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  1. Article ; Online: Babesiosis Surveillance - United States, 2011-2015.

    Gray, Elizabeth B / Herwaldt, Barbara L

    Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002)

    2019  Volume 68, Issue 6, Page(s) 1–11

    Abstract: Problem/condition: Babesiosis is caused by parasites of the genus Babesia, which are transmitted in nature by the bite of an infected tick. Babesiosis can be life threatening, particularly for persons who are asplenic, immunocompromised, or elderly.: ... ...

    Abstract Problem/condition: Babesiosis is caused by parasites of the genus Babesia, which are transmitted in nature by the bite of an infected tick. Babesiosis can be life threatening, particularly for persons who are asplenic, immunocompromised, or elderly.
    Period covered: 2011-2015.
    Description of system: CDC has conducted surveillance for babesiosis in the United States since January 2011, when babesiosis became a nationally notifiable condition. Health departments in states in which babesiosis is reportable voluntarily notify CDC of cases through the National Notifiable Diseases Surveillance System (NNDSS) and submit supplemental case information by using a babesiosis-specific case report form (CRF). As of 2015, babesiosis was a reportable condition in 33 states compared with 22 states in 2011.
    Results: For the 2011-2015 surveillance period, CDC was notified of 7,612 cases of babesiosis (6,277 confirmed [82.5%] and 1,335 probable [17.5%]). Case counts varied from year to year (1,126 cases for 2011, 909 for 2012, 1,761 for 2013, 1,742 for 2014, and 2,074 for 2015). Cases were reported among residents of 27 states. However, 7,194 cases (94.5%) occurred among residents of seven states with well-documented foci of tickborne transmission (i.e., Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin). Maine (152 cases) and New Hampshire (149 cases) were the only other states that reported >100 cases for the 5-year period, and both states also reported increasing numbers of cases over time. The median age of the 7,173 patients with available information was 63 years (range: <1-99 years; interquartile range: 51-73 years); 4,156 (57.9%) were aged ≥60 years, and 15 (<1%) were aged <1 year. The proportion of patients with symptom onset during June-August was >70% for each of the 5 surveillance years. Approximately half (3,004 of 6,404 [46.9%]) of the patients with available data were hospitalized at least overnight. Hospitalization rates ranged from 16.0% among patients aged 10-19 years (16 of 100) to 72.6% among those aged ≥80 years (552 of 760). Hospitalizations were reported significantly more often among patients who were asplenic than among patients who were not (106 of 126 [84.1%] versus 643 of 1,396 [46.1%]). Fifty-one cases of babesiosis among recipients of blood transfusions were classified by the reporting health department as transfusion associated. The median intervals from the earliest date associated with each case of babesiosis to the initial report via NNDSS and submission of supplemental CRF data to CDC were approximately 3 months and 1 year, respectively.
    Interpretation: For the first 5 years of babesiosis surveillance, the reported cases occurred most frequently during June-August in the Northeast and upper Midwest. Maine and New Hampshire reported increasing numbers of cases over time, which suggests that foci of transmission might be expanding. Hospitalizations were common, particularly among patients who were asplenic or elderly.
    Public health action: Persons who live in or travel to regions where babesiosis is endemic should avoid tick-infested areas, apply repellent to skin and clothing, conduct full-body inspections for ticks after being outdoors, and remove attached ticks with fine-tipped tweezers as soon as possible. Prevention measures are especially important for persons at risk for severe babesiosis. Increases in the number and geographic range of reported cases warrant investigation to identify contributory factors (e.g., changes in tick density or in testing or surveillance methods). Complete and timely submission of risk factor data could facilitate assessments of the geographic ranges and transmission routes of Babesia parasites. Efforts to allow for electronic submission of CRF data are under way at CDC; electronic submission is expected to improve the timeliness, uniformity, and completeness of the data.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Animals ; Babesia/isolation & purification ; Babesiosis/diagnosis ; Babesiosis/epidemiology ; Babesiosis/transmission ; Centers for Disease Control and Prevention, U.S. ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Middle Aged ; Population Surveillance ; Seasons ; Ticks ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2019-05-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605652-0
    ISSN 1545-8636 ; 0892-3787
    ISSN (online) 1545-8636
    ISSN 0892-3787
    DOI 10.15585/mmwr.ss6806a1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impact of subspecialty consultations on diagnosis in the pediatric intensive care unit.

