Epidemiology

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Babesiosis has some similarities to malaria, but much rarer. Seroprevalence estimated at 3-8%.[3] Common in coastal areas in the northeastern United States, especially the offshore islands of New York and Massachusetts.[2] Incidence and prevalence difficult to know as many cases of babesiosis are misdiagnosed as malaria where the latter is endogenous and many cases are self-limiting.[3]

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Is being increasingly recognised in patients who receive blood transfusion.[3] The incubation period is typically 1 to 4 weeks, but may be longer. Severe symptoms occur in elderly, immunocompromised or asplenic.

Symptoms and signs
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Most cases are asymptomatic Those who are symptomatic may have anorexia, fever,fatigue, myalgia Examination may reveal jaundice, hepatosplenomegaly,haemolytic anaemia, haemoglobinuria and renal failure

Investigations and diagnosis Babesial parasites invade the red cells directly, and multiply there - there is no exo-erythrocytic liver stage as required by human malarial parasites.
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Full blood count may reveal anaemia, thrombocytopenia, atypical lymphocytes andleucopenia. Diagnosis depends on microscopy of Giemsa-stained thin and thick films (the intracellular parasite resembles plasmodia). Several smears may be needed before diagnosis is apparent.

ELISA IgM for Lyme disease may also be positive .[3] .[2] Atovaquone with azithromycin is an alternative treatment used.[4] Azithromycin alone or trimethoprim-sulfamethoxazole may be tried if the above regime is ineffective.[5] Complications      Acute respiratory distress syndrome (ARDS) Pulmonary oedema . male sex and raised white cell count and alkaline phosphatase. this is based on a very small number of patients and thus must be interpreted cautiously.    ESR. Elderly.it is important to treat both conditions where they co-exist. an intensive care unit stay more than 2 days.most frequent lung complication and rarely fatal[6] Renal failure Multi-organ failure Coma Prognosis   Mortality rate estimated at 5%. bilirubin. and splenectomised patients should be treated with immediate intravenous clindamycin and oral quinine to avoid acute renal failure.[2] Immunofluorescence antibody testing or PCR may confirm diagnosis when blood films are negative. However. immunocompromised patients.[2] Consider exchange transfusion in severe cases . Differential diagnosis      Malaria Lyme disease Q-fever Tularaemia Other tick-borne infections Treatment      Supportive care is the only treatment required if the patient is young and otherwise healthy. LDH and transaminases may be elevated.[3] Poor outcomes are associated with hospitalisation for more than 14 days.to reduce the level of parasitaemia. Urine may be dark and urinalysis may show haemoglobinuria and proteinuria.

blood donors. alert the appropriate bloo Human babesiosis is a tick-borne infectious disease caused by intraerythrocytic protozoan species of the genus Babesiatransmitted by Ixodes. Prevention of transfusion-associated babesiosis largely depends on intervening before donation.S. advise the patient to refrain indefinitely from donating blood. If you have a patient who has (or had) laboratory evidence of Babesia infection. If the answer is "yes. Also. eg between the fingers and toes (common areas) Prevention of Transfusion-associated Babesiosis In the pre-donation interview. long sleeves and long pants to cover legs Use insecticides to repel or kill ticks Check for and remove ticks using tweezers. no Babesia tests have been licensed for screening U. Babesia microti is the most common cause of human babesiosis endemic in USA on the northeastern seabord and the upper midwest. The incubation period may last from 1 to 9 weeks and c . To date." they are indefinitely deferred from donating blood. potential blood donors are asked if they have ever been diagnosed with babesiosis. Babesia parasites appear to survive well during typical blood storage conditions. If the patient recently donated blood.Prevention     No vaccine is available When outside wear a hat. The first confirmed case was a normosplenic individual on Nantucket Island published in 1970. who can feel fine despite being infected.[1] After additional cases the disease became known as Nantucket fever.

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