Imported human babesiosis in the Republic of Korea, 2019: two case reports

김현정,김민재,신현일,주정원,이희일 대한기생충학ㆍ열대의학회 2023 The Korean Journal of Parasitology Vol.61 No.1

Human babesiosis is a tick-borne disease induced by the genus Babesia and has been significantly reported in the Republic of Korea. This report shows the cases of 2 patients with human babesiosis who traveled to the USA in 2019. The 2 patients experienced fever and had travel histories to babesiosis-endemic regions. The diagnoses of both cases were verified by the identification of Babesia-infected red blood cells on blood smears. One patient was found to be infected with Babesia microti using polymerase chain reaction (PCR) for 18S rRNA, which discovered the phylogenetic link to the B. microti strain endemic in the USA. The 2 patients recovered from fever with subsequent hemoparasite clearance. Babesiosis could be diagnosed in anyone with histories of travel to babesiosis- endemic countries and tick bites. Furthermore, Babesia-specific PCR is required for determining geno-and phenotypic characteristics.

Malaria와 Babesia의 중복 감염 1례

배현주,권숙희,김윤섭,박효순,박중경,최민호,채종일 대한감염학회 1998 감염 Vol.30 No.2

Despite efforts to control the spread of malaria, the disease persists in certain parts of the world. Moreover, there has been a resurgence of the disease recently. Another protozoan disease, babesiosis is a disease of animals; Humans are infected only incidentally, and when they are infected, they develop a nonspecific febrile illness. Babesia organism enters red blood cells and resembles malaria parasites, thus posing a problem in the differential diagnosis. We encountered an imported case of mixed infection of malaria and babesia. The patient was a 20-year old Korean male who had been in Saong-dume near Gabon for 3 months. We treated him with chloroquine with the diagnosis of Plasmodium malariae infection, but fever recurred after 2 weeks of the treatment. The second peripheral blood smear findings revealed specific ring forms of Babesia spp, so we changed to quinine and clindamycin. The treatment was successful and the patient was well after 4 months of follow-up period.

유입 바베시아증 1예

우준희,조용균,김은옥,채종일,김양수,양성연,유지소,이성순 대한감염학회 1997 감염 Vol.29 No.1

최근 외국으로의 여행이 빈번해지면서 유입 감염되는 경우가 많아지고 있는 추세이며 임상 증세가 말라리아와 유사하여 다소 진단이 어려울 수가 있어 한번쯤 바베시아증을 생각하는 것이 바람직하겠다. 저자들은 아프리카에 다녀온 뒤 나타난 바베시아증을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Babesiosis is a tick-borne, malaria-like illness caused by Babesia species that infect erythrocytes of mammals incidentally. The family Babesiidae is characterized by consisting of nonpigmented intraerythrocytic parasites that reproduce within erythocytes by asynchronous, asexual budding into two or four daughter cells (tetrad). We experienced a case of human babesiosis presenting fever and chills. The patient was a 49-year old man, who had been in Africa (Ethiopia, Uganda). Three weeks before admission intermittent spiking fever had developed, which had been accompanied by severe chills. The peripheral blood smear (Giemsa-stain) revealed characteristic forms of a intracellular quadraple parasite compatible with Babesia. The patient was improved significantly by the treatment with quinine and clindamycin for a week.

개 바베시아증 혈액상변화

신종욱,김덕유 한국임상수의학회 2000 한국임상수의학회지 Vol.17 No.2

In previous studies, high fever, inappentence, increased respiratory rate, muscle tremors, anemia, jaundice, loss of weight hemoglobinenuria and hemoglobinuria were found in dogs infected intraerythrocytic protzoan parasites of the gennus Babesia. These changes were mainly caused by the intravascular hemolysis. In this study, a Pit Bull Terrier, which was infected by babesia, was investigated clinical signs and patterms of blood. The findings from this study indicated that dog with severs clinical signs shown erythropenia, lymphocytophilia, neutropenia, thrombocytopenia and eosinpenia. Furthermore, it presenter low level of hemglobin and hematocrit. However MCV, MCH and MCHC did not decreased as compare to normal dogs.

