Tick-Borne Infections

  • Alaina K. PyleEmail author


Tick-borne disease is rare in the neonatal population, but an index of suspicion must exist for those infants that present with these unusual illnesses, such that appropriate treatment can be initiated as soon as possible. Obtaining a thorough clinical history from the parents of a child is of vital importance when assessing for a potential infection. Questions should include any known tick exposure (although the absence of a known tick bite should not preclude treatment); contact with animals including domestic pets, similar illness in a family member, or other close contact; and length of symptoms. Babesiosis, the most common tick-borne infection among neonates, may be transmitted via transfusion of infected blood products.


Babesia Blood transfusion Infant Lyme disease Tick 


  1. 1.
    Vannier EG, Diuk-Wasser MA, Ben Mamoun C, Krause PJ. Babesiosis. Infect Dis Clin N Am. 2015;29:357–70.CrossRefGoogle Scholar
  2. 2.
    Nelder MP, Russell CB, Sheehan NJ, et al. Human pathogens associated with the blacklegged tick Ixodes scapularis: a systematic review. Parasit Vectors. 2016;9:265.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Moritz ED, Winton CS, Tonnetti L, et al. Screening for Babesia microti in the U.S. blood supply. N Engl J Med. 2016;375:2236–45.CrossRefPubMedGoogle Scholar
  4. 4.
    Levin AE, Krause PJ. Transfusion-transmitted babesiosis: is it time to screen the blood supply? Curr Opin Hematol. 2016;23:573–80.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Joseph JT, Purtill K, Wong SJ, et al. Vertical transmission of Babesia microti, United States. Emerg Infect Dis. 2012;18:1318–21.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Simonsen KA, Harwell JI, Lainwala S. Clinical presentation and treatment of transfusion-associated babesiosis in premature infants. Pediatrics. 2011;128:e1019–24.CrossRefPubMedGoogle Scholar
  7. 7.
    Aderinboye O, Syed SS. Congenital babesiosis in a four-week-old female infant. Pediatr Infect Dis J. 2010;29:188.CrossRefPubMedGoogle Scholar
  8. 8.
    Sethi S, Alcid D, Kesarwala H, Tolan RW. Probable congenital babesiosis in infant, New Jersey, USA. Emerg Infect Dis. 2009;15:788–91.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Krause PJ, Telford S, Spielman A, et al. Comparison of PCR with blood smear and inoculation of small animals for diagnosis of Babesia microti parasitemia. J Clin Microbiol. 1996;34:2791–4.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Wang G, Wormser GP, Zhuge J, et al. Utilization of a real-time PCR assay for diagnosis of Babesia microti infection in clinical practice. Ticks Tick Borne Dis. 2015;6:376–82.CrossRefPubMedGoogle Scholar
  11. 11.
    Weiss LM. Babesiosis in humans: a treatment review. Expert Opin Pharmacother. 2002;3:1109–15.CrossRefPubMedGoogle Scholar
  12. 12.
    Raju M, Salazar JC, Leopold H, Krause PJ. Atovaquone and azithromycin treatment for babesiosis in an infant. Pediatr Infect Dis J. 2007;26:181–3.CrossRefPubMedGoogle Scholar
  13. 13.
    Powell VI, Grima K. Exchange transfusion for malaria and Babesia infection. Transfus Med Rev. 2002;16:239–50.CrossRefPubMedGoogle Scholar
  14. 14.
    Feder HM, Lawlor M, Krause PJ. Babesiosis in pregnancy. N Engl J Med. 2003;349:195–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Steere AC. Lyme disease. N Engl J Med. 2001;345:115–25.CrossRefPubMedGoogle Scholar
  16. 16.
    Centers for Disease Control and Prevention. Lyme disease graphs; cases by year. Accessed 25 Jan 2018.
  17. 17.
    Schwartz AM, Hinckley AF, Mead PS, Hook SA, Kugeler KJ. Surveillance for Lyme disease—United States, 2008-2015. MMWR Surveill Summ. 2017;66:1–12.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Schlesinger PA, Duray PH, Burke BA, Steere AC, Stillman MT. Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi. Ann Intern Med. 1985;103:67–8.CrossRefPubMedGoogle Scholar
  19. 19.
    MacDonald AB, Benach JL, Burgdorfer W. Stillbirth following maternal Lyme disease. N Y State J Med. 1987;87:615–6.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Weber K, Bratzke HJ, Neubert U, Wilske B, Duray PH. Borrelia burgdorferi in a newborn despite oral penicillin for Lyme borreliosis during pregnancy. Pediatr Infect Dis J. 1988;7:286–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Mylonas I. Borreliosis during pregnancy: a risk for the unborn child? Vector Borne Zoonotic Dis. 2011;11:891–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Strobino BA, Williams CL, Abid S, Chalson R, Spierling P. Lyme disease and pregnancy outcome: a prospective study of two thousand prenatal patients. Am J Obstet Gynecol. 1993;169:367–74.CrossRefPubMedGoogle Scholar
  23. 23.
    Schriefer ME. Lyme disease diagnosis: serology. Clin Lab Med. 2015;35:797–814.CrossRefPubMedGoogle Scholar
  24. 24.
    Sood SK. Lyme disease in children. Infect Dis Clin N Am. 2015;29:281–94.CrossRefGoogle Scholar
  25. 25.
    Schwameis M, Kundig T, Huber G, et al. Topical azithromycin for the prevention of Lyme borreliosis: a randomized, placebo-controlled, phase 3 efficacy trial. Lancet Infect Dis. 2017;17:322–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Nadelman RB, Nowakowski J, Fish D, et al. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med. 2001;345:79–84.CrossRefPubMedGoogle Scholar
  27. 27.
    Ismail N, McBride JW. Tick-borne emerging infections: ehrlichiosis and anaplasmosis. Clin Lab Med. 2017;37:317–40.CrossRefPubMedGoogle Scholar
  28. 28.
    Caulfield AJ, Pritt BS. Lyme disease coinfections in the United States. Clin Lab Med. 2015;35:827–46.CrossRefPubMedGoogle Scholar
  29. 29.
    Woods CR. Rocky mountain spotted fever in children. Pediatr Clin N Am. 2013;60:455–70.CrossRefGoogle Scholar
  30. 30.
    Dotters-Katz SK, Kuller J, Heine RP. Arthropod-borne bacterial diseases in pregnancy. Obstet Gynecol Surv. 2013;68:635–49.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Neonatal/Perinatal Medicine, Department of PediatricsYale School of MedicineNew HavenUSA

Personalised recommendations