Transplacental transmission of tick-borne Babesia microti in its natural host Peromyscus leucopus

Effects of residential acaricide treatments on patterns of pathogen coinfection in blacklegged ticks

Medically important ixodid ticks often carry multiple pathogens, with individual ticks frequently coinfected and capable of transmitting multiple infections to hosts, including humans. Acquisition of multiple zoonotic pathogens by immature blacklegged ticks (Ixodes scapularis) is facilitated when they feed on small mammals, which are the most competent reservoir hosts for Anaplasma phagocytophilum (which causes anaplasmosis in humans), Babesia microti (babesiosis) and Borrelia burgdorferi (Lyme disease). Here, we used data from a large-scale, long-term experiment to ask whether patterns of single and multiple infections in questing nymphal I. scapularis ticks from residential neighbourhoods differed from those predicted by independent assortment of pathogens, and whether patterns of coinfection were affected by residential application of commercial acaricidal products. Quantitative polymerase chain reaction was used for pathogen detection in multiplex reactions. In control neighbourhoods and those treated with a fungus-based biopesticide deployed against host-seeking ticks (Met52), ticks having only single infections of either B. microti or B. burgdorferi were significantly less common than expected, whereas coinfections with these 2 pathogens were significantly more common. However, use of tick control system bait boxes, which kill ticks attempting to feed on small mammals, eliminated the bias towards coinfection. Although aimed at reducing the abundance of host-seeking ticks, control methods directed at ticks attached to small mammals may influence human exposure to coinfected ticks and the probability of exposure to multiple tick-borne infections.

Histopathological Aspects of the Influence of Babesia microti on the Placentas of Infected Female Rats

Babesiosis is perceived mainly an animal disease; however, awareness that Babesia spp. parasites that can cause diseases in humans is increasing significantly. Babesiosis is spread by the bite of an infected tick (Ixodes spp.), but it can also be transmitted by transfusion of infected blood and from an infected mother to her child during pregnancy or childbirth. The parasites multiply in the bloodstream and destroy red blood cells. This study aimed to assess the influence of Babesia microti on the histological structure of the placenta. Histopathological material collected from pregnant rats infected with Babesia microti was used in the experiment. Microscopic images of the placentas were assessed by Mallory staining and by using methylene blue-stained semi-thin sections. In addition, FISH was used to detect parasite DNA. The presence of piroplasms in both maternal and fetal vessels was demonstrated. Babesia microti infection caused vacuolization of syncytioblasts and cytotrophoblasts, accumulation of collagen fibers in placental villi, and increased adhesion of erythrocytes to the vascular walls. These results indicate that Babesia may influence the course of pregnancy and invite further research on the mechanism of piroplasm penetration into cells.

Histopathological Analysis of Selected Organs of Rats with Congenital Babesiosis Caused by Babesia microti

Babesiosis is a tick-borne disease with an increasing number of cases each year. Due to the non-specific symptoms of babesiosis, insightful analyses of the pathogenesis of babesiosis are still very important. Transmission of the disease occurs in a few ways, which makes laboratory diagnosis of piroplasmosis important. Complications associated with the infection can be tragic, especially in patients with immunological disorders. The aim of this study was the histopathological analysis of the spleen and kidney of young Wistar rats infected transplacentally with Babesia microti. Female rats were infected with a reference strain of B. microti (ATCC 30221), and then, birth 3-week-old males were euthanized with isoflurane. Subsequently, the material was collected at autopsy for microscopic and ultrastructural examination. Microscopic and ultrastructural analysis of the spleen and kidney showed degenerative changes within the organ parenchyma and the capsules surrounding the organ. Regenerative and reparative changes through mitotic divisions of parenchymal cells were also evident. Merozoites of B. microti were visible in the section of erythrocytes and the cells building the organ stroma. The results presented in this study proved the negative effects of B. microti on cells and tissues in rats with congenital babesiosis.

