Quick R E, Herwaldt B L, Thomford J W, Garnett M E, Eberhard M L, Wilson M, Spach D H, Dickerson J W, Telford S R, Steingart K R, Pollock R, Persing D H, Kobayashi J M, Juranek D D, Conrad P A
Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia.
Ann Intern Med. 1993 Aug 15;119(4):284-90. doi: 10.7326/0003-4819-119-4-199308150-00006.
To characterize the etiologic agent (WA1) of the first reported case of babesiosis acquired in Washington State.
Case report, and serologic, molecular, and epizootiologic studies.
South-central Washington State.
A 41-year-old immunocompetent man with an intact spleen who developed a moderately severe case of babesiosis.
Serum specimens from the patient were assayed by indirect immunofluorescent antibody (IFA) testing for reactivity with seven Babesia species and with WA1, which was propagated in hamsters inoculated with his blood. A Babesia-specific, ribosomal-DNA (rDNA) probe was hybridized to Southern blots of restriction-endonuclease-digested preparations of DNA from WA1, Babesia microti, and Babesia gibsoni. Serum specimens from 83 family members and neighbors were assayed for IFA reactivity with WA1 and B. microti. Small mammals and ticks were examined for Babesia infection.
The patient's serum had very strong IFA reactivity with WA1, strong reactivity with B. gibsoni (which infects dogs), but only weak reactivity with B. microti. DNA hybridization patterns with the rDNA probe clearly differentiated WA1 from B. gibsoni and B. microti. Four of the patient's neighbors had IFA titers to WA1 of 256. The tick vector and animal reservoir of WA1 have not yet been identified, despite trapping 83 mammals and collecting 235 ticks.
WA1 is morphologically indistinguishable but antigenically and genotypically distinct from B. microti. Some patients elsewhere who were assumed to have been infected with B. microti may have been infected with WA1. Improved serodiagnostic and molecular techniques are needed for characterizing Babesia species and elucidating the epidemiology of babesiosis, an emergent zoonosis.
鉴定华盛顿州首例报告的巴贝斯虫病病例的病原体（WA1）。
病例报告以及血清学、分子学和动物流行病学研究。
华盛顿州中南部。
一名41岁免疫功能正常、脾脏完整的男性，患中度严重的巴贝斯虫病。
对患者的血清标本进行间接免疫荧光抗体（IFA）检测，以检测其与7种巴贝斯虫属物种及WA1的反应性，WA1是通过接种该患者血液的仓鼠繁殖而来。将一种巴贝斯虫特异性核糖体DNA（rDNA）探针与经限制性内切酶消化的WA1、微小巴贝斯虫和吉氏巴贝斯虫DNA制剂的Southern印迹杂交。对83名家庭成员和邻居的血清标本检测其与WA1和微小巴贝斯虫的IFA反应性。检查小型哺乳动物和蜱虫是否感染巴贝斯虫。
患者血清与WA1有很强的IFA反应性，与感染犬类的吉氏巴贝斯虫有较强反应性，但与微小巴贝斯虫只有较弱反应性。rDNA探针的DNA杂交模式清楚地将WA1与吉氏巴贝斯虫和微小巴贝斯虫区分开来。该患者的4名邻居对WA1的IFA滴度为256。尽管捕获了83只哺乳动物并采集了235只蜱虫，但WA1的蜱传播媒介和动物宿主尚未确定。
WA1在形态上无法与微小巴贝斯虫区分，但在抗原性和基因类型上与微小巴贝斯虫不同。其他地方一些被认为感染微小巴贝斯虫的患者可能感染的是WA1。需要改进血清诊断和分子技术来鉴定巴贝斯虫属物种并阐明巴贝斯虫病（一种新出现的人畜共患病）的流行病学。
