infections, Biological and Chemical Research Centre, 101 Żwirki and Wigury Street, 02-089, Warsaw, Poland
| | - Małgorzata Bednarska
- Department of Parasitology, Faculty of Biology, University of Warsaw, 1 Miecznikowa Street, 02-096, Warsaw, Poland.,AmerLab Ltd. Diagnostic Laboratory of Parasitic Diseases and Zoonotic Infections, Biological and Chemical Research Centre, 101 Żwirki and Wigury Street, 02-089, Warsaw, Poland
| | - Justyna D Kowalska
- Department of Adults' Infectious Diseases, Medical University of Warsaw, 37 Wolska Street, 01-201, Warsaw, Poland
| | - Beata Uszyńska-Kałuża
- Blood Center of the Ministry of Internal Affairs and Administration, 137 Wołoska Street, 02-507, Warsaw, Poland
| | - Marek Radkowski
- Department of Immunopathology of Infectious and Parasitic Diseases, Medical University of Warsaw, 3C Pawińskiego Street, 02-106, Warsaw, Poland
| | - Renata Welc-Falęciak
- Department of Parasitology, Faculty of Biology, University of Warsaw, 1 Miecznikowa Street, 02-096, Warsaw, Poland. .,AmerLab Ltd. Diagnostic Laboratory of Parasitic Diseases and Zoonotic Infections, Biological and Chemical Research Centre, 101 Żwirki and Wigury Street, 02-089, Warsaw, Poland.
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11
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The Babesia divergens Asia Lineage Is Maintained through Enzootic Cycles between Ixodes persulcatus and Sika Deer in Hokkaido, Japan. Appl Environ Microbiol 2018; 84:AEM.02491-17. [PMID: 29374041 DOI: 10.1128/aem.02491-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/24/2018] [Indexed: 12/20/2022] Open
Abstract
Parasites of the Babesiadivergens Asia lineage, which are closely related to B. divergens in Europe and Babesia sp. strain MO1 in the United States, were recently reported in sika deer (Cervus nippon) in eastern Japan. To identify the tick vector(s) for this parasite, we conducted a field survey in Hokkaido, Japan, where the infection rate in sika deer is the highest in the country. A specific PCR system which detects and discriminates between lineages within B. divergens and between those lineages and Babesia venatorum showed that Ixodes persulcatus (11/822), but not sympatric Ixodes ovatus (0/595) or Haemaphysalis sp. (0/163) ticks, carried B. divergens Asia lineage. Genomic DNA was archived from salivary glands of partially engorged I. persulcatus females and three isolates of B. divergens Asia lineage were newly described. The 18S rRNA gene sequence of the isolates formed the Asia lineage cluster with those previously described in sika deer isolates. One salivary gland also contained parasites of Babesia microti U.S. lineage, which were subsequently isolated in a hamster in vivoB. venatorum (strain Etb5) was also detected in one I. persulcatus tick. The 18S rRNA sequence of Etb5 was 99.7% identical to that of B. venatorum (AY046575) and was phylogenetically positioned in a taxon composed of B. venatorum isolates from Europe, China, and Russia. The geographical distribution of I. persulcatus is consistent with that of B. divergens in sika deer in Japan. These results suggest that I. persulcatus is a principal vector for B. divergens in Japan and Eurasia, where I. persulcatus is predominantly distributed.IMPORTANCE The Babesiadivergens Asia lineage of parasites closely related to B. divergens in Europe and Babesia sp. MO1 in the United States was recently reported in Cervus nippon in eastern Japan. In this study, specific PCR for the Asia lineage identified 11 positives in 822 host-seeking Ixodes persulcatus ticks, a principal vector for many tick-borne disease agents. Gene sequences of three isolates obtained from DNA in salivary glands of female ticks were identical to each other and to those in C. nippon We also demonstrate the coinfection of B. divergens Asia lineage with Babesia microti U.S. lineage in a tick salivary gland and, furthermore, isolated the latter in a hamster. These results suggest that I. persulcatus is the principal vector for B. divergens as well as for B. microti, and both parasites may be occasionally cotransmitted by I. persulcatus This report will be important for public health, since infection may occur through transfusion.
