Humane Babesiose – eine seltene, aber potenziell gefährliche Zoonose

Zusammenfassung

Die humane Babesiose ist eine Erkrankung durch intraerythrozytäre Parasiten des Genus Babesia (Stamm Apicomplexa). Die Übertragung auf den Menschen erfolgt in der Regel durch Zecken, seltener ist auch eine Transmission über kontaminierte Blutprodukte oder perinatal möglich. Während in den USA endemische Staaten bekannt sind und die Bedeutung der Erreger in der Transfusionsmedizin jährlich zunimmt, gibt es für Europa nur unzureichende Daten zur klinischen Relevanz der humanpathogenen Spezies. Der folgende Beitrag soll die Gefahr der Erkrankung für Deutschland näher beleuchten.

Die humane Babesiose ist eine zoonotische Erkrankung, die aufgrund der steigenden Anzahl immunsupprimierter Personen weltweit zunehmende Bedeutung erlangt. Das klinische Bild reicht von asymptomatischen bis zu sehr schweren letalen Verläufen. Die bisherigen Ergebnisse zum Nachweis infizierter Zecken sowie zur Seroepidemiologie in Europa zeigen das Vorkommen von 3 humanpathogenen Spezies: B. microti, B. divergens und B. venatorum (EU1–3). Die dazu verhältnismäßig geringe Anzahl von ca. 50 dokumentierten humanpahogenen Fällen resultiert sehr wahrscheinlich aus der Unkenntnis der Existenz und mangelnden diagnostischen Möglichkeiten.

Umfassende systematisierte flächendeckende Untersuchungen der Prävalenz in Zecken, weitere seroepidemiologische Studien und verbesserte diagnostische Tests sind zur Evaluation der Bedeutung des Erregers unter Einbezug der Transfusionsmedizin dringend erforderlich.

Abstract

Human babesiosis is caused by the intraerythrocytic parasite of the genus Babesia (phylum Apicomplexa). Humans are commonly infected by the bite of Ixodid ticks. Rarely, transmission does occur perinatal or via contaminated blood transfusion. There is only insufficient data available on the clinical relevance in Europe, whereas there are known endemic states in the United States with an increasing importance of the disease in transfusion medicine. The following article gives an overview of the situation in Germany.

Human babesiosis is a zoonotic disease with a worldwide increasing importance according to the increasing number of immunocompromised patients. Clinical symptoms have a wide range from asymptomatic to severe and letal cases. So far, the detection of the parasites in ticks and seroepidemiological data in Europe identified 3 humanpathogenic species: B. microti, B. divergens und B. venatorum (EU1–3). The relative small number of approximately 50 documented human cases is probably due to the lack of knowledge of the disease and the availability of diagnostic tools.

Comprehensive systematic investigations of the prevalence in ticks, seroepidemiological data and improved diagnostic tests are urgently needed to evaluate the importance of the parasite.

Schlüsselwörter

Babesien - Zoonose - Zecken

Keywords

Babesia - zoonosis - ticks

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