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Here is an article about Babesiosis in New Jersey, from 2003.
There are lots of babesiosis cases reported on Martha's Vinyard. I think any of the diseases we call "coinfections" can be acquired one by one.
[quote] Little-known tick-borne illness found in New Jersey
The Associated Press 1/29/03 10:54 AM
NEWARK, N.J. (AP) -- A rarely diagnosed tick-borne illness has infected people in eight New Jersey counties, according to a federal study that will be published next month.
Babesiosis, caused by a parasite that invades red blood cells, was confirmed in 40 cases in New Jersey from 1993 to 2001, according to investigators with the Centers for Disease Control and Prevention.
Two of the patients, who were not identified, died, the study said.
Babesiosis is transmitted by the same tick that carries Lyme disease, which is common in New Jersey. The ticks are found on deer and mice, although humans can also get the disease through blood transfusions.
Most of the babesiosis cases were found in Burlington and Ocean counties, although others were discovered in Hunterdon, Somerset, Mercer, Monmouth, Camden and Atlantic counties.
The study said the 40 diagnoses probably represent only a fraction of actual cases because few doctors know to check for the disease.
"I think babesiosis is a problem that will grow as people move closer to areas with deer," Michal P. Gerwel, a senior public health physician for New Jersey, told The Star-Ledger of Newark.
The disease has long been known to infect people in Connecticut, Rhode Island, Massachusetts and New York, but it was not thought to be a problem in New Jersey.
"We want to educate medical professionals that, yes, babesiosis can be a diagnosis in New Jersey," said Barbara L. Herwaldt, lead investigator of the study, which will be published in the February issue of the journal Emerging Infectious Diseases.
The presence of babesiosis could help explain why some people with Lyme disease do not get better, despite antibiotic treatment, according to the study.
Not everyone infected with babesiosis will get sick, doctors say. Some may experience mild flu-like symptoms and get better without treatment. Patients in the worst cases experience muscle aches, fever and hemolytic anemia, in which red blood cells are destroyed.
About 5 percent of people who get the disease die. The elderly are more likely to become seriously ill.
The CDC began the New Jersey investigation in 1999 after a previously healthy 53-year-old woman in Burlington County was hospitalized with respiratory distress and anemia.
She was eventually diagnosed with babesiosis and survived.[end quote]