INCREASING HEALTH BURDEN OF HUMAN BABESIOSIS IN ENDEMIC SITES

PETER J. KRAUSE Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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KATHLEEN MCKAY Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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JOSEPH GADBAW Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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DIANE CHRISTIANSON Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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LINDA CLOSTER Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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TIMOTHY LEPORE Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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SAM R. TELFORD III Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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VIJAY SIKAND Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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RAYMOND RYAN Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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DAVID PERSING Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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JUSTIN D. RADOLF Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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ANDREW SPIELMAN Departments of Pediatrics and Medicine, University of Connecticut School of Medicine and Connecticut Children’s Medical Center, Hartford, Connecticut; Block Island Medical Center, Block Island, Rhode Island; Nantucket Cottage Hospital, Nantucket, Massachusetts; Corixa Corporation, Seattle, Washington; Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts

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Human infection due to Babesia microti has been regarded as infrequent and a condition primarily affecting the elderly or immunocompromised. To determine whether risk in endemic sites may be increasing relative to that of Borrelia burgdorferi and to define its age-related clinical spectrum, we carried out a 10-year community-based serosurvey and case finding study on Block Island, Rhode Island. Less intensive observations were conducted in nearby sites. Incidence of babesial infection on Block Island increased during the early 1990s, reaching a level about three-fourths that of borrelial infection. The sera of approximately one-tenth of Block Island residents reacted against babesial antigen, a seroprevalence similar to those on Prudence Island and in southeastern Connecticut. Although the number and duration of babesial symptoms in people older than 50 years of age approximated those in people 20 to 49 years of age, more older adults were admitted to hospital than younger adults. Few Babesia-infected children were hospitalized. Babesial incidence at endemic sites in southern New England appears to have risen during the 1990s to a level approaching that due to borreliosis.

Author Notes

Reprint requests: Peter Krause, Connecticut Children’s Medical Center, 282 Washington Street, Hartford, CT 06106, Telephone: 860-545-9490, Fax: 860-545-9371, E-mail: Pkrause@ccmckids.org
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