Linden Jeanne V, Prusinski Melissa A, Crowder Lauren A, Tonnetti Laura, Stramer Susan L, Kessler Debra A, White Jennifer, Shaz Beth, Olkowska Danuta
Wadsworth Center, New York State Department of Health, Albany, New York.
Bureau of Communicable Disease Control, New York State Department of Health, Albany, New York.
Transfusion. 2018 Mar;58(3):660-668. doi: 10.1111/trf.14476. Epub 2018 Jan 31.
Babesiosis is a potentially life-threatening zoonotic infection most frequently caused by the intraerythrocytic parasite Babesia microti. The pathogen is usually tickborne, but may also be transfusion or vertically transmitted. Healthy persons, including blood donors, may be asymptomatic and unaware they are infected. Immunocompromised patients are at increased risk for symptomatic disease.
All reported community-acquired babesiosis cases in New York from 2004 to 2015 were evaluated, enumerated, and characterized. All potential transfusion-transmitted babesiosis (TTB) cases reported through one or more of three public health surveillance systems were investigated to determine the likelihood of transfusion transmission. In addition, host-seeking ticks were actively collected in public parks and other likely sites of human exposure to B. microti.
From 2004 to 2015, a total of 3799 cases of babesiosis were found; 55 (1.4%) of these were linked to transfusion. The incidence of both community-acquired babesiosis and TTB increased significantly during the 12-year study period. The geographic range of both ticks and tickborne infections also expanded. Among TTB cases, 95% of recipients had at least one risk factor for symptomatic disease. Implicated donors resided in five states, including in 10 New York counties. More than half of implicated donors resided in counties known to be B. microti endemic.
The increasing incidence of TTB correlated with increases in community-acquired babesiosis and infection of ticks with B. microti. Surveillance of ticks and community-acquired cases may aid identification of emerging areas at risk for Babesia transfusion transmission.
巴贝斯虫病是一种潜在的危及生命的人畜共患感染病，最常见的病因是红细胞内寄生虫微小巴贝斯虫。该病原体通常通过蜱传播，但也可能通过输血或垂直传播。包括献血者在内的健康人可能没有症状，也未意识到自己已被感染。免疫功能低下的患者出现症状性疾病的风险更高。
对2004年至2015年纽约市所有报告的社区获得性巴贝斯虫病病例进行评估、统计和特征分析。对通过三个公共卫生监测系统中的一个或多个报告的所有潜在输血传播巴贝斯虫病（TTB）病例进行调查，以确定输血传播的可能性。此外，在公园和其他人类可能接触微小巴贝斯虫的场所主动采集寻找宿主的蜱。
2004年至2015年，共发现3799例巴贝斯虫病病例；其中55例（1.4%）与输血有关。在12年的研究期间，社区获得性巴贝斯虫病和TTB的发病率均显著上升。蜱和蜱传播感染的地理范围也有所扩大。在TTB病例中，95%的受血者至少有一个出现症状性疾病的风险因素。涉及的献血者居住在五个州，包括纽约的10个县。超过一半的涉及献血者居住在已知微小巴贝斯虫流行的县。
TTB发病率的上升与社区获得性巴贝斯虫病的增加以及微小巴贝斯虫感染蜱的增加相关。对蜱和社区获得性病例的监测可能有助于识别巴贝斯虫输血传播的新兴风险地区。
