Bovine babesiosis and anaplasmosis complex: diagnosis and evaluation of the risk factors from Bahia, Brazil / Complexo tristeza parasitária bovina: diagnóstico e avaliação dos fatores de risco na Bahia, Brasil

Direct diagnoses were made by using - blood smears and nested PCR (nPCR) tests on 309 blood samples from crossbred dairy cattle in the municipality of Ibicaraí, Bahia. From diagnostic blood smear slides, the observed parasitic frequencies were 31.1% for Anaplasma marginale and 20.4% for Babesia sp. From nPCR diagnoses, they were 63% for A. marginale, 34% for Babesia bigemina and 20.4% for Babesia bovis. There were significant differences (P <0.01) between the two diagnostic methods (nPCR and blood smear slides). The compliance obtained from the kappa test was 0.41 and 0.48 for A. marginale and Babesia sp., respectively. The tick samples from the six farms analyzed using nPCR were only positive for A. marginale. Evaluation of the risk factors relating to the presence of ticks and the age of the animals showed that there was a significant association (P <0.01) with the frequency of animals infected with both pathogens. Therefore, under the conditions studied, nPCR proved to be a good tool for diagnosing the agents of the bovine babesiosis and anaplasmosis complex because of its sensitivity and specificity in comparison with blood smears. The municipality of Ibicaraí is an area with endemic prevalence of bovine babesiosis and anaplasmosis confirmed by nPCR and A. marginale is the main agent of the disease.

Realizou-se o diagnóstico direto por esfregaço sanguíneo e nested PCR (nPCR) em 309 amostras de sangue de bovinos mestiços leiteiros provenientes do município de Ibicaraí, Bahia. A frequência observada no diagnóstico por lâminas de esfregaço sanguíneo foi 31,1% para Anaplasma marginale e 20,4% para Babesia sp. Enquanto que no diagnóstico por nPCR foi 63% para A. marginale, 34% para Babesia bigemina e 20,4% Babesia bovis. Verificaram-se diferenças significativas (P<0,01) na comparação entre os dois métodos de diagnósticos (nPCR e esfregaço sanguíneo). A concordância ao teste KAPPA obtida foi de 0,41 e 0,48 para A. marginale e Babesia sp., respectivamente. As amostras de carrapatos das seis propriedades analisadas por nPCR foram positivas apenas para A. marginale. Na avaliação dos fatores de risco verificou-se que a presença de carrapato e idade dos animais apresentaram associação significativa (P<0,01) com a frequência de animais infectados por ambos os patógenos analisados por nPCR. Portanto, nas condições estudadas, a nPCR revelou-se uma boa ferramenta para diagnóstico dos agentes do complexo tristeza parasitária bovina (TPB) devido a sensibilidade e especificidade, quando comparado ao esfregaço sanguíneo. O município de Ibicaraí apresenta-se como uma área endêmica para TPB com prevalência comprovada através de nPCR e, A. marginale o principal agente encontrado.

An Imported Case of Severe Falciparum Malaria with Prolonged Hemolytic Anemia Clinically Mimicking a Coinfection with Babesiosis

While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

Molecular and serological detection of tick-borne pathogens in dogs from an area endemic for Leishmania infantum in Mato Grosso do Sul, Brazil / Detecção sorológica e molecular de patógenos transmitidos por carrapatos em cães de uma área endêmica para Leishmania infantum do estado do Mato Grosso do Sul

Tick-borne pathogens affect a wide range of vertebrate hosts. To identify tick-borne pathogens among dogs from Campo Grande, MS, Brazil testing seropositive for Leishmania infantum (syn. L. chagasi), a serological and molecular study was conducted to detect Ehrlichia canis, Anaplasma platys and Babesia vogeli in 60 serum and spleen samples. A confirmatory diagnosis of L. infantum based on serological and molecular assays was also performed, as was sequence alignment and phylogenetic analysis to assess the identity of the parasite species infecting these animals. IgG antibodies to Ehrlichia spp., B. vogeli and L. infantum were found, respectively, in 39 (65%), 49 (81.6%) and 60 (100%) of the sampled dogs. Twenty-seven (45%), fifty-four (90%), fifty-three (88.3%), two (3.3%) and one (1.6%) dog were positive, respectively, for E. canis, Leishmania spp., Leishmania donovani complex, Babesia sp. and Anaplasma sp. in PCR assays. After sequencing, the amplicons showed 99% of identity with E. canis, B. vogeli, A. platys and Leishmania chagasi isolates. The findings of this study indicate that L. infantum-seropositive dogs from Campo Grande are exposed to multiple tick-borne pathogens, which should therefore be included in the differential diagnosis of dogs with clinical suspicion of leishmaniasis.

