{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:20:24Z","timestamp":1760235624460,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["x"],"award-info":[{"award-number":["x"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Fifty years ago, the index case of human babesiosis due to Babesia microti was diagnosed in a summer resident of Nantucket Island. Human babesiosis, once called \u201cNantucket fever\u201d due to its seeming restriction to Nantucket and the terminal moraine islands of southern New England, has emerged across the northeastern United States to commonly infect people wherever Lyme disease is endemic. We review the history of babesiosis on Nantucket, analyze its epidemiology and ecology there, provide summaries of the first case histories, and comment on its future public health burden.<\/jats:p>","DOI":"10.3390\/pathogens10091159","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T21:36:58Z","timestamp":1631223418000},"page":"1159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Semicentennial of Human Babesiosis, Nantucket Island"],"prefix":"10.3390","volume":"10","author":[{"suffix":"III","given":"Sam R.","family":"Telford","sequence":"first","affiliation":[{"name":"Department of Infectious Disease and Global Health, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi K.","family":"Goethert","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease and Global Health, Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Lepore","sequence":"additional","affiliation":[{"name":"Nantucket Cottage Hospital, Nantucket, MA 02554, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1056\/NEJM197010152831607","article-title":"Babesiosis in a Massachusetts resident","volume":"283","author":"Western","year":"1970","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1001\/jama.1977.03280130063022","article-title":"Nantucket fever: An additional case of babesiosis","volume":"238","author":"Scharfman","year":"1977","journal-title":"J. Am. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss6806a1","article-title":"Babesiosis surveillance\u2014United States, 2011\u20132015","volume":"68","author":"Gray","year":"2019","journal-title":"MMWR Surveill. Summ."},{"key":"ref_4","unstructured":"Desowitz, R.S. (1981). New Guinea Tapeworms and Jewish Grandmothers, WW Norton."},{"key":"ref_5","first-page":"291","article-title":"Long odyssey of babesiosis","volume":"87","author":"Moss","year":"1990","journal-title":"N. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.2307\/3277582","article-title":"The Gray strain of Babesia microti established in laboratory animals","volume":"56","author":"Gleason","year":"1970","journal-title":"J. Parasitol."},{"key":"ref_7","first-page":"1029","article-title":"Infection of Microtus ochrogaster with piroplasms isolated from man","volume":"56","author":"Healy","year":"1971","journal-title":"J. Parasitol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4269\/ajtmh.1971.20.14","article-title":"Babesia species isolated from a woman with clinical babesiosis","volume":"20","author":"Ristic","year":"1971","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Goethert, H.K., Molloy, P.J., Berardi, V.P., Weeks, K., and Telford, S.R. (2018). Zoonotic Babesia microti in the northeastern United States: Evidence for expansion of a specific parasite lineage. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193837"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/nmicrobiol.2016.79","article-title":"A global map of genetic diversity in Babesia microti reveals strong population structure and identifies variants associated with clinical relapse","volume":"1","author":"Lemieux","year":"2016","journal-title":"Nat. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1093\/ajcp\/62.5.612","article-title":"Babesiosis in man: Sixth documented case","volume":"62","author":"Anderson","year":"1974","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"430","DOI":"10.2307\/3280290","article-title":"Susceptibility of five strains of laboratory mice to Babesia microti of human origin","volume":"65","author":"Ruebush","year":"1979","journal-title":"J. Parasitol."},{"key":"ref_13","unstructured":"Clark, I.A. (1976). Immunity to Intra-Erythrocytic Protozoa in Mice, with Special Reference to Babesia sp.. [Ph.D. Thesis, University of London]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/0008-8749(80)90347-0","article-title":"Transfer of immunity to Babesia microti of human origin using T lymphocytes in mice","volume":"52","author":"Ruebush","year":"1980","journal-title":"Cell. