Globally, the overall pooled estimate for Babesia infections in humans is 2.23%, with a continental range of 1.54% in North America to 4.17% in Europe.[9]Karshima SN, Karshima MN, Ahmed MI. Global meta-analysis on Babesia infections in human population: prevalence, distribution and species diversity. Pathog Glob Health. 2022 Jun;116(4):220-35.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9132453
http://www.ncbi.nlm.nih.gov/pubmed/34788196?tool=bestpractice.com
Babesiosis has been a nationally notifiable condition in the US since 2011, although it may not be a reportable condition in every state. The incidence increased significantly between 2011 and 2019 in northeastern states. A total of 16,456 cases were reported by 37 states during this time. The states with the largest number of cases were New York, Massachusetts, and Connecticut. Cases increased significantly in Maine, New Hampshire, and Vermont, states not considered to have endemic babesiosis.[10]Swanson M, Pickrel A, Williamson J, et al.Trends in reported babesiosis cases - United States, 2011-2019. MMWR Morb Mortal Wkly Rep. 2023 Mar 17;72(11):273-7.
https://www.cdc.gov/mmwr/volumes/72/wr/mm7211a1.htm?s_cid=mm7211a1_w
http://www.ncbi.nlm.nih.gov/pubmed/36928071?tool=bestpractice.com
In 2022, 1708 cases were reported, with the majority reported from states in the northeastern and upper midwestern US (i.e., Massachusetts, New Jersey, New York [excluding New York City], and Maine).[11]Centers for Disease Control and Prevention. Nationally notifiable infectious diseases and conditions, United States: weekly tables. Dec 2022 [internet publication].
https://wonder.cdc.gov/nndss/static/2022/52/2022-52-table1d.html
Peak transmission occurs from May to September in upper midwestern and northeastern US.[6]Centers for Disease Control and Prevention. Tickborne diseases of the United States: a reference manual for health care providers, sixth edition. Aug 2022 [internet publication].
https://www.cdc.gov/ticks/tickbornediseases/TickborneDiseases-P.pdf
In the US, most cases of babesiosis are caused by Babesia microti.[1]Vannier E, Krause PJ. Human babesiosis. N Engl J Med. 2012;366:2397-2407.
http://www.ncbi.nlm.nih.gov/pubmed/22716978?tool=bestpractice.com
However, babesiosis due to species other than B microti (such as B duncani/MO-1) has been reported in northern California, Washington State, Kentucky, and Missouri in the US, and in Canada.[4]Conrad PA, Kjemtrup AM, Carreno RA, et al. Description of Babesia duncani n.sp. (Apicomplexa: Babesiidae) from humans and its differentiation from other piroplasms. Int J Parasitol. 2006;36:779-789.
http://www.ncbi.nlm.nih.gov/pubmed/16725142?tool=bestpractice.com
CDC: Babesiosis - national surveillance
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Babesiosis is rare in Europe, occurring mostly in splenectomised patients in France and the UK, and is most frequently due to B divergens.[8]Gelfand JA, Vannier E. Babesia species. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett's principles and practice of infectious disease. 6th ed. Philadelphia, PA: Elsevier; 2005:3209-3215. A case of babesiosis was reported in the UK in 2020.[12]Public Health England. News story: rare tick-borne infections diagnosed in England. Jul 2020 [internet publication].
https://www.gov.uk/government/news/rare-tick-borne-infections-diagnosed-in-england
Babesiosis is also rare in other countries. Infection with B venatorum has been reported in East Asia.[13]Vannier E, Gelfand JA. Babesia species. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practices of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: 3400-9