Molecular investigation of tick-borne pathogens in ticks from grazing cattle in Korea

Kang, S.W.,Doan, H.T.T.,Choe, S.E.,Noh, J.H.,Yoo, M.S.,Reddy, K.E.,Kim, Y.H.,Kweon, C.H.,Jung, S.C.,Chang, K.Y. Elsevier 2013 Parasitology international Vol.62 No.3

This study was carried out to identify the tick species that infest grazing cattle and to determine the presence of tick-borne pathogens transmitted by these ticks in Korea. A total of 903 ticks (categorized into 566 tick pools) were collected from five provinces during 2010-2011. The most prevalent tick species was Haemaphysalis longicornis, followed by three Ixodes spp. ticks. The collected ticks were infected with both rickettsial and protozoan pathogens. In all, 469 (82.9%) tick pools tested positive for the Anaplasma/Ehrlichia 16S rRNA gene, whereas 67 (11.8%) were positive for the Babesia/Theileria 18S rRNA gene. Among the rickettsial pathogens, E. canis was detected with the highest rate (22.3%), followed by A. platys (20%), E. chaffeensis (19.4%), E. ewingii (19.3%), Rickettsia sp. (12.4%), A. phagocytophilum (5.5%) and E. muris (0.5%). Among the protozoan pathogens, T. equi was detected with the highest rate (7.2%), followed by T. sergenti/T. buffeli (3.7%) and B. caballi (0.35%). Simultaneous infections with up to seven pathogens were also identified. In particular, ticks infected with rickettsial pathogens were also infected with protozoan pathogens (22 samples). All five provinces investigated infected with tick-borne pathogens.

바베시아 원충감염 예방과 치료에 대한 비타민 E의 응용

이경갑,김근형,이영재,Lee, Kyoung-kap,Kim, Geun-hyoung,Lee, Young-jae 대한수의학회 1999 大韓獸醫學會誌 Vol.39 No.5

This study was carried out to investigate the effects of vitamin E on the prevention and treatment of Babesia gibsoni. Fifteen mongrel dogs, uninfected with Babesia spp, were assigned to three groups according to vitamin E(${\alpha}-tocopherol$) concentrations in the RBC. The concentrations in each of the three groups were, respectively : ${\alpha}-tocopherol$ in RBC less than $30{\mu}g/{\mu}l$(Group I), $30{\mu}g/{\mu}l{\sim}60{\mu}g/{\mu}l$(Group II), more than $60{\mu}g/{\mu}l$(Group III). Artificial infection was accomplished by injecting $2{\times}10^7{\sim}2{\times}10^8$ erythrocyte of Babesia gibsoni-infected dog into the cephalic vein. We investigated the clinical signs, vitamin E concentrations in RBC and serum, Vitamin A concentrations in serum, hematological values, white blood cell(WBC) viability and RBC membrane osmotic fragility after infection of Babesia gibsoni for a period of 20 days at 5 day intervals. The results obtained are summarized as follows : 1. After infection by Babesia gibsoni, clinical examination revealed depression, anorexia, pale mucous membranes, dark brown urine and diarrhea in proportion as time went on. After 10 days of infection, one dog each of Groups I, II and III revealed depression and anorexia. Two dogs in Group I and one dog each of Groups II and III showed dark brown urine after 15 days. Diarrhea was observed in one dog in each of the 3 groups after 20 days of infection. 2. After 5 days of infection, two dogs in each of Groups I, II and III showed Babesia gibsoni in RBC of blood smear stained with Giemsa. At the 15th day after infection with Babesia gibsoni, they were observed in all experimental animals. After both 5 days and 10 days of infection, the rate of Babesia gibsoni parasitized RBC(permillage, ‰) was 1‰, and increased as time went on. 3. After 5 days of infection by Babesia gibsoni, Group I, which had the lowest vitamin E concentration, showed significantly decreased RBC and PCV levels(p < 0.01). Group II and group III also showed significantly decreased RBC and PCV levels after 15 days of infection(p < 0.05). Particularly after 10 days of infection, Group I showed lower values in RBC and PCV levels compared to Groups II and III. WBC, RBC, fibrinogen and total protein levels between the groups did not differ during experimental periods. 4. According to the WBC differential counts, the ratios of neutrophil to lymphocyte showed a tendency to be slightly higher in Group III (more than $60{\mu}g/{\mu}l$) than in Groups I and II. 5. WBC viability did not differ between the groups. 6. RBC membrane osmotic fragility did not differ between the groups.

