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Principles and Practice of Clinical Parasitology. Edited by S. Gillespie & Richard D. Pearson Copyright © 2001 John Wiley & Sons Ltd Print ISBN 0-471-97729-2 Online ISBN 0-470-84250-4
Jeffrey A. Gelfand1 and Debra D. Poutsiaka2
1 Massachusetts General Hospital, Boston, MA, USA 2New England Medical Center, Boston, MA, USA
Infection by the malaria-like protozoan, Babesia, has been recognized for over 100 years. The first written reference to babesiosis was probably made in the Bible (Exodus 9:3), in a description of a plague which had befallen the cattle of the Pharoah Rameses II (Dammin, 1978). Babesiosis, also known as piroplasmosis, was considered a disease of animals, affecting mostly livestock and other domesticated animals. In 1888, V. Babes described an intraerythrocytic pathogen, thought to be a bacterium, in his studies on febrile hemoglobinuria of Romanian cattle (Dammin, 1978). Several years later, in 1893, Smith and Kilbourne provided the first description of an arthropod vector with the demonstration of the transmission of the protozoan causing Texas cattle fever via a bloodsucking tick. The first case of human babesiosis was described by Skrabalo in 1957 (Dammin, 1978). Initial case descriptions were in splenectomized individuals. However, in 1969, human babesiosis in a patient with a functioning spleen was reported from the island of Nantucket off the coast of Massachusetts (Western et al., 1970). Since then, over 100 cases of human babesiosis have been reported. The disease has been described in the eastern, central and western regions of the USA and in Europe and Asia (Garnham, 1980; Quick et al., 1993; Persing et al., 1995; Herwaldt et al., 1996; Shih et al., 1997). The rodent strain B. microti has been implicated