    Ramesh, Sonali / Ayres, Brennan / Eyck, Patrick Ten / Dawson, Jeffrey D / Reisinger, Heather Schacht / Singh, Hardeep / Herwaldt, Loreen A / Cifra, Christina L

    Diagnosis (Berlin, Germany)

    2022  Volume 9, Issue 3, Page(s) 379–384

    Abstract: Objectives: Intensivists and subspecialists often collaborate in diagnosing patients in the pediatric intensive care unit (PICU). Our objectives were to characterize critically ill children for whom subspecialty consultations were requested, describe ... ...

    Abstract Objectives: Intensivists and subspecialists often collaborate in diagnosing patients in the pediatric intensive care unit (PICU). Our objectives were to characterize critically ill children for whom subspecialty consultations were requested, describe consultation characteristics, and determine consultations' impact on PICU diagnosis.
    Methods: We performed a retrospective study using chart review in a single tertiary referral PICU including children admitted for acute illness. We collected data on patients with and without subspecialty consultations within the first three days of PICU admission and determined changes in PICU clinicians' diagnostic evaluation or treatment after consultations.
    Results: PICU clinicians requested 152 subspecialty consultations for 87 of 101 (86%) patients. Consultations were requested equally for assistance in diagnosis (65%) and treatment (66%). Eighteen of 87 (21%) patients with consultations had a change in diagnosis from PICU admission to discharge, 11 (61%) attributed to subspecialty input. Thirty-nine (45%) patients with consultations had additional imaging and/or laboratory testing and 48 (55%) had medication changes and/or a procedure performed immediately after consultation.
    Conclusions: Subspecialty consultations were requested during a majority of PICU admissions. Consultations can influence the diagnosis and treatment of critically ill children. Future research should investigate PICU interdisciplinary collaborations, which are essential for teamwork in diagnosis.
    MeSH term(s) Child ; Critical Illness/therapy ; Hospitalization ; Humans ; Intensive Care Units, Pediatric ; Referral and Consultation ; Retrospective Studies
    Language English
    Publishing date 2022-04-11
    Publishing country Germany
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, Non-U.S. Gov't
    ISSN 2194-802X
    ISSN (online) 2194-802X
    DOI 10.1515/dx-2021-0137
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Laboratory-acquired parasitic infections from accidental exposures.

    Herwaldt, B L

    Clinical microbiology reviews

    2001  Volume 14, Issue 4, Page(s) 659–88, table of contents

    Abstract: Parasitic diseases are receiving increasing attention in developed countries in part because of their importance in travelers, immigrants, and immunocompromised persons. The main purpose of this review is to educate laboratorians, the primary readership, ...