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12
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Sayama Y, Zamoto-Niikura A, Matsumoto C, Saijo M, Ishihara C, Matsubayashi K, Nagai T, Satake M. Analysis of antigen-antibody cross-reactivity among lineages and sublineages of Babesia microti parasites using human babesiosis specimens. Transfusion 2018. [PMID: 29524239 DOI: 10.1111/trf.14558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Human babesiosis is caused mainly by Babesia microti and has recently become a public health concern due to an increase in transfusion-transmitted infection. Thus, the development of an antibody detection method with high specificity and sensitivity is a priority. Seroreactivity against B. microti has been reported to be highly specific not only to B. microti lineages but also to sublineages. This study aimed to elucidate the human antibody reactivity against various lineages, including US, Kobe, and Hobetsu, and sublineages (North America and East Asia) in the US lineage. STUDY DESIGN AND METHODS Twenty samples obtained from individuals infected with B. microti in the United States were tested for the presence of anti-B. microti antibodies using indirect immunofluorescence assay (IFA) and Western blotting (WB) to indicate antigens of each (sub-)lineage. RESULTS By IFA, 20 samples showed reactivity to the North America sublineage (titer range, 64-4096), 16 to the East Asia sublineage (64-512), 10 to the Kobe (64-128), and five to the Hobetsu (64). Antibody titers to the East Asia sublineage, Kobe, and Hobetsu were significantly lower than those to the North America sublineage (p < 0.01). By WB, in parallel with the IFA results, 18 samples showed strong reactions to the North America sublineage, weak reactions to the East Asia sublineage, and near-zero reactions to the Kobe and Hobetsu. CONCLUSION Human antibodies induced by B. microti infection are highly specific against B. microti lineages and sublineages with low cross-reactivity. Developing a precise antibody detection method may require specific antigens based on B. microti lineages and sublineages.
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Affiliation(s)
- Yusuke Sayama
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, National Institute of Infectious Diseases, Tokyo, Japan.,Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Aya Zamoto-Niikura
- Division of Experimental Animal Diseases, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chieko Matsumoto
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Chiaki Ishihara
- School of Veterinary Medicine, Rakuno-Gakuen University, Ebetsu, Japan
| | - Keiji Matsubayashi
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tadashi Nagai
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiro Satake
- Central Blood Institute, Blood Service Headquarters, Japanese Red Cross Society, National Institute of Infectious Diseases, Tokyo, Japan
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13
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Ixodes persulcatus Ticks as Vectors for the Babesia microti U.S. Lineage in Japan. Appl Environ Microbiol 2016; 82:6624-6632. [PMID: 27590815 DOI: 10.1128/aem.02373-16] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 12/19/2022] Open
Abstract
The U.S. lineage, one of the major clades in the Babesia microti group, is known as a causal agent of human babesiosis mostly in the northeastern and upper midwestern United States. This lineage, however, also is distributed throughout the temperate zone of Eurasia with several reported human cases, although convincing evidence of the identity of the specific vector(s) in this area is lacking. Here, the goal was to demonstrate the presence of infectious parasites directly in salivary glands of Ixodes persulcatus, from which U.S. lineage genetic sequences have been detected in Asia, and to molecularly characterize the isolates. Five PCR-positive specimens were individually inoculated into hamsters, resulting in infections in four; consequently, four strains were newly established. Molecular characterization, including 18S rRNA, β-tubulin, and CCT7 gene sequences, as well as Western blot analysis and indirect fluorescent antibody assay, revealed that all four strains were identical to each other and to the U.S. lineage strains isolated from rodents captured in Japan. The 18S rRNA gene sequence from the isolates was identical to those from I. persulcatus in Russia and China, but the genetic and antigenic profiles of the Japanese parasites differ from those in the United States and Europe. Together with previous epidemiological and transmission studies, we conclude that I. persulcatus is likely the principal vector for the B. microti U.S. lineage in Japan and presumably in northeastern Eurasia. IMPORTANCE The major cause of human babesiosis, the tick-borne blood parasite Babesia microti, U.S. lineage, is widely distributed in the temperate Northern Hemisphere. However, the specific tick vector(s) remains unidentified in Eurasia, where there are people with antibodies to the B. microti U.S. lineage and cases of human babesiosis. In this study, the first isolation of B. microti U.S. lineage from Ixodes persulcatus ticks, a principal vector for many tick-borne diseases, is described in Japan. Limited antigenic cross-reaction was found between the Japan and United States isolates. Thus, current serological tests based on U.S. isolates may underestimate B. microti occurrence outside the United States. This study and previous studies indicate that I. persulcatus is part of the B. microti U.S. lineage life cycle in Japan and, presumably, northeastern Eurasia. This report will be important for public health, especially since infection may occur through transfusion, and also to researchers in the field of parasitology.
