Infection with a Babesia-like organism in Northern California

D. H. Persing, B. L. Herwaldt, C. Glaser, R. S. Lane, J. W. Thomford, D. Mathiesen, Patricia A Conrad, D. F. Phillip, P. A. Conrad

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Abstract

Background. Human babesiosis is a tick-transmitted zoonosis associated with two protozoa of the family Piroplasmorida: Babesia microti (in the United States) and B. divergens (in Europe). Recently, infection with an unusual babesia-like piroplasm (designated WA1) was described in a patient from Washington State. We studied four patients in California who were identified as being infected with a similar protozoal parasite. All four patients had undergone splenectomy, two because of trauma and two for other medical reasons. Two of the patients had complicated courses, and one died. Methods. Piroplasm-specific nuclear small-subunit ribosomal DNA was recovered from the blood of the four patients by amplification with the polymerase chain reaction. The genetic sequences were compared with those of other known piroplasm species. Indirect immunofluorescent-antibody testing of serum from the four patients and from other potentially exposed persons was performed with WA1 and babesia antigens. Results. Genetic sequence analysis showed that the organisms from all four patients were nearly identical. Phylogenic analysis showed that this strain is more closely related to a known canine pathogen (B. gibsoni) and to theileria species than to some members of the genus babesia. Serum from three of the patients was reactive to WA1 but not to B. microti antigen. Serologic testing showed WA1-antibody seroprevalence rates of 16 percent (8 of 51 persons at risk) and 3.5 percent (4 of 115) in two geographically distinct areas of northern California. Conclusions. A newly identified babesia-like organism causes infections in humans in the western United States. The clinical spectrum associated with infection with this protozoan ranges from asymptomatic infection or influenza-like illness to fulminant, fatal disease.

Original languageEnglish (US)
Pages (from-to)298-303
Number of pages6
JournalNew England Journal of Medicine
Volume332
Issue number5
DOIs
StatePublished - 1995

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Babesia
Infection
Babesia microti
Protozoan Infections
Theileria
Babesiosis
Antigens
Asymptomatic Infections
Antibodies
Seroepidemiologic Studies
Zoonoses
Ticks
Splenectomy
Ribosomal DNA
Serum
Human Influenza
Sequence Analysis
Canidae
Parasites
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Persing, D. H., Herwaldt, B. L., Glaser, C., Lane, R. S., Thomford, J. W., Mathiesen, D., ... Conrad, P. A. (1995). Infection with a Babesia-like organism in Northern California. New England Journal of Medicine, 332(5), 298-303. https://doi.org/10.1056/NEJM199502023320504

Infection with a Babesia-like organism in Northern California. / Persing, D. H.; Herwaldt, B. L.; Glaser, C.; Lane, R. S.; Thomford, J. W.; Mathiesen, D.; Conrad, Patricia A; Phillip, D. F.; Conrad, P. A.

In: New England Journal of Medicine, Vol. 332, No. 5, 1995, p. 298-303.

Research output: Contribution to journalArticle

Persing, DH, Herwaldt, BL, Glaser, C, Lane, RS, Thomford, JW, Mathiesen, D, Conrad, PA, Phillip, DF & Conrad, PA 1995, 'Infection with a Babesia-like organism in Northern California', New England Journal of Medicine, vol. 332, no. 5, pp. 298-303. https://doi.org/10.1056/NEJM199502023320504
Persing DH, Herwaldt BL, Glaser C, Lane RS, Thomford JW, Mathiesen D et al. Infection with a Babesia-like organism in Northern California. New England Journal of Medicine. 1995;332(5):298-303. https://doi.org/10.1056/NEJM199502023320504
Persing, D. H. ; Herwaldt, B. L. ; Glaser, C. ; Lane, R. S. ; Thomford, J. W. ; Mathiesen, D. ; Conrad, Patricia A ; Phillip, D. F. ; Conrad, P. A. / Infection with a Babesia-like organism in Northern California. In: New England Journal of Medicine. 1995 ; Vol. 332, No. 5. pp. 298-303.
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abstract = "Background. Human babesiosis is a tick-transmitted zoonosis associated with two protozoa of the family Piroplasmorida: Babesia microti (in the United States) and B. divergens (in Europe). Recently, infection with an unusual babesia-like piroplasm (designated WA1) was described in a patient from Washington State. We studied four patients in California who were identified as being infected with a similar protozoal parasite. All four patients had undergone splenectomy, two because of trauma and two for other medical reasons. Two of the patients had complicated courses, and one died. Methods. Piroplasm-specific nuclear small-subunit ribosomal DNA was recovered from the blood of the four patients by amplification with the polymerase chain reaction. The genetic sequences were compared with those of other known piroplasm species. Indirect immunofluorescent-antibody testing of serum from the four patients and from other potentially exposed persons was performed with WA1 and babesia antigens. Results. Genetic sequence analysis showed that the organisms from all four patients were nearly identical. Phylogenic analysis showed that this strain is more closely related to a known canine pathogen (B. gibsoni) and to theileria species than to some members of the genus babesia. Serum from three of the patients was reactive to WA1 but not to B. microti antigen. Serologic testing showed WA1-antibody seroprevalence rates of 16 percent (8 of 51 persons at risk) and 3.5 percent (4 of 115) in two geographically distinct areas of northern California. Conclusions. A newly identified babesia-like organism causes infections in humans in the western United States. The clinical spectrum associated with infection with this protozoan ranges from asymptomatic infection or influenza-like illness to fulminant, fatal disease.",
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AU - Thomford, J. W.