    Abstract Parasitic diseases are receiving increasing attention in developed countries in part because of their importance in travelers, immigrants, and immunocompromised persons. The main purpose of this review is to educate laboratorians, the primary readership, and health care workers, the secondary readership, about the potential hazards of handling specimens that contain viable parasites and about the diseases that can result. This is accomplished partly through discussion of the occupationally acquired cases of parasitic infections that have been reported, focusing for each case on the type of accident that resulted in infection, the length of the incubation period, the clinical manifestations that developed, and the means by which infection was detected. The article focuses on the cases of infection with the protozoa that cause leishmaniasis, malaria, toxoplasmosis, Chagas' disease (American trypanosomiasis), and African trypanosomiasis. Data about 164 such cases are discussed, as are data about cases caused by intestinal protozoa and by helminths. Of the 105 case-patients infected with blood and tissue protozoa who either recalled an accident or for whom the likely route of transmission could be presumed, 47 (44.8%) had percutaneous exposure via a contaminated needle or other sharp object. Some accidents were directly linked to poor laboratory practices (e.g., recapping a needle or working barehanded). To decrease the likelihood of accidental exposures, persons who could be exposed to pathogenic parasites must be thoroughly instructed in safety precautions before they begin to work and through ongoing training programs. Protocols should be provided for handling specimens that could contain viable organisms, using protective clothing and equipment, dealing with spills of infectious organisms, and responding to accidents. Special care should be exercised when using needles and other sharp objects.
    MeSH term(s) Accidents, Occupational/statistics & numerical data ; Helminthiasis/epidemiology ; Helminthiasis/parasitology ; Helminthiasis/therapy ; Helminthiasis/transmission ; Humans ; Laboratory Infection/epidemiology ; Laboratory Infection/parasitology ; Laboratory Infection/therapy ; Laboratory Infection/transmission ; Parasitic Diseases/epidemiology ; Parasitic Diseases/parasitology ; Parasitic Diseases/therapy ; Parasitic Diseases/transmission ; Protozoan Infections/epidemiology ; Protozoan Infections/parasitology ; Protozoan Infections/therapy ; Protozoan Infections/transmission ; Risk ; Wounds and Injuries/epidemiology ; Wounds and Injuries/parasitology ; Wounds and Injuries/therapy
    Language English
    Publishing date 2001-10-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645015-5
    ISSN 1098-6618 ; 0893-8512
    ISSN (online) 1098-6618
    ISSN 0893-8512
    DOI 10.1128/CMR.14.3.659-688.2001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Cyclospora cayetanensis: a review, focusing on the outbreaks of cyclosporiasis in the 1990s.

    Herwaldt, B L

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2000  Volume 31, Issue 4, Page(s) 1040–1057

    Abstract: Cyclospora cayetanensis, a coccidian parasite that causes protracted, relapsing gastroenteritis, has a short recorded history. In retrospect, the first 3 documented human cases of Cyclospora infection were diagnosed in 1977 and 1978. However, not much ... ...

    Abstract Cyclospora cayetanensis, a coccidian parasite that causes protracted, relapsing gastroenteritis, has a short recorded history. In retrospect, the first 3 documented human cases of Cyclospora infection were diagnosed in 1977 and 1978. However, not much was published about the organism until the 1990s. One of the surprises has been the fact that a parasite that likely requires days to weeks outside the host to become infectious has repeatedly caused foodborne outbreaks, including large multistate outbreaks in the United States and Canada. In this review, I discuss what has been learned about this enigmatic parasite since its discovery and what some of the remaining questions are. My focus is the foodborne and waterborne outbreaks of cyclosporiasis that were documented from 1990 through 1999. The occurrence of the outbreaks highlights the need for health care personnel to consider that seemingly isolated cases of infection could be part of widespread outbreaks and should be reported to public health officials. Health care personnel should also be aware that stool specimens examined for ova and parasites usually are not examined for Cyclospora unless such testing is specifically requested and that Cyclospora infection is treatable with trimethoprim-sulfamethoxazole.
    MeSH term(s) Animals ; Canada/epidemiology ; Cyclospora/isolation & purification ; Cyclosporiasis/diagnosis ; Cyclosporiasis/drug therapy ; Cyclosporiasis/epidemiology ; Disease Outbreaks ; Feces/parasitology ; Food Parasitology ; Foodborne Diseases/epidemiology ; Fruit/parasitology ; Gastroenteritis/diagnosis ; Gastroenteritis/drug therapy ; Gastroenteritis/epidemiology ; Humans ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use ; United States/epidemiology ; Water/parasitology
    Chemical Substances Water (059QF0KO0R) ; Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2)
    Language English
    Publishing date 2000-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1086/314051
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Miltefosine--the long-awaited therapy for visceral leishmaniasis?

