New study shows babesiosis cases growing in New Jersey
By RICK HEPP
A difficult to diagnose and potentially-deadly tick-borne disease has reached endemic proportions in New Jersey just six years after the state recorded no such cases, according to a federal study that will be published next month.
Investigators for the Centers for Disease Control and Prevention also found the parasitic disease, known as babesiosis, was particularly acute in Ocean and Burlington counties. Of the 40 studied cases reported between 1993 and 2001, more than half of them emanated from the two counties.
However, authors of the study, which will be published in the February issue of Emerging Infectious Diseases, stopped short of saying the disease was more prevalent in central counties than elsewhere in the state.
Babesiosis (pronounced bah-BEE-see-oh-sis) is caused by a parasite that invades red blood cells and can be transmitted by the same tick that carries Lyme disease. Humans can also get the disease through blood transfusions.
Two of the cases studied by the CDC involved patients who later died from the disease, although the center noted babesiosis rarely results in fatalities. Early symptoms include tiredness, loss of appetite, and a general malaise while late-stage symptoms can include fever, drenching sweats, muscle aches and a headache.
Researchers also suspect the number of cases they looked at "probably represent only a fraction of the clinical cases" of babesiosis because few doctors know to check for the disease.
Most reported cases of babesiosis have been found in the Northeast -- particularly in New York, Massachusetts, Connecticut and Rhode Island -- so it is not surprising that the disease has made its way to New Jersey, the study found.
Of the 40 cases studied, all were acquired in eight of the state's 21 counties. While Ocean (12 cases) and Burlington (13) accounted for 65 percent of the cases, the disease was also discovered in Atlantic (5), Monmouth (3), Hunterdon (3), Somerset (2), Mercer (1) and Camden (1).
The study also found that most of the cases occurred in elderly people -- the median age of patients was 67 years -- and more than half were men.
The New Jersey Department of Health and Senior Services began collecting data on the disease in 1985 but discontinued the practice five years later because no cases had been reported. The department reinstated the reporting in 1995, and the first case of babesiosis was recorded in 1997.
Since then 72 cases have been reported, including 21 in 2001 and 23 last year, according to department statistics. Not all cases recorded by the state were included in the CDC study.
Dr. Eddy Bresnitz, the state epidemiologist and assistant health commissioner, said the study raises some concern from a public-health perspective, but that clearly babesiosis will not reach the infection levels of the more prevalent Lyme disease, which afflicted more than 2,000 people two years ago.
"I think it is endemic, and we'll always have some cases," Bresnitz said. "But it's not likely to take over Lyme disease in terms of the state's primary tick-related illness. In perspective, it's not as significant an illness."
The presence of babesiosis could help also explain why some people with Lyme disease do not improve in health despite antibiotic treatment, according to the study.
"For those doctors who are in areas where they have ticks and tick-related illnesses, this might be one more thing to consider," Bresnitz said.
Researchers said the escalation of the disease could could include a growing abundance of the local deer tick population or the introduction of a more virulent strain of babesiosis. It could also be attributed to an increased awareness or better reporting of the disease.
The health department may send a message through the state's health-alert network informing physicians that the study is available on the Internet, Bresnitz said.
The CDC initialized its investigation in 1999 after a 53-year-old Burlington woman was hospitalized with respiratory distress and anemia. She was eventually diagnosed with babesiosis and survived.
Rick Hepp: (732) 643-4212 or firstname.lastname@example.org