Pathogen prevalence in Amblyomma americanum and Ixodes scapularis ticks from central Appalachian Virginia, U.S.A

Ticks are known vectors of several viral, bacterial, and protozoal pathogens that cause disease in both humans and animals. While pathogen prevalence has been studied extensively in other portions of the United States, pathogen surveillance studies within tick populations in the central Appalachian region of Virginia is almost nonexistent. Two prominent species in this region are Ixodes scapularis (the blacklegged tick) and Amblyomma americanum (the lone star tick). In this study, we collected ticks biweekly from three habitat types (forest, urban, and pasture) across eight counties in southwest Virginia from June, 2019-November, 2020. Ixodes scapularis and A. americanum captures were screened for evidence of associated tick-borne pathogens. In this region, Borrelia burgdorferi sensu stricto (15.3% in nymphs and 37.6% in adults), Anaplasma phagocytophilum (1.9% in nymphs and 12.2% in adults), and Borrelia miyamotoi (2.97% in nymphs and 2.33% in adults) were detected in I. scapularis ticks. Aside from two previously reported Powassan-positive I. scapularis ticks from Floyd County, VA, no additional Powassan-positive ticks are reported here. No evidence of Ehrlichia chaffeensis, Heartland virus (HRTV), or Bourbon virus (BRBV) was detected in collected A. americanum. Detection and confirmation of multiple emerging tick-borne pathogens in this region raises an increased concern for public health risk, calling for heightened awareness of tick-borne pathogen transmission and increased tick surveillance in understudied areas.

Global meta-analysis on Babesia infections in human population: prevalence, distribution and species diversity

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.

In Silico Survey and Characterization of Babesia microti Functional and Non-Functional Proteases

Human babesiosis caused by the intraerythrocytic apicomplexan Babesia microti is an expanding tick-borne zoonotic disease that may cause severe symptoms and death in elderly or immunocompromised individuals. In light of an increasing resistance of B. microti to drugs, there is a lack of therapeutic alternatives. Species-specific proteases are essential for parasite survival and possible chemotherapeutic targets. However, the repertoire of proteases in B. microti remains poorly investigated. Herein, we employed several combined bioinformatics tools and strategies to organize and identify genes encoding for the full repertoire of proteases in the B. microti genome. We identified 64 active proteases and 25 nonactive protease homologs. These proteases can be classified into cysteine (n = 28), serine (n = 21), threonine (n = 14), asparagine (n = 7), and metallopeptidases (n = 19), which, in turn, are assigned to a total of 38 peptidase families. Comparative studies between the repertoire of B. bovis and B. microti proteases revealed differences among sensu stricto and sensu lato Babesia parasites that reflect their distinct evolutionary history. Overall, this data may help direct future research towards our understanding of the biology and pathogenicity of Babesia parasites and to explore proteases as targets for developing novel therapeutic interventions.

Ticks, Human Babesiosis and Climate Change

The effects of current and future global warming on the distribution and activity of the primary ixodid vectors of human babesiosis (caused by Babesia divergens, B. venatorum and B. microti) are discussed. There is clear evidence that the distributions of both Ixodes ricinus, the vector in Europe, and I. scapularis in North America have been impacted by the changing climate, with increasing temperatures resulting in the northwards expansion of tick populations and the occurrence of I. ricinus at higher altitudes. Ixodes persulcatus, which replaces I. ricinus in Eurasia and temperate Asia, is presumed to be the babesiosis vector in China and Japan, but this tick species has not yet been confirmed as the vector of either human or animal babesiosis. There is no definite evidence, as yet, of global warming having an effect on the occurrence of human babesiosis, but models suggest that it is only a matter of time before cases occur further north than they do at present.

Congenital Transmission of Apicomplexan Parasites: A Review

Apicomplexans are a group of pathogenic protists that cause various diseases in humans and animals that cause economic losses worldwide. These unicellular eukaryotes are characterized by having a complex life cycle and the ability to evade the immune system of their host organism. Infections caused by some of these parasites affect millions of pregnant women worldwide, leading to various adverse maternal and fetal/placental effects. Unfortunately, the exact pathogenesis of congenital apicomplexan diseases is far from being understood, including the mechanisms of how they cross the placental barrier. In this review, we highlight important aspects of the diseases caused by species of Plasmodium, Babesia, Toxoplasma, and Neospora, their infection during pregnancy, emphasizing the possible role played by the placenta in the host-pathogen interaction.