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14
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Cézanne R, Mrowietz N, Eigner B, Duscher GG, Glawischnig W, Fuehrer HP. Molecular analysis of Anaplasma phagocytophilum and Babesia divergens in red deer (Cervus elaphus) in Western Austria. Mol Cell Probes 2016; 31:55-58. [PMID: 27417532 DOI: 10.1016/j.mcp.2016.07.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 07/09/2016] [Accepted: 07/10/2016] [Indexed: 01/27/2023]
Abstract
Wild ungulates may act as reservoirs of various vector borne pathogens that can infect humans and domestic animals. In the present study, blood samples from 196 red deer (Cervus elaphus) from Western Austria (Vorarlberg, Tyrol and Salzburg) were collected on filter paper and tested for Anaplasmataceae, Piroplasmida, Rickettsia and filarioid helminths using molecular tools. Babesia divergens was detected in ten (5.1%) and Anaplasma phagocytophilum in three (1.5%) of the 196 samples. Filarioid helminths, Rickettsia spp. and Theileria spp. were not detected. These findings indicate that red deer may serve as reservoirs of Babesia divergens and Anaplasma phagocytophilum in Western Austria. Further investigations are needed to assess the presence of these pathogens in ticks in this geographical region, and the significance of these pathogens in both animals and humans.
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Affiliation(s)
- Rita Cézanne
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Naike Mrowietz
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Barbara Eigner
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Georg Gerhard Duscher
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria
| | - Walter Glawischnig
- Institute for Veterinary Disease Control, Austrian Agency for Health and Food Safety, Technikerstraße 70, 6020, Innsbruck, Austria
| | - Hans-Peter Fuehrer
- Institute of Parasitology, Department of Pathobiology, University of Veterinary Medicine Vienna, Veterinaerplatz 1, 1210, Vienna, Austria.
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15
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Garraud O, Cognasse F, Tissot JD, Chavarin P, Laperche S, Morel P, Lefrère JJ, Pozzetto B, Lozano M, Blumberg N, Osselaer JC. Improving platelet transfusion safety: biomedical and technical considerations. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2016; 14:109-122. [PMID: 26674828 PMCID: PMC4781777 DOI: 10.2450/2015.0042-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/16/2015] [Indexed: 12/25/2022]
Abstract
Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related to patients themselves, who may be particularly at risk of side effects because of their underlying illness, there are aspects of platelet collection and storage that predispose to adverse events. Platelets for transfusion are strongly activated by collection through disposal equipment, which can stress the cells, and by preservation at 22 °C with rotation or rocking, which likewise leads to platelet activation, perhaps more so than storage at 4 °C. Lastly, platelets constitutively possess a very large number of bioactive components that may elicit pro-inflammatory reactions when infused into a patient. This review aims to describe approaches that may be crucial to minimising side effects while optimising safety and quality. We suggest that platelet transfusion is complex, in part because of the complexity of the "material" itself: platelets are highly versatile cells and the transfusion process adds a myriad of variables that present many challenges for preserving basal platelet function and preventing dysfunctional activation of the platelets. The review also presents information showing--after years of exhaustive haemovigilance--that whole blood buffy coat pooled platelet components are extremely safe compared to the gold standard (i.e. apheresis platelet components), both in terms of acquired infections and of immunological/inflammatory hazards.
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Affiliation(s)
- Olivier Garraud
- National Institute of Blood Transfusion (INTS), Paris, France
- GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Fabrice Cognasse
- GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France
- Auvergne-Loire Blood Establishment, Saint-Etienne, France
| | - Jean-Daniel Tissot
- Blood Transfusion Service of the Swiss Red Cross, Epalinges, Switzerland
| | | | - Syria Laperche
- National Institute of Blood Transfusion (INTS), Paris, France
| | - Pascal Morel
- Bourgogne Franche-Comté Blood Establishment, Besançon, France
| | - Jean-Jacques Lefrère
- National Institute of Blood Transfusion (INTS), Paris, France
- Paris Descartes University, Paris, France
| | - Bruno Pozzetto
- GIMAP-EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, Saint-Etienne, France
| | - Miguel Lozano
- Department of Hemotherapy and Hemostasis, University Clinic Hospital, Barcelona, Spain
| | - Neil Blumberg
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States of America
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