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Journal of Clinical Microbiology, June 2001, p. 2178-2183, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2178-2183.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Human Babesiosis in Japan: Isolation of Babesia microti-Like Parasites from an Asymptomatic Transfusion Donor and from a Rodent from an Area Where Babesiosis Is Endemic

Qiang Wei,¹ Masayoshi Tsuji,^1,* Aya Zamoto,¹ Masatoshi Kohsaki,² Toshimitsu Matsui,³ Tsunezo Shiota,⁴ Sam R. Telford III,⁵ and Chiaki Ishihara¹

School of Veterinary Medicine, Rakuno-Gakuen University, Ebetsu 069-8501,¹ Hoygo Red Cross Blood Center, Kobe 651-0062,² Third Division of the Department of Medicine, Kobe University School of Medicine, Kobe 650-0017,³ and Kyoto Prefectural University of Medicine, Kyoto 602-8566,⁴ Japan, and Harvard School of Public Health, Boston, Massachusetts 02115⁵

Received 16 January 2001/Returned for modification 20 March 2001/Accepted 2 April 2001

To determine the source of infection for the Japanese index case of human babesiosis, we analyzed blood samples from an asymptomatic individual whose blood had been transfused into the patient. In addition, we surveyed rodents collected from near the donor's residence. Examination by microscopy and PCR failed to detect the parasite in the donor's blood obtained 8 months after the donation of the blood that was transfused. However, we were able to isolate Babesia parasites by inoculating the blood sample into SCID mice whose circulating red blood cells (RBCs) had been replaced with human RBCs. A Babesia parasite capable of propagating in human RBCs was also isolated from a field mouse (Apodemus speciosus) captured near the donor's residential area. Follow-up surveys over a 1-year period revealed that the donor continued to be asymptomatic but had consistently high immunoglobulin G (IgG) titers in serum and low levels of parasitemia which were microscopically undetectable yet which were repeatedly demonstrable by inoculation into animals. The index case patient's sera contained high titers of IgM and, subsequently, rising titers of IgG antibodies, both of which gradually diminished with the disappearance of the parasitemia. Analysis of the parasite's rRNA gene (rDNA) sequence and immunodominant antigens revealed the similarity between donor and patient isolates. The rodent isolate also had an rDNA sequence that was identical to that of the human isolates but that differed slightly from that of the human isolates by Western blot analysis. We conclude that the index case patient acquired infection by transfusion from a donor who became infected in Japan, that parasitemia in an asymptomatic carrier can persist for more than a year, and that A. speciosus serves as a reservoir of an agent of human babesiosis in Japan.

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^* Corresponding author. Mailing address: School of Veterinary Medicine, Rakuno-Gakuen University, 582-1 Bunkyodai-Midorimachi, Ebetsu 069-8501, Japan. Phone and fax: 81-11-386-3144. E-mail: tsuji{at}rakuno.ac.jp.

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Journal of Clinical Microbiology, June 2001, p. 2178-2183, Vol. 39, No. 6
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.6.2178-2183.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

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