Prevalence of Babesia spp. in dogs of Seogwipo-si, Jeju-do, South Korea

( Seung Tae Oh ),( Ho Choon Woo ) 한국가축위생학회 2009 韓國家畜衛生學會誌 Vol.32 No.4

Dogs with canine babesiosis may present with wide variation in the severity of clinical signs, ranging from a hyperacute, shock-associated, hemolytic crisis to an inapparent, subclinical infection. Dogs typically present with the acute form of babesiosis, which is characterized by general findings such as pyrexia, weakness, mucous membrane pallor, depression, hemorrhagic anemia. This study was conducted to investigate the prevalence of babesia spp. infection in dogs of Seogwipo-si. A survey of canine babesia spp. infections among 173 dogs in Seogwipo-si was performed from July 2008 to August 2008. Blood samples were collected from dogs raised outdoors through cephalic or jugular vein and Babesia spp. was diagnosed by examination of blood smear stained with Giemsa stain. Of 173 dogs, 9 dogs (5.2%) were infected with the babesia spp. This result was a little lower than the prevalence of Babesia spp. in dogs of other areas.

개 바베시아병에 관한 연구 I. Babesia gibsoni의 시험관내 분리와 항원성상에 관한 연구

이호권,서명득,Lee, Ho-kweon,Suh, Myung-deuk 대한수의학회 1996 大韓獸醫學會誌 Vol.36 No.3

The present study was conducted to isolate Babesia gibsoni by culture method of the microaerophilous stationary phase(MASP) and analyse the antigenic properties of the parasite by SDS-PAGE and immunoblot. The results obtained were summarized as follows. The protozoan parasite Babesia gibsoni multiplied in canine erythrocytes in RPMI 1640 medium(pH7.0) containing 20 40% normal canine serum under the MASP condition of 5% CO2 and 95% air at $37^{\circ}C$ incubator. The levels of parasitaemia in the erythrocytes were shown more higher by exchanging the medium at 24 hours interval. Under the above condition of MASP, the percentage of parasitized erythrocytes(PPE) after incubation for 8 days increased about 14 times more than that in the initiation of the 1% infected canine erythrocyte culture. The parasites were purely isolated from the MASP culture of red blood cells collected from dogs infected with Babesia gibsoni naturally or artificially. Among the total of 36 canine(Pit-bullterier) blood samples the parasites were isolated from 17 cases(47.2%) in the MASP culture while the parasites were detected from 20 cases(56%) and 12 cases(33.3%), respectively, by indirect fluorescent antibody(IFA) test and direct light microscopy(DLM). On the other hand, Babesia gibsoni was isolated by MASP culture from 15 cases(75%) and 11 cases(92%) of positive cases of IFA and DLM, respectively. In the analysis of the erythrocytic merozoite(AEOM) antigen derived from infected dog approximately 11 antigenic bands in molecular weight of 130, 120, 97.4, 92, 80, 52, 50, 42, 36, 30 and 29 KDa were observed on SDS-PAGE. Antigenic bands in the endoerythrocytic merozoite(CEOM) antigen derived from infected erythrocyte (sediment) in MASP culture were much similar to those of AEOM bands. In the exoerythrocytic merozoite(CEEM) antigen derived from supernatant of the infected erythrocyte culture approximately 20 antigenic bands were observed and the molecular weight of the major bands among these were 140, 120, 114, 105, 96, 93, 92, 80, 60, 52, 50, 38, 36, 30, 24, 18.5 and 16 KDa. In the protein patterns of AEOM and CEOM antigen by immunoblot 15 bands were observed and these patterns were much similar between each other. The molecular weight of the major bands in the both antigens were 130, 120, 80, 60, 52, 50, 42, 30, 29, 18.5 and 16 KDa. Approximately 21 bands were observed in CEEM antigen and the molecular weight of the major bands were 140, 120, 96, 92, 85, 80, 76, 60, 52, 50, 37, 30, 24, 16 and 15 KDa. The specific antigenic bands in the artificially infected dogs were firstly observed at 3 weeks afrer inoculation of infected blood and these antigenic bands were maintained up to 18 months after inoculation. In the immunoblot of the sera of the splenectomized dogs the specific antigenic bands with the molecular weight of 93 KDa and 52 KDa, respectively, were observed weakly comparing to those of non-splenectomized dog. In immunoblot of the sera collected from the naturally infected dogs the antigenic bands were observed as same as those of artificially infected dogs while antigenic band of 29 KDa in some individual dog showed strongly. In comparison of immunoblot of the sera collected from dogs non-treated and treated with diminazene aceturate(7mg/kg, IM) after artificial infection no differences of antigenic bands were observed. In analysis of antigenic bands by digoxigenin glycan/protein double labeling, antigenic bands in the molecular weight of 106, 60 58, 36, 30 and 29 KDa were determined as glycoproteins.

