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Persistence of Babesia microti Infection in Humans

Johns Hopkins University School of Medicine; Baltimore, MD 21287, USA
Food and Drug Administration, Silver Spring, MD 20993, USA
Yale School of Public Health and Yale School of Medicine, New Haven, CT 06520 USA
Author to whom correspondence should be addressed.
Pathogens 2019, 8(3), 102;
Received: 25 June 2019 / Revised: 12 July 2019 / Accepted: 13 July 2019 / Published: 17 July 2019
(This article belongs to the Special Issue Persistence in Babesia)
Persistent infection is a characteristic feature of babesiosis, a worldwide, emerging tick-borne disease caused by members of the genus Babesia. Persistence of Babesia infection in reservoir hosts increases the probability of survival and transmission of these pathogens. Laboratory tools to detect Babesia in red blood cells include microscopic detection using peripheral blood smears, nucleic acid detection (polymerase chain reaction and transcription mediated amplification), antigen detection, and antibody detection. Babesia microti, the major cause of human babesiosis, can asymptomatically infect immunocompetent individuals for up to two years. Chronically infected blood donors may transmit the pathogen to another person through blood transfusion. Transfusion-transmitted babesiosis causes severe complications and death in about a fifth of cases. Immunocompromised patients, including those with asplenia, HIV/AIDS, malignancy, or on immunosuppressive drugs, often experience severe disease that may relapse up to two years later despite anti-Babesia therapy. Persistent Babesia infection is promoted by Babesia immune evasive strategies and impaired host immune mechanisms. The health burden of persistent and recrudescent babesiosis can be minimized by development of novel therapeutic measures, such as new anti-parasitic drugs or drug combinations, improved anti-parasitic drug duration strategies, or immunoglobulin preparations; and novel preventive approaches, including early detection methods, tick-avoidance, and blood donor screening. View Full-Text
Keywords: Babesia; Babesia microti; persistence; recurrence; Plasmodia; malaria; spleen; blood transfusion Babesia; Babesia microti; persistence; recurrence; Plasmodia; malaria; spleen; blood transfusion
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Bloch, E.M.; Kumar, S.; Krause, P.J. Persistence of Babesia microti Infection in Humans. Pathogens 2019, 8, 102.

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