Program Schedule

1739
Babesiosis in Eastern Pennsylvania: an emerging concern

Session: Poster Abstract Session: Public Health
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • MahmoodBabesia.pdf (7.1 MB)
  • Background: Babesiosis is a human tick-borne parasitic infection affecting erythrocytes with potentially severe and complications and some fatalities. Endemic areas include areas in the northeastern and midwestern United States. The incidence and prevalence of babesiosis has steadily increased over the past decade, and appears to be spreading to areas previously regarded as low endemic regions, including eastern Pennsylvania, where it had not been previously described.

    Methods:   see below

    Results: We report five cases of babesiosis in eastern Pennsylania in patients with no history of travel outside the region, pointing to the emergence of babesiosis in this region (table 1, figure 1, figure2).

    Conclusion: As the symptoms of babesiosis are non-specific, a thorough history, including travel, woodland exposure and blood transfusions are important in identifying high-risk individuals. Increased physician awareness regarding the increasing geographical spread of babesia should further assist in the identification and appropriate treatment of affected individuals. More comprehensive disease reporting and data may enable public health authorities to better determine trends and evaluate geographic patterns as endemic areas evolve. 

     

    Table 1. Summary of patient characteristics presenting with babesiosis

    Case

    Age (y), sex

    LOS (d)

    Presentation

    Comorbidity

    Parasitemia (%)

    Nadir hemoglobin level (g/dL)

    Nadir platelet count (109/L)

    Nadir WCC (109/L)

    Elevated AST/ALT

    Exposure

    Co-infection

    Time of Diagnosis

    1

    55, male

    6

    Fever

    Malaise

    Rigors

     

    Splenectomy

     OSA

    HTN

    14%

    8.7

    86

    9.2

    Yes

    Tick bite

    Travel to NJ

    Blood transfusion

    E. coli bacteremia

    July

    2

    69, male

    7

    Fever

    Malaise

    Rash

    Lung carcinoma

    6%

    10.1

    75

    2.8

    Yes

    None

    None

    August

    3

    56, male

    7

    Fever

    Malaise

    Arthralgia

    Afib

    HTN

    1%

    9.8

    82

    4

    Yes

    Travel to Canada

    None

    July

    4

    55, male

    4

    Fever

    Nausea

    Abdominal pain

    OSA

    CHF

    NIDDM

    2%

    9.4

    15

    2.8

    Yes

    Tick bite

    Travel to NJ, NY, VA

    Lyme

    July

    5

    53, male

    5

    Fever

    Headache

    None

    <1%

    12.7

    162

    6

    No

    Tick bite

    Lyme

    July

    y = years; LOS = length of stay; d = days; OSA = obstructive sleep apnea; HTN = hypertension; Afib = atrial fibrillation; CHF = congestive heart failure; NIDDM = non insulin dependent diabetes mellitus; WCC = white cell count; AST = aspartate aminotransferase; ALT = alanine aminotransferase

     

    Maryam Mahmood, MD1, Sarah Luber, DO2, Jessica Young, DO2, Gliciria Kalathas2, Paras Karmacharya2 and Anthony Donato2, (1)Internal Medicine, Reading Hospital, West Reading, PA, (2)Reading Hospital, West Reading, PA

    Disclosures:

    M. Mahmood, None

    S. Luber, None

    J. Young, None

    G. Kalathas, None

    P. Karmacharya, None

    A. Donato, None

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