AU - Mathiesen, D.

AU - Conrad, Patricia A

AU - Phillip, D. F.

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N2 - Background. Human babesiosis is a tick-transmitted zoonosis associated with two protozoa of the family Piroplasmorida: Babesia microti (in the United States) and B. divergens (in Europe). Recently, infection with an unusual babesia-like piroplasm (designated WA1) was described in a patient from Washington State. We studied four patients in California who were identified as being infected with a similar protozoal parasite. All four patients had undergone splenectomy, two because of trauma and two for other medical reasons. Two of the patients had complicated courses, and one died. Methods. Piroplasm-specific nuclear small-subunit ribosomal DNA was recovered from the blood of the four patients by amplification with the polymerase chain reaction. The genetic sequences were compared with those of other known piroplasm species. Indirect immunofluorescent-antibody testing of serum from the four patients and from other potentially exposed persons was performed with WA1 and babesia antigens. Results. Genetic sequence analysis showed that the organisms from all four patients were nearly identical. Phylogenic analysis showed that this strain is more closely related to a known canine pathogen (B. gibsoni) and to theileria species than to some members of the genus babesia. Serum from three of the patients was reactive to WA1 but not to B. microti antigen. Serologic testing showed WA1-antibody seroprevalence rates of 16 percent (8 of 51 persons at risk) and 3.5 percent (4 of 115) in two geographically distinct areas of northern California. Conclusions. A newly identified babesia-like organism causes infections in humans in the western United States. The clinical spectrum associated with infection with this protozoan ranges from asymptomatic infection or influenza-like illness to fulminant, fatal disease.

AB - Background. Human babesiosis is a tick-transmitted zoonosis associated with two protozoa of the family Piroplasmorida: Babesia microti (in the United States) and B. divergens (in Europe). Recently, infection with an unusual babesia-like piroplasm (designated WA1) was described in a patient from Washington State. We studied four patients in California who were identified as being infected with a similar protozoal parasite. All four patients had undergone splenectomy, two because of trauma and two for other medical reasons. Two of the patients had complicated courses, and one died. Methods. Piroplasm-specific nuclear small-subunit ribosomal DNA was recovered from the blood of the four patients by amplification with the polymerase chain reaction. The genetic sequences were compared with those of other known piroplasm species. Indirect immunofluorescent-antibody testing of serum from the four patients and from other potentially exposed persons was performed with WA1 and babesia antigens. Results. Genetic sequence analysis showed that the organisms from all four patients were nearly identical. Phylogenic analysis showed that this strain is more closely related to a known canine pathogen (B. gibsoni) and to theileria species than to some members of the genus babesia. Serum from three of the patients was reactive to WA1 but not to B. microti antigen. Serologic testing showed WA1-antibody seroprevalence rates of 16 percent (8 of 51 persons at risk) and 3.5 percent (4 of 115) in two geographically distinct areas of northern California. Conclusions. A newly identified babesia-like organism causes infections in humans in the western United States. The clinical spectrum associated with infection with this protozoan ranges from asymptomatic infection or influenza-like illness to fulminant, fatal disease.

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