The Contribution of Wildlife Hosts to the Rise of Ticks and Tick-Borne Diseases in North America

Wildlife vertebrate hosts are integral to enzootic cycles of tick-borne pathogens, and in some cases have played key roles in the recent rise of ticks and tick-borne diseases in North America. In this forum article, we highlight roles that wildlife hosts play in the maintenance and transmission of zoonotic, companion animal, livestock, and wildlife tick-borne pathogens. We begin by illustrating how wildlife contribute directly and indirectly to the increase and geographic expansion of ticks and their associated pathogens. Wildlife provide blood meals for tick growth and reproduction; serve as pathogen reservoirs; and can disperse ticks and pathogens-either through natural movement (e.g., avian migration) or through human-facilitated movement (e.g., wildlife translocations and trade). We then discuss opportunities to manage tick-borne disease through actions directed at wildlife hosts. To conclude, we highlight key gaps in our understanding of the ecology of tick-host interactions, emphasizing that wildlife host communities are themselves a very dynamic component of tick-pathogen-host systems and therefore complicate management of tick-borne diseases, and should be taken into account when considering host-targeted approaches. Effective management of wildlife to reduce tick-borne disease risk further requires consideration of the 'human dimensions' of wildlife management. This includes understanding the public's diverse views and values about wildlife and wildlife impacts-including the perceived role of wildlife in fostering tick-borne diseases. Public health agencies should capitalize on the expertise of wildlife agencies when developing strategies to reduce tick-borne disease risks.

Impact of Babesia microti infection on the initiation and course of pregnancy in BALB/c mice

Background

Protozoa in the genus Babesia are transmitted to humans through tick bites and cause babesiosis, a malaria-like illness. Vertical transmission of Babesia spp. has been reported in mammals; however, the exact timing and mechanisms involved are not currently known. The aims of this study were to evaluate the success of vertical transmission of B. microti in female mice infected before pregnancy (mated during the acute or chronic phases of Babesia infection) and that of pregnant mice infected during early and advanced pregnancy; to evaluate the possible influence of pregnancy on the course of parasite infections (parasitaemia); and to assess pathological changes induced by parasitic infection.

Methods

The first set of experiments involved two groups of female mice infected with B. microti before mating, and inseminated on the 7th day and after the 40th day post infection. A second set of experiments involved female mice infected with B. microti during pregnancy, on the 4th and 12th days of pregnancy. Blood smears and PCR targeting the 559 bp 18S rRNA gene fragment were used for the detection of B. microti. Pathology was assessed histologically.

Results

Successful development of pregnancy was recorded only in females mated during the chronic phase of infection. The success of vertical transmission of B. microti in this group was 63%. No evidence of pregnancy was found in females mated during the acute phase of infection or on the 4th day of pregnancy. In the group infected on the 12th day of pregnancy, numerous complications including loss of pregnancy and stillbirths were recorded. During the acute phase of infection, parasitaemia was lower in pregnant females in comparison to infected, non-pregnant control females.

Conclusions

Acute B. microti infection prevents the initiation of pregnancy and embryonic development if it occurs during the first trimester, and causes severe complications in foetal BALB/c mice in the second and third trimesters of pregnancy. Chronic B. microti infection has no detrimental impact on the initiation and development of pregnancy, but results in congenital infection of the offspring. Further study is required to determine the extent to which maternal anti-babesial immune responses contribute to compromise pregnancy in the murine model of congenital Babesia infection.

Vertical Transmission: A Vector-Independent Transmission Pathway of Babesia microti in the Natural Reservoir Host Peromyscus leucopus

BACKGROUND

Babesia microti, a malaria-like pathogen, is increasing in mammal and human populations in endemic areas and is unlikely to be the sole result of horizontal pathogen transmission.

METHODS

Peromyscus leucopus mice, natural reservoir hosts, were infected via Ixodes scapularis nymphs. Infected parental females (n = 6) produced F1 offspring (n = 36) that were screened for B. microti using quantitative PCR. Xenodiagnostic larvae were fed on infected offspring to determine horizontal transmission and pathogen viability. Fifty engorged larvae were screened; the rest were allowed to molt and then screened to determine transstadial transmission. Infected F1 generation offspring were placed in breeding groups, producing 34 F2 offspring and screened for B. microti infection. Chronic infection was monitored in parental females since time of initial vector infection.

RESULTS

Vertical transmission of B. microti was 74% efficient in offspring born in the first 6 months. Horizontal transmission occurred in larvae (61% prevalence) and molted nymphs (58% prevalence); these nymphs were able to infect susceptible hosts. F2 generation offspring infection prevalence was 38%. Chronic infection persisted for 1 year in some adults.

CONCLUSIONS

These results demonstrate that vertical transmission is an important nonvector-mediated pathway of B. microti transmission in the natural reservoir host.

