[Subjectivist]

Babesiosis has recently come to my attention because it is a tick born disease like Lymes disease and is often transmitted with it. Babesiosis infects the red blood cells and in many people remains a low level chronic condition that doesn't get diagnosed for many years. Until 2011 the CDC recognized it as a tropical disease and thought it was very rare in the US. In 2011 the CDC reclassified it as a reportable disease because cases have been spreading from north east port cities in Massachusetts, Connecticut, and New York at a rate of 5 to 15 miles per year. Babesiosis in the past has been recognized as a tropical disease and in serious cases leads to anemia, with some people progressing to organ damage and death. Because Malaria is prevalent in the same regions Babesiosis came from severe cases are often undiagnosed because it takes an expensive lab test to tell the difference between the two diseases.

Unfortunately Babesiosis survives in the tick population unless temperatures go very cold in the winter, it is spreading steadily in southern New England and the mid atlantic states and travelers have carried it to over a dozen states including California, Minnesota and Wisconsin. Because the weather is favorable south of New England it seems likely Babesiosis is here to stay in the US.

[Subjectivist]

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6127a2.htm

Babesiosis is caused by protozoan parasites of the genus Babesia that infect red blood cells. Babesia infection can range from asymptomatic to life threatening. Clinical manifestations might include fever, other nonspecific influenza-like symptoms, and hemolytic anemia (1). Babesia parasites in nature usually are tickborne but they also are transmissible via blood transfusion or congenitally (1,2). In recent years, reports of tickborne and transfusion-associated cases have increased in number and geographic distribution (2–6). However, the lack of a standard case definition hindered the ability of public health authorities to monitor cases and to develop evidence-based prevention and control measures. In January 2011, national surveillance for human babesiosis was begun in 19 jurisdictions (18 states and one city), using a standard case definition developed jointly by CDC and the Council of State and Territorial Epidemiologists (7). This report summarizes the results for 2011. For the first year of babesiosis surveillance, health departments notified CDC of 1,124 confirmed and probable cases. Cases were reported by 15 of the 18 states where babesiosis was reportable; however, 1,092 cases (97%) were reported by seven states (Connecticut, Massachusetts, Minnesota, New Jersey, New York [including New York City], Rhode Island, and Wisconsin). Cases were identified in persons aged <1–98 years; 57% were in persons aged ≥60 years. Among patients for whom data were available, 82% (717 of 879) had symptom onset dates during June–August. Ongoing national surveillance using the standard case definition will provide a foundation for developing evidence-based prevention and control measures to reduce the burden of babesiosis.

Health departments notify CDC of cases of babesiosis via the National Notifiable Diseases Surveillance System (NNDSS), using a standard case definition (Table 1). In addition to basic demographic information (e.g., age, sex, and county of residence) provided via NNDSS, supplemental data (e.g., symptoms and history of transfusion) can be submitted to CDC using a disease-specific case report form (CRF). In 2011, babesiosis was reportable in 18 states and one city (Table 2) (8). Because babesiosis has been a reportable condition in some states for years, state-developed CRFs already had been in use to capture supplemental data. To promote standard data collection, CDC developed a babesiosis CRF, which was approved by the Office of Management and Budget in August 2011.* Supplemental data, derived from CDC's or a state's CRF, were merged manually with NNDSS records by matching a case identification number or demographic data. If case records had conflicting data, the more detailed record was considered correct.

In this summary, data for confirmed and probable cases were combined. Incidence rates were calculated by using 2010 population data from the U.S. Census Bureau (9). The seven states with well-established foci of zoonotic transmission (Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin) are referred to as Babesia microti–endemic states (2). The Wilcoxon rank-sum test was used to compare the ranked distributions of ordinal variables.

For 2011, CDC was notified via NNDSS of 1,124 cases of babesiosis: 847 were classified as confirmed cases and 277 as probable cases. Supplemental data were provided for 797 (71%) of the 1,124 cases. The median age of patients was 62 years (range: <1–98 years); 63% were male, 34% were female, and the sex was unknown for 3% (Table 2). Among the 583 cases for which data on both race and ethnicity were available, more cases were reported in non-Hispanic whites than in persons of other races and ethnicities.

The 1,124 cases occurred in residents of 15 of the 18 states in which babesiosis was a reportable disease in 2011 (Table 2); 1,092 cases (97%) were reported by the seven main B. microti–endemic states. County-level incidence rates ranged from 0 to >100 cases per 100,000 persons (Figure 1). The state in which exposure occurred was available for 202 patients, 192 (95%) of whom became infected in their state of residence and 10 (5%) in a different state. Of the 295 patients for whom data were available, 156 (53%) recalled a tick bite in the 8 weeks before symptom onset. Reports for nine patients indicated that they also were diagnosed with another tickborne disease, either Lyme disease or anaplasmosis.

Ten cases of babesiosis in transfusion recipients were classified by the reporting health departments as transfusion associated, and two blood donors were reported. Each of the two blood donors was linked to one recipient; linked donors were not reported for eight of the 10 cases. Four other patients received blood transfusions before symptom onset, but whether these cases were transfusion associated was not known. One reported case was attributed to congenital transmission.

Thanks to Pops for trying to help me recover this post after the website ate it, the CDC has more info at the link.

[vision-master]

The CDC does not recognize long term treatment of Lyme. One cycle of antibiotics and it's gone, no matter how long you have been infected.