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Answer: c. Thirty-seven days is the median time from transfusion to onset of symptoms (if symptoms appear) reported in the literature, with a range from 11 to 176 days.
Answer: a. Ixodes scapularis can also transmit Borrelia burgdorferi, the causative agent of Lyme disease. The other tick species listed are matched with appropriate infectious agents, but they do not transmit Babesia spp.
Answer: c. Giemsa-stained blood smears remain the gold standard for diagnosis. Real-time PCR is the most sensitive and specific diagnostic test, but there are no FDA-cleared tests commercially available. Antibody detection and titer by IFA analysis is available through reference laboratories and may be helpful in certain situations but is not recommended for primary diagnosis. Inoculation of a hamster (or other small rodent) is widely reported for detection of Babesia spp. directly from patient blood samples but is not practical for clinical laboratories.