title: Coinfection by Ixodes Tick-Borne Pathogens: Ecological, Epidemiological, and Clinical Consequences.
abstract: Ixodes ticks maintain a large and diverse array of human pathogens in the enzootic cycle, including Borrelia burgdorferi and Babesia microti. Despite the poor ecological fitness of B. microti, babesiosis has recently emerged in areas endemic for Lyme disease. Studies in ticks, reservoir hosts, and humans indicate that coinfection with B. burgdorferi and B. microti is common, promotes transmission and emergence of B. microti in the enzootic cycle, and causes greater disease severity and duration in humans. These interdisciplinary studies may serve as a paradigm for the study of other vector-borne coinfections. Identifying ecological drivers of pathogen emergence and host factors that fuel disease severity in coinfected individuals will help guide the design of effective preventative and therapeutic strategies.
authors.affiliation: Columbia University, New York, NY, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Diuk-Wasser
authors.affiliation: Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
authors.forename: Edouard
authors.initials: E
authors.lastname: Vannier
authors.affiliation: Yale School of Public Health and Yale School of Medicine, New Haven, CT, USA. Electronic address: peter.krause@yale.edu.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Krause
mesh_terms: D000818:Animals; D001096:Arachnid Vectors / Q000382:microbiology / Q000469:parasitology; D041001:Babesia microti / Q000502:physiology; D001404:Babesiosis / Q000150:complications* / Q000453:epidemiology / Q000473:pathology / Q000635:transmission; D025065:Borrelia burgdorferi / Q000502:physiology; D060085:Coinfection / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D018884:Ixodes / Q000382:microbiology* / Q000469:parasitology*; D008193:Lyme Disease / Q000150:complications* / Q000453:epidemiology / Q000473:pathology / Q000635:transmission
keywords: Babesia; Borrelia; Lyme disease; babesiosis; coinfection; tick