Lactobacilli and other gastrointestinal microbiota of Peromyscus leucopus, reservoir host for agents of Lyme disease and other zoonoses in North America

The cricetine rodent Peromyscus leucopus is an important reservoir for several human zoonoses, including Lyme disease, in North America. Akin to hamsters, the white-footed deermouse has been unevenly characterized in comparison to the murid Mus musculus. To further understanding of P. leucopus’ total genomic content, we investigated gut microbiomes of an outbred colony of P. leucopus, inbred M. musculus, and a natural population of P. leucopus. Metagenome and whole genome sequencing were combined with microbiology and microscopy approaches. A focus was the genus Lactobacillus, four diverse species of which were isolated from forestomach and feces of colony P. leucopus. Three of the species—L. animalis, L. reuteri, and provisionally-named species “L. peromysci”—were identified in fecal metagenomes of wild P. leucopus but not discernibly in samples from M. musculus. L. johnsonii, the fourth species, was common in M. musculus but absent or sparse in wild P. leucopus. Also identified in both colony and natural populations were a Helicobacter sp. in feces but not stomach, and a Tritrichomonas sp. protozoan in cecum or feces. The gut metagenomes of colony P. leucopus were similar to those of colony M. musculus at the family or higher level and for major subsystems. But there were multiple differences between species and sexes within each species in their gut metagenomes at orthologous gene level. These findings provide a foundation for hypothesis-testing of functions of individual microbial species and for interventions, such as bait vaccines based on an autochthonous bacterium and targeting P. leucopus for transmission-blocking.

Zoonotic Babesia: A scoping review of the global evidence

BACKGROUND

Babesiosis is a parasitic vector-borne disease of increasing public health importance. Since the first human case was reported in 1957, zoonotic species have been reported on nearly every continent. Zoonotic Babesia is vectored by Ixodes ticks and is commonly transmitted in North America by Ixodes scapularis, the tick species responsible for transmitting the pathogens that also cause Lyme disease, Powassan virus, and anaplasmosis in humans. Predicted climate change is expected to impact the spread of vectors, which is likely to affect the distribution of vector-borne diseases including human babesiosis.

METHODS

A scoping review has been executed to characterize the global evidence on zoonotic babesiosis. Articles were compiled through a comprehensive search of relevant bibliographic databases and targeted government websites. Two reviewers screened titles and abstracts for relevance and characterized full-text articles using a relevance screening and data characterization tool developed a priori.

RESULTS

This review included 1394 articles relevant to human babesiosis and/or zoonotic Babesia species. The main zoonotic species were B. microti, B. divergens, B. duncani and B. venatorum. Articles described a variety of study designs used to study babesiosis in humans and/or zoonotic Babesia species in vectors, animal hosts, and in vitro cell cultures. Topics of study included: pathogenesis (680 articles), epidemiology (480), parasite characterization (243), diagnostic test accuracy (98), mitigation (94), treatment (65), transmission (54), surveillance (29), economic analysis (7), and societal knowledge (1). No articles reported predictive models investigating the impact of climate change on Babesia species.

CONCLUSION

Knowledge gaps in the current evidence include research on the economic burden associated with babesiosis, societal knowledge studies, surveillance of Babesia species in vectors and animal hosts, and predictive models on the impact of climate change. The scoping review results describe the current knowledge and knowledge gaps on zoonotic Babesia which can be used to inform future policy and decision making.

Babesia microti-Borrelia Burgdorferi Coinfection

The incidence and geographic distribution of human babesiosis is growing in the U.S. Its major causative agent is the protozoan parasite, Babesia microti. B. microti is transmitted to humans primarily through the bite of Ixodes scapularis ticks, which are vectors for a number of other pathogens. Other routes of B. microti transmission are blood transfusion and in rare cases of mother-to-foetus transmission, through the placenta. This review discusses the current literature on mammalian coinfection with B. microti and Borrelia burgdorferi, the causative agent Lyme disease.

The role of juvenile Dermacentor reticulatus ticks as vectors of microorganisms and the problem of 'meal contamination'