Patógenos transmitidos por carrapatos atingem uma variedade de hospedeiros vertebrados. Para identificar os agentes patogênicos transmitidos por carrapatos entre cães soropositivos para Leishmania infantum no município Campo Grande-MS, foi realizado um estudo sorológico e molecular para a detecção de Ehrlichia canis, Anaplasma platys e Babesia vogeli em 60 amostras de soro e baço, respectivamente. Adicionalmente, foi realizado o diagnóstico confirmatório de L. infantum por meio de técnicas sorológicas e moleculares. Também foi realizado o alinhamento e análise filogenética das sequências para indicar a identidade das espécies de parasitas que infectam esses animais. Anticorpos IgG anti-Ehrlichia spp., anti-B. vogeli e anti-L. infantum foram detectados em 39 (65%), 49 (81,6%) e 60 (100%) dos cães amostrados, respectivamente. Vinte e sete (45%), cinquenta e quatro (90%), cinquenta e três (88,3%), dois (3,3%) e um (1,6%) cães mostraram-se positivos na PCR para E. canis, Leishmania spp., Leishmania donovani complex, Babesia sp. e Anaplasma sp., respectivamente. Após o seqüenciamento, os amplicons mostraram 99% de similaridade com isolados de E. canis, B. vogeli e A. platys e Leishmania chagasi. Os resultados deste estudo indicaram que os cães soropositivos para L. infantum de Campo Grande, MS, são expostos a vários agentes transmitidos por carrapatos, e, portanto, devem ser incluídos no diagnóstico diferencial em cães com suspeita clínica de leishmaniose.

Prevalence of equine Piroplasmosis and its association with tick infestation in the State of São Paulo, Brazil / Prevalência da Piroplasmose equina e sua associação com infestação por carrapatos no Estado de São Paulo

Serum samples were collected from 582 horses from 40 stud farms in the State of São Paulo and tick (Acari: Ixodidae) infestations were evaluated on them. Serum samples were subjected to the complement fixation test (CFT) and a competitive inhibition ELISA (cELISA) for Babesia caballi and Theileria equi. Logistic regression analyses were performed to construct multivariate models that could explain the dependent variable (horses positive for B. caballi or T. equi) as a function of the independent variables (presence or abundance of each one of the tick species found on the farms). A higher overall prevalence of B. caballi (54.1 percent) than of T. equi (21.6 percent) was found by the two tests. The ticks Dermacentor nitens Neumann, 1897, Amblyomma cajennense (Fabricius, 1787) and Rhipicephalus (Boophilus) microplus (Canestrini, 1887) were present on horses on 38 (95 percent), 20 (50 percent), and 4 (10 percent) farms, respectively. Infestations by D. nitens were statistically associated with B. caballi-positive horses on the farms by either the CFT or cELISA. Infestations by A. cajennense were statistically associated with T. equi-positive horses on the farms by either CFT or cELISA.

Amostras de soro sanguineo foram coletadas de 582 equinos de 40 haras no estado de São Paulo, onde as infestações por carrapatos foram avaliadas nos animais. Os soros foram testados por reação de fixação do complemento (RFC) e ELISA competitivo por inibição (cELISA) com antígenos de Babesia caballi e Theileria equi. Análises de regressão logística foram realizadas para construir modelos multivariados que pudessem explicar as variáveis dependentes (equinos positivos para B. caballi ou T. equi) em função de variáveis independentes (presença e abundância de cada uma das espécies de carrapatos encontradas nos equinos dos haras). Em geral, os dois testes sorológicos indicaram uma prevalência maior para B. caballi (54,1 por cento) do que para T. equi (21,6 por cento). Os carrapatos Dermacentor nitens Neumann, 1897, Amblyomma cajennense (Fabricius, 1787) e Rhipicephalus (Boophilus) microplus (Canestrini, 1887) estiveram presentes em equinos de 38 (95 por cento), 20 (50 por cento) e 4 (10 por cento) haras, respectivamente. As infestações por D. nitens estiveram estatisticamente associadas com equinos positivos para B. caballi tanto pela RFC como pelo cELISA. As infestações por A. cajennense estiveram estatisticamente associadas com equinos soropositivos para T. equi, tanto pela RFC como pelo cELISA.

Human babesiosis--a case report.

Babesiosis is an emerging, tick-transmitted, zoonotic disease caused by hematotropic parasites of the genus Babesia. Most cases of Babesial infections in humans have been acquired in temperate regions of the United States, Europe, France and England. A few cases of Babesiosis have been described in other parts of the world, including China, Taiwan, Egypt, South Africa, and Mexico.1,2 We report the first case of human Babesiosis, in a normosplenic, previously healthy individual from India.

Emerging pathogens associated with tick-borne infections

In recent years, several microbial agents have been identified that result in significant morbidity and mortality. The newly recongnized tick borne infections, babesiosis and ehrlichiosis, may be transmitted by the same tick that transmits Borrelia burgdorferi and simultaneous infections may occur. Babesia are intraerythrocytic protozoa that may cause severe hemolytic anemia, whereas Ehrlichia, depending on the species, may infect either monocytes or granulocytes, with associated leukopenia, thrombocytopenia and anemia. Improved laboratory surveillance is urgently needed to assess the prevalence of these worldwide pathogens in order to institute appropriate infection control efforts.