Human babesial infections in Europe.

The tick transmission of Babesia from infected animals to human has been clearly demonstrated. Including the first case described by Skaraballo in 1957 in Yugoslavia, 22 cases of human babesiosis have been reported in Europe. B. divergens, which is the most common pathogen for cattle, was involved in 17/22 cases. France, British Isles and Ireland accounted for more than half of the cases, occurring especially between May and October, the period of maximal activity of Ixodes ricinus, considered as the major vector. Splenectomy was the main factor of risk which was found in 86% of the patients. Clinically, babesial infections appeared suddenly with a non periodic high fever, shaking chills, sweat, headache, myalgia and jaundice induced by intravascular hemolysis. The mortality rate was higher than 50%. Treatment should be promptly initiated with a massive blood exchange, followed by intravenous clindamycin (600 mg) three time daily. For prophylaxis, attenuated vaccines could provide effective protection in cattle, but no vaccine is available for human protection.