Babezioz

Description:

Babezioz (a piroplasmosis, бабезиеллёз, babesiosis) - the acute infectious disease of the person and animals which is characterized by intoxication, fever, development of anemia and the heavy progressing current. Babezioz treats transmissible parasitic zoonotic infections. The disease was for the first time diagnosed for the person in Yugoslavia in 1957.

Diseases proceed with displays of fever, anemia, jaundice, a haemoglobinuria. Babezioza small and cattle, and also dogs have the greatest veterinary value. The disease of the person is possible. Are widespread on all continents, except Antarctic, within areas of carriers - several species of pasturable mites. In Russia - generally in the northwest and the South of the European part and in steppe regions of the South of Siberia.

Because of insufficient study and distinction of opinions of researchers, often бабезиоз identify with a piroplasmosis that is not quite correct because of distinctions in an etiology of activators, and also a clinical picture of diseases. On the International classification of diseases of MKB-10 бабезиоз the B60.0 code has the person.

Reasons of a babezioz:

The activator of a babezioz belongs to type of protozoa, a class of Sporozoa, the Babesiidae family. The disease of the person is caused by three types of babeziya: Babesia divergens, rodhaini - in Europe and Babesia micron in America. Babezioz of animals is called also V. by bovis and V. bigemina. Babeziya are located in the struck erythrocytes in the center or for the periphery of cells. When coloring across Gram have an appearance of thin rings with a diameter of 2-3 microns or formations of a pear-shaped form with a diameter of 4-5 microns.

In the world literature only about 100 cases of a babezioz, the majority of which ended letalno, are so far described. Manifest forms of a disease developed at persons with sharp disturbances of immune system, in particular after a splenectomy. Manifestation of a babezioz at HIV-positive people is considered probable. At people with normally functioning immune system the disease proceeds asymptomatically, despite existence of the parasitemia reaching 1-2%.

The disease meets in Europe (The Scandinavian countries, France, Germany, Yugoslavia, Poland) and in the USA (east coast). An owner are mice voles and other rodents, dogs, cats and cattle. Babezioz of animals is opened in 1888 by V. Babesh. Annually only in Europe tens of thousands of cases of domestic animals are registered. A carrier - an eurysynusic pasturable tick of Ixodes ricinus and argasovy mites. The activator remains in an organism of mites for life and can be transferred transovarialno. Tourists, selkhozyaystvenny workers, shepherds in the period of activity of mites (spring and summer and aestivo-autumnal seasons) get sick. Transmission of infection by hemotransfusions from the infected persons who have an asymptomatic parasitemia is possible.

Pathogeny:

The pathogeny of a babezioz is studied insufficiently.
It is transmitted бабезиоз through stings of mites of almost all families of the Ixodidae family, mites of the sorts Dermacentor, Rhipicephalus, Hyalomma are most known as transmitters. Transfer happens through saliva during food of a tick.

As natural tank of activators in the nature serve patients babeziozy animals. Intermediate tanks - small rodents.

The had animals within 2 - 3 years are unreceptive to repeated acute infection. In many endemic areas the majority or all livestock of the cattle is infected.

After a sting of a tick the activator gets into circulatory capillaries and into erythrocytes. Reproduction of babeziya happens in erythrocytes which lysis is caused not only by influence of parasites, but also emergence of anti-erythrocyte antibodies. Clinical manifestations arise when the number of the struck erythrocytes reaches 3-5%. At destruction of erythrocytes waste products of parasites and heterogeneous proteins get to blood that causes powerful pyrogenic reaction and other all-toxic manifestations. The accruing anemia is followed by the expressed fabric hypoxia and disturbances of microcirculation. In renal capillaries settle cellular covers ("shadows") of erythrocytes and free hemoglobin that leads to development of a hamaturia and an acute renal failure. At a massive lysis of erythrocytes disturbances of pigmental exchange with accumulation in blood of preferential indirect bilirubin develop.

Symptoms of a babezioz:

Incubation interval duration at Babesia divergens infection through ticks of 10-15 days, through blood - 6–12 days, at infection of sheep of Babesia ovis respectively 8-12 and 5–7 days. At sick animals body temperature sharply increases (to 40–41 °C), cardiac performance is broken, breath becomes frequent. The general depression, locks alternate from ponosa. Animals quickly grow thin. Yields of milk of cows decrease by 4–5 times. Milk becomes yellow, sometimes reddish, bitter on taste. For the 2-3rd day of a disease bloody urine appears. At sheep often there comes abortion. Duration of the acute period of a disease of 4-8 days.

Lethality at cattle of 40% and more, at sheep and goats - to 80% of number of the diseased with an acute form.

Babezioz at the person develops generally against the background of the lowered immune status (the elderly or undergone heavy operations sick with AIDS). Cases began to fix only in the second half of the 20th century, several tens of cases are described. The probability of insufficient level of diagnosis of this disease at the person is high, for his increase considerable work in many countries is carried out. At the person with normal immune system proceeds asymptomatically, despite high degree of a parasitemia (1–2%).

Complications. Babezioz naturally is complicated by an acute renal failure, acute renal and hepatic and multiorgan insufficiency. The joining nonspecific pneumonia worsens the forecast.

Diagnosis:

Clinical diagnosis is difficult. Long fever in combination with anemia, a hepatomegalia in the absence of effect of treatment using antibacterial agents is the basis for laboratory researches on oh-bezioz. The accounting of epidemiological data (stings of mites, stay in the endemic area) and identification of disturbances of the immune status at the patient is especially important. The diagnosis is confirmed parasitological by detection of the activator in a smear and a thick drop of blood, and also in reaction of an indirect immunofluorescence. A diagnostic caption at a single research not less than 1:256. Apply also reaction of binding complement.

At a low parasitemia sometimes use a biological method at which blood of the patient is entered to the splenectomized golden hamsters. Later 2-4 weeks at animals the disease develops and babeziya easily come to light in a blood smear.

Differential diagnosis is carried out with tropical malaria, sepsis, blood diseases, HIV infection, GLPS.

Treatment of a babezioz:

The good medical effect is given piroplazmit, berenit, гемоспоридин, acaprin, ихтарган, альбаргин, тиарген, наганин, etc. Provide to sick animals absolute rest (they cannot be overtaken), provide with green and juicy sterns.

For severe forms of a babezioz at the person combinations of clindamycin and quinine or azithromycin and an atovakvon are recommended. In hard cases hemotransfusion is necessary.

Forecast. Without etiotropic treatment the disease is frequent (50-80% of cases) comes to an end with a lethal outcome. At the timely beginning of antiparasitic therapy the forecast favorable.