    Herwaldt, B L

    The New England journal of medicine

    1999  Volume 341, Issue 24, Page(s) 1840–1842

    MeSH term(s) Administration, Oral ; Antiprotozoal Agents/adverse effects ; Antiprotozoal Agents/therapeutic use ; Female ; Gastrointestinal Diseases/chemically induced ; Humans ; Leishmaniasis, Visceral/drug therapy ; Phosphorylcholine/adverse effects ; Phosphorylcholine/analogs & derivatives ; Phosphorylcholine/therapeutic use
    Chemical Substances Antiprotozoal Agents ; Phosphorylcholine (107-73-3) ; miltefosine (53EY29W7EC)
    Language English
    Publishing date 1999-12-09
    Publishing country United States
    Document type Comment ; Editorial
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJM199912093412411
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Gentamicin/collagen sponge use may reduce the risk of surgical site infections for patients undergoing cardiac operations: a meta-analysis.

    Formanek, Michelle B / Herwaldt, Loreen A / Perencevich, Eli N / Schweizer, Marin L

    Surgical infections

    2014  Volume 15, Issue 3, Page(s) 244–255

    Abstract: Objective: A meta-analysis of all published randomized controlled trials of the effectiveness of gentamicin/collagen sponges for preventing surgical site infections (SSIs).: Background: Despite routine use of systemic prophylactic antimicrobial ... ...

    Abstract Objective: A meta-analysis of all published randomized controlled trials of the effectiveness of gentamicin/collagen sponges for preventing surgical site infections (SSIs).
    Background: Despite routine use of systemic prophylactic antimicrobial agents, SSIs continue to be associated with substantial morbidity. RESULTS conflict of studies of the efficacy of gentamicin/collagen sponges for preventing SSIs. However, many of these studies have assessed sponge use in only a single specific type of operation. The general effect of sponge use among different types of operations has not been previously assessed.
    Methods: The PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched for articles appearing from 1990 through January 2012 that were related to gentamicin/collagen sponge use and SSIs. Summary estimates were obtained through a random effects model. After reviewing 714 article abstracts and reviewing 22 articles in detail, we pooled the odds ratios (OR) for 13 independent study populations (cardiac, n=4; colorectal, n=4; pilonidal sinus, n=2; hernia, n=2; gastrointestinal, n=1) in which the association between prophylactic use of gentamicin/collagen sponges and SSIs was assessed.
    Results: Pooling of the results of all studies included in the review in a random effects model showed a significant protective effect of prophylactic use of gentamicin/collagen sponges against SSI (pooled OR: 0.66; 95% confidence interval [CI]: 0.45, 0.97; n=13). However, when the data were stratified by type of operation, a significant protective effect was observed in cardiac procedures (pooled OR: 0.59; 95% CI: 0.37, 0.96; n=4) but not in colorectal procedures (pooled OR: 0.74; 95% CI: 0.29-1.92; n=4).
    Conclusion: Use of gentamicin/collagen sponges was associated with a reduced risk of SSI following cardiac operations but not following colorectal procedures.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Biostatistics ; Collagen/therapeutic use ; Gentamicins/therapeutic use ; Humans ; Randomized Controlled Trials as Topic ; Risk Assessment ; Surgical Sponges ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Bacterial Agents ; Gentamicins ; Collagen (9007-34-5)
    Language English
    Publishing date 2014-04-28
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1440120-4
    ISSN 1557-8674 ; 1096-2964
    ISSN (online) 1557-8674
    ISSN 1096-2964
    DOI 10.1089/sur.2012.209
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Leishmaniasis.

    Herwaldt, B L

    Lancet (London, England)

    1999  Volume 354, Issue 9185, Page(s) 1191–1199

    Abstract: ... formulations of amphotericin B (though expensive and administered parenterally) represent a major advance ...

