*Ever been bitten by a tick?

1. *Ever been bitten by a tick? *Ever received a Blood transfusion?

2. Babesiamicroti By: Michelle Raths

3. What is it? • Babesiamicroti, commonly known as babesiosis, is a parasitic, tick-borne infection that destroys RBCs. • Babesiosis, generically, covers multiple strains of Babesiaincluding: B. microti, B. divergens, B. duncani, B. bigemina, B. canis, B. bovis, MO-1 • B. microti, B. divergens, B. duncani all affect humans.

4. RBC interaction • Babesia find their way into the RBCs, where they are able to split, due to binary schizogony, thus forming merozoites. • Babesia continue with their reproduction inside the RBC until the RBC can no longer house them. • The Babesiaare evicted into the blood when the RBC breaks, due to overpopulation, and are forced to invade new RBCs so that they can continue reproducing.

5. *Pear-Shaped *Pairs or Fours*Joined at tip *Maltese Cross

6. So What’s the Big Deal? • RBCs are being compromised! • HEMOLYTIC ANEMIA! • As RBCs break, RBC volume decreases. As RBC volume decreases, Oxygen decreases. • Hemoglobin is released into blood plasma. This may result in jaundice. • Blood flow may be blocked, as the spleen may not be able to keep up with the removal of broken RBCs!

7. Where in the World is Babesiamicroti? • Worldwide! In the U.S. it’s prominent in the Northeast and Upper Midwest. (Peaks during warm months) • Unsure about prevalence of Babesiain countries that exhibit malaria. • Europe exhibits primarily B. divergens. • North America exhibits primarily B. microti. • B. duncanifound in Washington and California. • MO-1 found in Missouri.

8. Whose the Host? • Definitive Host: Ixodesscapularis(deer tick) • Intermediate Host: Rodent (primarily the white-footed mouse)

9. What’s the Life Cycle?

10. How will it affect you? • Everybody is different! • May be life-threatening (immunocompromised, lacking a spleen, elderly). • May cause no problem at all. • http://animal.discovery.com/videos/monsters-inside-me-babesiosis.html

11. What are the Clinical Signs? • Fever • Chills • Sweats • Headache • Body Aches • Loss of Appetite • Nausea • Fatigue • Hemolytic Anemia • OFTEN CONFUSED WITH MILARIA!!!!!

12. Main points for differentiating Babesiamicrotiand Malaria? • The patient hasn’t travelled to an area that exhibits malaria. • There is an absence of hemozoin, as seen in Malaria.

13. Is Babesia the same as Lyme Disease? • No! • Lyme Disease is Borreliaburgdorferi not the same genus or species. • Both are transmitted via ticks (Ixodesscapularis) • Can co-exist more severe!

14. Diagnosis • Blood smear must be examined under a microscope for Babesiain the RBCs. • Prevalence of Babesia depends on how much is found in the RBCs. • Some species look identical, so other methods, such as serologic or molecular methods must be used.

15. Treatment • Asymptomatic patients = no treatment required • Symptomatic patients may use a combination of two drugs • Atovaquone and Azithromycin • Clindamycin and Quinine (more severe cases) • Supportive Care (antipyretics, vasopressors, blood transfusion, exchange transfusions, mechanical ventilation, dialysis)

16. Control Measures Avoid habitats that are inhabited by ticks! Walk on trails that are cleared, instead of brushy trails. Don’t expose your skin. Use tick repellent! (DEET) Check yourself and others for ticks! If you see a tick on you or a friend, REMOVE it CORRECTLY!!! http://www.youtube.com/watch?v=0wotB38WrRY&feature=relatedhttp://www.youtube.com/watch?v=OctrGD4JW8U&feature=related (58s)

17. References • http://www.cdc.gov/ncidod/eid/vol11no03/04-0599.htm • http://www.cdc.gov/parasites/babesiosis/gen_info/faqs.html • http://www.cdc.gov/parasites/babesiosis/prevent.html • http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html#tx • http://www.dpd.cdc.gov/dpdx/html/frames/a-f/babesiosis/body_Babesiosis_page1.htm#Causal Agent • Sullivan, John. “A Color Atlas of Parasitology.” 2009.