Prevalence of Babesia spp. in dogs of Seogwipo-si, Jeju-do, South Korea

오승태,우호춘 한국동물위생학회 2009 韓國家畜衛生學會誌 Vol.32 No.4

Cases of canine babesiosis may present with a wide variation of severity of clinical signs, ranging from a hyper-acute, shock-associated, hemolytic crisis to an inapparent, subclinical infection. Dogs typically present with the acute form of babesiosis, which is characterized by general findings such as pyrexia, weakness, mucous membrane pallor, depression, hemorrhagic anemia. This study was conducted to investigate the prevalence of Babesia spp. infection in dogs of Seogwipo-si. A survey of canine Babesia spp. infections among 173 dogs in Seogwipo-si was performed from July 2008 to August 2008, taking a blood sample from dogs raised outdoors through cephalic vein and jugular vein. And Babesia spp. was diagnosed by examination of blood smear stained with Giemsa stain. Of 173 dogs, 9 dogs (5.2%) were infected with the Babesia spp. This result was a little lower than the prevalence of Babesia spp. in dogs of other areas.

Prevalence of Babesia spp. in dogs of Seogwipo-si, Jeju-do, South Korea

Oh, Seung-Tae,Woo, Ho-Choon The Korean Society of Veterinary Service 2009 韓國家畜衛生學會誌 Vol.32 No.4

Dogs with canine babesiosis may present with wide variation in the severity of clinical signs, ranging from a hyperacute, shock-associated, hemolytic crisis to an inapparent, subclinical infection. Dogs typically present with the acute form of babesiosis, which is characterized by general findings such as pyrexia, weakness, mucous membrane pallor, depression, hemorrhagic anemia. This study was conducted to investigate the prevalence of babesia spp. infection in dogs of Seogwipo-si. A survey of canine babesia spp. infections among 173 dogs in Seogwipo-si was performed from July 2008 to August 2008. Blood samples were collected from dogs raised outdoors through cephalic or jugular vein and Babesia spp. was diagnosed by examination of blood smear stained with Giemsa stain. Of 173 dogs, 9 dogs (5.2%) were infected with the babesia spp. This result was a little lower than the prevalence of Babesia spp. in dogs of other areas.