    Abstract In 1903, Leishman and Donovan separately described the protozoan now called Leishmania donovani in splenic tissue from patients in India with the life-threatening disease now called visceral leishmaniasis. Almost a century later, many features of leishmaniasis and its major syndromes (ie, visceral, cutaneous, and mucosal) have remained the same; but also much has changed. As before, epidemics of this sandfly-borne disease occur periodically in India and elsewhere; but leishmaniasis has also emerged in new regions and settings, for example, as an AIDS-associated opportunistic infection. Diagnosis still typically relies on classic microbiological methods, but molecular-based approaches are being tested. Pentavalent antimony compounds have been the mainstay of antileishmanial therapy for half a century, but lipid formulations of amphotericin B (though expensive and administered parenterally) represent a major advance for treating visceral leishmaniasis. A pressing need is for the technological advances in the understanding of the immune response to leishmania and the pathogenesis of leishmaniasis to be translated into field-applicable and affordable methods for diagnosis, treatment, and prevention of this disease.
    MeSH term(s) Amphotericin B/therapeutic use ; Animals ; Antimony/therapeutic use ; Antiprotozoal Agents/therapeutic use ; Drug Administration Schedule ; Female ; HIV Infections/complications ; Humans ; Leishmania/isolation & purification ; Leishmaniasis/diagnosis ; Leishmaniasis/drug therapy ; Leishmaniasis/immunology ; Leishmaniasis/transmission ; Leishmaniasis, Cutaneous/diagnosis ; Leishmaniasis, Cutaneous/drug therapy ; Leishmaniasis, Mucocutaneous/diagnosis ; Leishmaniasis, Mucocutaneous/drug therapy ; Leishmaniasis, Visceral/complications ; Leishmaniasis, Visceral/diagnosis ; Leishmaniasis, Visceral/drug therapy ; Male
    Chemical Substances Antiprotozoal Agents ; Amphotericin B (7XU7A7DROE) ; Antimony (9IT35J3UV3)
    Language English
    Publishing date 1999-10-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0140-6736 ; 0023-7507
    ISSN (online) 1474-547X
    ISSN 0140-6736 ; 0023-7507
    DOI 10.1016/S0140-6736(98)10178-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Staphylococcus aureus in the nose and throat of Iowan families.

    Hanson, B M / Kates, A E / O'Malley, S M / Mills, E / Herwaldt, L A / Torner, J C / Dawson, J D / Farina, S A / Klostermann, C / Wu, J Y / Quick, M K / Forshey, B M / Smith, T C

    Epidemiology and infection

    2018  Volume 146, Issue 14, Page(s) 1777–1784

    Abstract: The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus colonisation. In total 263 participants (177 adults and ... ...

    Abstract The study objective was to determine the prevalence of Staphylococcus aureus colonisation in the nares and oropharynx of healthy persons and identify any risk factors associated with such S. aureus colonisation. In total 263 participants (177 adults and 86 minors) comprising 95 families were enrolled in a year-long prospective cohort study from one urban and one rural county in eastern Iowa, USA, through local newspaper advertisements and email lists and through the Keokuk Rural Health Study. Potential risk factors including demographic factors, medical history, farming and healthcare exposure were assessed. Among the participants, 25.4% of adults and 36.1% minors carried S. aureus in their nares and 37.9% of adults carried it in their oropharynx. The overall prevalence was 44.1% among adults and 36.1% for minors. Having at least one positive environmental site for S. aureus in the family home was associated with colonisation (prevalence ratio: 1.34, 95% CI: 1.07-1.66). The sensitivity of the oropharyngeal cultures was greater than that of the nares cultures (86.1% compared with 58.2%, respectively). In conclusion, the nares and oropharynx are both important colonisation sites for healthy community members and the presence of S. aureus in the home environment is associated with an increased probability of colonisation.
    MeSH term(s) Adolescent ; Adult ; Aged ; Carrier State/epidemiology ; Carrier State/microbiology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Iowa/epidemiology ; Male ; Middle Aged ; Nose/microbiology ; Oropharynx/microbiology ; Prevalence ; Prospective Studies ; Risk Factors ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/microbiology ; Staphylococcus aureus/isolation & purification ; Young Adult
    Language English
    Publishing date 2018-06-22
    Publishing country England
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 632982-2
    ISSN 1469-4409 ; 0950-2688
    ISSN (online) 1469-4409
    ISSN 0950-2688
    DOI 10.1017/S0950268818001644
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: A longitudinal study of Babesia microti infection in seropositive blood donors.