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"742","DOI":"10.4269\/ajtmh.1980.29.742","article-title":"Human babesiosis on Nantucket Island: Prevalence of Babesia microti in ticks","volume":"29","author":"Piesman","year":"1980","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1128\/jcm.30.8.2097-2103.1992","article-title":"Detection of Babesia microti by polymerase chain reaction","volume":"30","author":"Persing","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.7326\/0003-4819-86-1-6","article-title":"Human babesiosis on Nantucket Island: Clinical characteristics","volume":"86","author":"Ruebush","year":"1977","journal-title":"Ann. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1126\/science.769166","article-title":"Human babesiosis: Reservoir of infection on Nantucket Island","volume":"192","author":"Healy","year":"1976","journal-title":"Science"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1056\/NEJM197710132971511","article-title":"Human babesiosis on Nantucket Island. Evidence for self-limited and subclinical infections","volume":"297","author":"Ruebush","year":"1977","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1093\/clind\/15.6.1019","article-title":"Human babesiosis in New York State: An epidemiological description of 136 cases","volume":"15","author":"Meldrum","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1128\/jcm.24.3.446-447.1986","article-title":"Concurrent Borrelia burgdorferi and Babesia microti infection in nymphal Ixodes dammini","volume":"24","author":"Piesman","year":"1986","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","first-page":"1320","article-title":"Babesiosis on Shelter Island","volume":"77","author":"Grunwaldt","year":"1977","journal-title":"N. Y. State J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1093\/infdis\/170.4.1027","article-title":"Detection of Borrelia burgdorferi DNA in museum specimens of Peromyscus leucopus","volume":"170","author":"Marshall","year":"1994","journal-title":"J. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"200","DOI":"10.7326\/0003-4819-88-2-200","article-title":"Failure of chloroquine in human babesiosis (Babesia microti)","volume":"88","author":"Miller","year":"1978","journal-title":"Ann. Intern. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.pt.2007.09.005","article-title":"Shared features in the pathobiology of babesiosis and malaria","volume":"23","author":"Krause","year":"2007","journal-title":"Trends Parasitol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1038\/s41584-020-0372-x","article-title":"Mechanisms of action of hydroxychloroquine and chloroquine: Implications for rheumatology","volume":"16","author":"Schrezenmeier","year":"2020","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"937","DOI":"10.4269\/ajtmh.1981.30.937","article-title":"Epidemiology of human babesiosis on Nantucket Island","volume":"30","author":"Ruebush","year":"1981","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"784","DOI":"10.4269\/ajtmh.1976.25.784","article-title":"Human babesiosis on Nantucket Island: Transmission by nymphal Ixodes ticks","volume":"25","author":"Spielman","year":"1976","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1056\/NEJMoa1600897","article-title":"Screening for Babesia microti in the US blood supply","volume":"375","author":"Moritz","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_30","unstructured":"Piesman, J. (1980). Ixodes Dammini: Its Role in Transmitting Babesia microti to Man. [Ph.D. Thesis, Harvard School of Public Health]."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1093\/jmedent\/15.3.218","article-title":"Human babesiosis on Nantucket Island, USA: Description of the vector, Ixodes (Ixodes) dammini, n. sp. (Acarina: Ixodidae)","volume":"15","author":"Spielman","year":"1979","journal-title":"J. Med. Entomol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"132","DOI":"10.3201\/eid0401.980126","article-title":"The name Ixodes dammini epidemiologically justified","volume":"4","author":"Telford","year":"1998","journal-title":"Emerg. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.meegid.2015.04.003","article-title":"Natural hybridization of the ticks Ixodes persulcatus and Ixodes pavlovskyi in their sympatric populations in Western Siberia","volume":"32","author":"Kovalev","year":"2015","journal-title":"Infect. Genet. Evol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Sakamoto, J.M., Goddard, J., and Rasgon, J. (2014). Population and demographic structure of Ixodes scapularis Say in the Eastern United States. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0101389"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4269\/ajtmh.1978.27.14","article-title":"Babesia microti infection in man: Evaluation of an indirect immu nofluorescent antibody test","volume":"27","author":"Chisholm","year":"1978","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1093\/oxfordjournals.aje.a114757","article-title":"Seasonal variation of transmission risk of Lyme disease and human babesiosis","volume":"126","author":"Piesman","year":"1987","journal-title":"Am. J. Epidemiol."