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The study described below found that babesiosis

(http://en.wikipedia.org/wiki/Babesiosis) is increasing in the elderly, and its

range is spreading.

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Babesiosis, a malaria-like disease, may be rising among elderly in U.S.

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Some individuals, particularly elderly individuals who are experiencing flu-like

symptoms might be actually suffering from a malaria-like disease called

babesiosis. A study by scientists at the U.S. Food and Drug Administration (FDA)

and researchers from a consulting firm and the Centers for Medicare and Medicaid

Services (CMS) found that elderly populations living in Connecticut, Rhode

Island, New York, and Massachusetts had the highest rates of babesiosis among

the elderly population and that such infections appear to be on rise in

land, Virginia, and the District of Columbia.

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The study, which focused on babesiosis diagnosed among elderly (65 years of age

and older) Medicare beneficiaries from 2006 through 2008, found that that the

disease was diagnosed in this population most often during the summer. Overall,

41% of all cases were diagnosed during the months of July and August. This

seasonal concentration of diagnosed cases is probably due to the transmission

season of Babesia parasites and activity of the tick that carries Babesia. In

addition, people are more likely to spend time outdoors during these months and

be exposed to the tick.

The FDA scientists and their collaborators collected data on clinical babesiosis

in this population from Medicare enrollment files, as well as data bases from

various medical facilities, such as skilled nursing homes. The scientists used

the data to estimate the number of cases of babesiosis per each 100,000 Medicare

beneficiaries each year from 2006 through 2008.

The number of elderly Medicare patients (65 years of age and older) who had

babesiosis from 2006 through 2008 was 985 in 2006, 851 in 2007, and 1,223 in

2008. That is equivalent to rates of 3.6/100,000 beneficiaries (2006),

3.2/100,000 (2007), and 4.7/100,000 (2008).

Annual rates of babesiosis were significantly higher for men versus women and

for women aged 65-84 years compared to women 85 years and older. This was

consistent with data previously collected by various state health agencies.

Annual rates among elderly whites were 4.0/100,000 (beneficiaries) (2006),

3.6/100,000 (2007), and 5.2/100,000 (2008). The rates among elderly nonwhites

were 0.6/100,000 (2006), 0.9/100,000 (2007), and 1.4/100,000 (2008).

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Babesiosis is caused by infection of red blood cells by a protozoan (a

single-celled parasite) called Babesia which are closed related to the parasites

that cause malaria. Babesia infections can be asymptomatic (no visible clinical

disease) or cause mild, flu-like symptoms such as fever, chills and aches.

Severe complications, including multi-organ failure, and death, occur mostly in

people without a spleen, those with immune system dysfunction, and the neonates

and elderly. T he Babesia parasite is carried and spread by ticks, which acquire

the parasite while feeding on infected mice or some other mammals.

The study is important because it suggests that large administrative healthcare

databases such as those maintained by Medicare, state public health departments,

and health insurance companies can be used to assess the risk of emerging

infections in the United States.

Title

**Babesiosis among Elderly Medicare Beneficiaries, United States, 2006-2008**

Emerging Infectious Diseases

Vol. 18, No. 1, January 2012

Authors:

Mikhail Menis, A. , S. Izurieta, Sanjai Kumar, Dale R.

Burwen, Mark Walderhaug (CBER, US Food and Drug Administration)

Gibbs, Garner Kropp, Tugce Erten, E. MaCurdy (Acumen LLC,

Burlingame, California)

M. Worrall and A. Kelman (Centers for Medicare & Medicare

Services, Baltimore, MD)

http://www.fda.gov/BiologicsBloodVaccines/ScienceResearch/ucm297401

Abstract at: http://www.ncbi.nlm.nih.gov/pubmed/22257500

PDF at: http://wwwnc.cdc.gov/eid/article/18/1/pdfs/11-0305.pdf