Juvenile Dermacentor reticulatus ticks inhabit nests and burrows of their rodent hosts and cannot be collected from vegetation. To detect vertical transmission of Babesia canis in D. reticulatus, we studied larvae and nymphs collected from rodents. However, the molecular techniques used for detection of pathogen DNA are sensitive enough to detect not only pathogens vectored by ticks but also those taken up with current or previous blood meals ('meal contamination') or just present in the environment and on the tick or host surface ('environmental contaminations'). Thus, an additional aim of our study was to evaluate the extent of such contamination while studying feeding ticks collected from rodents. Juvenile D. reticulatus were collected from 140 rodents: 91 bank voles trapped in two forest sites in the Mazury Lake District and 49 rodents (Apodemus and Microtus spp.) from an open habitat near the town of Białobrzegi in Central Poland. Altogether 504 D. reticulatus ticks, comprising 266 individually evaluated nymphs and 238 larvae assigned to 50 larval pools, were studied for the presence of Babesia, Bartonella and Rickettsia spp. DNA. Statistical analyses were conducted to (1) evaluate the effect of rodent host factors (species, sex and age) on prevalence of infection in ticks, and (2) to compare the frequency of positive samples between groups of pathogen-positive and pathogen-negative rodent hosts. To complete the last aim, blood samples obtained from 49 rodents from Białobrzegi were studied for the presence of Babesia and Bartonella DNA. Infestation of rodent hosts with juvenile ticks ranged between 46 and 78%, with a mean abundance of 3.6 ticks/rodent for D. reticulatus and 4.8 ticks/rodent for Ixodes ricinus. The highest prevalence of PCR-positive D. reticulatus samples was obtained for Rickettsia spp. (28%) and R. raoultii was identified in 22 sequenced PCR products. Babesia DNA was detected in 20 (7.5%), including B. microti in 18 (6.8%) and B. canis in two (0.8%) of 266 D. reticulatus nymphs that were analyzed. Babesia microti DNA was also detected in four pools of D. reticulatus larvae (4/50 pools = 8%). The detection success of B. microti in D. reticulatus was associated with the species of the rodent hosts of the ticks (much higher for typical B. microti-host-species such as Microtus spp. than for Apodemus spp.) and host age (3 × higher in ticks collected from adult hosts in comparison to juvenile ones). Moreover, the DNA of B. microti was detected in 68% of D. reticulatus nymphs collected from B. microti-positive rodents in comparison to only 1.6% of nymphs collected from B. microti-negative rodents. Bartonella DNA was detected in 18% of D. reticulatus tick samples (38% of larval pools, 14% of nymphs). Again, host factors played important roles for 'tick positivity'-the highest prevalence of positive ticks was on Apodemus spp., which are regarded as Bartonella reservoirs. Bartonella DNA was detected in 42% of nymphs and 57% of larval pools collected from Bartonella-positive rodents in comparison to 28% of nymphs and 11% of larvae collected from Bartonella-negative rodents. Vertical transmission of B. canis in D. reticulatus ticks was confirmed in the field. Additionally, we demonstrated that 'meal contamination' generates a confounding signal in molecular detection of pathogen DNA extracted from ticks collected from infected hosts and must be taken into account in evaluating the competence of tick species as vectors.

Prevalence, distribution, and diversity of cryptic piroplasm infections in raccoons from selected areas of the United States and Canada

The order Piroplasmida contains a diverse group of intracellular parasites, many of which can cause significant disease in humans, domestic animals, and wildlife. Two piroplasm species have been reported from raccoons (Procyon lotor), Babesia lotori (Babesia sensu stricto clade) and a species related to Babesia microti (called B. microti-like sp.). The goal of this study was to investigate prevalence, distribution, and diversity of Babesia in raccoons. We tested raccoons from selected regions in the United States and Canada for the presence of Babesia sensu stricto and Babesia microti-like sp. piroplasms. Infections of Babesia microti-like sp. were found in nearly all locations sampled, often with high prevalence, while Babesia sensu stricto infections had higher prevalence in the Southeastern United States (20–45% prevalence). Co-infections with both Babesia sp. were common. Sequencing of the partial 18S rRNA and cytochrome oxidase subunit 1 (cox1) genes led to the discovery of two new Babesia species, both found in several locations in the eastern and western United States. One novel Babesia sensu stricto sp. was most similar to Babesia gibsoni while the other Babesia species was present in the ‘western piroplasm’ group and was related to Babesia conradae. Phylogenetic analysis of the cox1 sequences indicated possible eastern and western genetic variants for the three Babesia sensu stricto species. Additional analyses are needed to characterize these novel species; however, this study indicates there are now at least four species of piroplasms infecting raccoons in the United States and Canada (Babesia microti-like sp., Babesia lotori, a novel Babesia sensu stricto sp., a novel western Babesia sp.) and a possible fifth species (Babesia sensu stricto) in raccoons in Japan.

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Raccoons in all locations tested were infected with piroplasms.

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Babesia microti-like sp. was commonly found in raccoons throughout North America.

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Babesia sensu stricto spp. were less common throughout North America.

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Four, possibly five, distinct species of piroplasms in raccoons.

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Possible spatial genetic variation within the two raccoon piroplasm species.