},{"key":"ref_37","first-page":"1","article-title":"Not \u201cout of Nantucket\u201d: Babesia microti in southern New England comprises at least two major populations","volume":"7","author":"Goethert","year":"2014","journal-title":"Parasits Vectors"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1017\/S0031182000025774","article-title":"Cytoecetes microti, n.g., n.sp., a parasite developing in granulocytes and infective for small rodents","volume":"30","author":"Tyzzer","year":"1938","journal-title":"Parasitology"},{"key":"ref_39","first-page":"1","article-title":"Babesial infections of humans and wildlife","volume":"Volume 5","author":"Kreier","year":"1993","journal-title":"Parasitic Protozoa"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1001\/jama.1994.03520030054028","article-title":"Human granulocytic ehrlichiosis in the upper Midwest United States. A new species emerging?","volume":"272","author":"Bakken","year":"1994","journal-title":"JAMA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"277","DOI":"10.7326\/0003-4819-123-4-199508150-00006","article-title":"Human granulocytic ehrlichiosis in Massachusetts","volume":"123","author":"Telford","year":"1995","journal-title":"Ann. Int. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"6209","DOI":"10.1073\/pnas.93.12.6209","article-title":"Perpetuation of the agent of human granulocytic ehrlichiosis in a deer tick-rodent cycle","volume":"93","author":"Telford","year":"1996","journal-title":"Proc. Nat. Acad. Sci. USA"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"455","DOI":"10.4269\/ajtmh.2003.69.455","article-title":"Enzootic transmission of Babesia divergens among cottontail rabbits on Nantucket Island, Massachusetts","volume":"69","author":"Goethert","year":"2003","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"165","DOI":"10.3201\/eid0302.970209","article-title":"A new tick-borne encephalitis-like virus infecting deer ticks, Ixodes dammini","volume":"3","author":"Telford","year":"1997","journal-title":"Emerg. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4269\/ajtmh.2000.63.36","article-title":"Enzootic transmission of deer tick virus in New England and Wisconsin sites","volume":"63","author":"Ebel","year":"2000","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/jmedent\/25.4.224","article-title":"Reduced abundance of immature Ixodes dammini (Acari: Ixodidae) following elimination of deer","volume":"25","author":"Wilson","year":"1988","journal-title":"J. Med. \u00c8ntomol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"609","DOI":"10.4269\/ajtmh.1987.36.609","article-title":"Lyme disease and babesiosis: Acaricide focused on potentially infected ticks","volume":"36","author":"Mather","year":"1987","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1056\/NEJM200011163432004","article-title":"Atovaquone and azithromycin for the treatment of babesiosis","volume":"343","author":"Krause","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"556","DOI":"10.7326\/0003-4819-97-4-556","article-title":"Therapy of experimental babesiosis","volume":"97","author":"Rowin","year":"1982","journal-title":"Ann. Intern. Med."},{"key":"ref_50","first-page":"65","article-title":"Epidemiologic notes and reports: Clindamycin and quinine treatment for Babesia microti infections","volume":"32","author":"Dammin","year":"1983","journal-title":"MMWR"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1084\/jem.20151519","article-title":"Radical cure of experimental babesiosis in immunodeficient mice using a combination of an endochin-like quinolone and atovaquone","volume":"213","author":"Lawres","year":"2016","journal-title":"J. Exp. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1086\/525852","article-title":"Persistent and relapsing babesiosis in immunocompromised patients","volume":"46","author":"Krause","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"20180105","DOI":"10.1098\/rstb.2018.0105","article-title":"Mice against ticks: An experimental community-guided effort to prevent tick-borne disease by altering the shared environment","volume":"374","author":"Buchthal","year":"2019","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/9\/1159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:59:23Z","timestamp":1760165963000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/9\/1159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,9]]},"references-count":53,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["pathogens10091159"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10091159","relation":{},"ISSN":["2076-0817"],"issn-type":[{"type":"electronic","value":"2076-0817"}],"subject":[],"published":{"date-parts":[[2021,9,9]]}}}