    Leiby, David A / Johnson, Stephanie T / Won, Kimberly Y / Nace, Eva K / Slemenda, Susan B / Pieniazek, Norman J / Cable, Ritchard G / Herwaldt, Barbara L

    Transfusion

    2014  Volume 54, Issue 9, Page(s) 2217–2225

    Abstract: ... methods: Eligible donors had B. microti indirect fluorescent antibody (IFA) titers of 64 or greater ... Enrollees were monitored up to 3 years, by IFA and three methods for evidence of parasitemia: B. microti ...

    Abstract Background: Babesia infection is caused by intraerythrocytic tick-borne parasites. Cases of transfusion-transmitted babesiosis have been increasingly recognized. To date, no Babesia test has been licensed for screening US blood donors. We conducted a longitudinal study to assess the course and markers of Babesia infection among seropositive donors identified in a seroprevalence study.
    Study design and methods: Eligible donors had B. microti indirect fluorescent antibody (IFA) titers of 64 or greater. Enrollees were monitored up to 3 years, by IFA and three methods for evidence of parasitemia: B. microti nested polymerase chain reaction (PCR) analysis (at two laboratories), hamster inoculation, and blood-smear examination.
    Results: Among 115 eligible donors, 84 (73%) enrolled. Eighteen enrollees (21%) had evidence of parasitemia for 30 total specimens (17% of 181), which were collected in 9 different months and tested positive by various approaches: PCR (25 specimens/16 persons), hamster inoculation (13 specimens/8 persons), and blood smear (one specimen positive by all three approaches). Overall, 14 persons had one or more specimen with positive PCR results at both laboratories (12 persons) and/or had parasitologically confirmed infection (eight persons). Three of nine persons who had more than one specimen with evidence of parasitemia had nonconsecutive positives. Several enrollees likely had been infected at least 1 year when their last positive specimen was collected. The final three specimens for seven persons tested negative by all study methods, including IFA.
    Conclusion: Seropositive blood donors can have protracted low-level parasitemia that is variably and intermittently detected by parasitologic and molecular methods. Donor-screening algorithms should include serologic testing and not solely rely on molecular testing.
    MeSH term(s) Adult ; Aged ; Antibodies, Protozoan/analysis ; Babesia microti/immunology ; Babesia microti/pathogenicity ; Babesiosis/blood ; Babesiosis/immunology ; Blood Donors/statistics & numerical data ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; Parasitemia/blood ; Parasitemia/immunology ; Parasitemia/parasitology
    Chemical Substances Antibodies, Protozoan
    Language English
    Publishing date 2014-03-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 208417-x
    ISSN 1537-2995 ; 0041-1132
    ISSN (online) 1537-2995
    ISSN 0041-1132
    DOI 10.1111/trf.12622
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Cryptosporidiosis: an outbreak associated with drinking water despite state-of-the-art water treatment

    Herwaldt, B. L.

    Annals of Internal Medicine

    1996  Volume 124, Issue 5, Page(s) 459–468

    Institution Mailstop F-22, 4770 Buford Highway NE, USA-Atlanta, GA 30341-3724 c/o B.L. Herwaldt, Centers for Disease Control and Prevention, Division of Parasitic Diseases
    Keywords Protozoeninfektion ; Trinkwasser ; Fallkontrollstudie ; HIV-Infektion
    Language English
    Document type Article
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    Database Social Medicine (SOMED)

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