Human babesiosis: a general review with special reference to Egypt

Babesiosis is a tick-borne malaria-like illness caused by species of the intra-erythrocytic protozoan Babesia. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, Africa and the northwestern and northeastern United States. Human babesiosis was first described in 1957 but is now known to have worldwide distribution. The increase in reported cases is likely due to increases in actual incidence as well as increased awareness of the disease. Despite the diagnostic and preventive advances resulting from extensive research and a greater understanding of the disease, babesiosis continues to have significant medical impact as a confounding variable in the diagnosis and treatment of Lyme disease and as a potential threat to the blood supply, especially in the United States. Diagnostic advances, like the development of PCR assays, have resulted in increased sensitivity for detection as well as the discovery and characterization of new babesial species. Further studies using the molecular tools now available and those to be developed will lead to a better understanding of the natural history of these organisms, including the transmission cycle and the potential role of Babesia parasites themselves as immunomodulator. Human babesiosis is usually an asymptomatic infection in healthy individuals. Several patients become symptomatic, and, within these subpopulations, significant morbidity and mortality occur, especially in elderly, immunocompromised, or asplenic patients. It is difficult to diagnose. Although the index of suspicion should be high in rural Babesia endemic areas, patients with babesiosis have few, if any, localizing signs to suggest the disease. Diagnosis confirmation depends on the parasitemia degree, the expertise and well trained laboratory personnel. Most patients infected by B microti who are otherwise healthy appear to have a mild illness and typically recover without specific chemotherapy, however, treatment is recommended for all diagnosed cases to prevent sequelae and potential transmission through blood donation. In addition, patients should be advised to take precautions against tick exposure and to refrain from donating blood until completely cured of babesiosis

current status of fleas according to environmental changes in some Governorates in Egypt

A preliminary survey of domestic rodent and their fleas was carried out in different environmental Governorates [Ismailia, Dakahlia, El Fayoum, North Sinai and Matrouh], Egypt. Flea index [number of flea/rodent] and percentage frequency of different flea species were recorded in spring [2009-2010]. The main rodent species found were the Norway rat, Rattus norvegicus, the grey-bellied rat, Rattus rattus alexandrinus, the white-bellied rat, Rattus rattus frugivorus, the house mouse, Mus musculus and the spiny mouse Acomys cahirinus. The common flea species attacking rodents were: the oriental rat flea, Xenopsylla cheopis, the mouse flea, Leptopsylla segnis, the dog flea, Ctenocephalides canis and the sticktight flea Echidnophaga gallinacea. The flea index at Ismailia and Matrouh Governorates showed the highest indices [8.93 and 7.68], while El Fayoum and North Sinai Governorates showed the lowest ones [1.09 and 1.68]. Dakhalia showed moderate flea index [4.52]. The highest number of fleas was recorded on R. norvegicus lives in places that are easy to dig buarrows, which are suitable medium for fleas breeding. The lowest number was recorded on Mus musculus and Acomys cahirinus. The oriental rat flea, Xenopsylla cheopis was the highest frequency distribution for all domestic rodent species, while, the stick-tight flea, Echidnophaga gallinacea was the lowest which recorded at Ismailia and Dakahlia only