Babesiosis is a tick-borne malaria-like illness caused by species of the protozoan Babesia that infects your red blood cells. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, and the northwestern and northeastern United States. Babesiosis often occurs at the same time as Lyme disease because the tick that carries the Lyme bacteria can also be infected with the Babesia parasite.
Dr. Omar Morales, founder of Lyme Mexico Clinic, answers some frequently asked questions and provides us with insight on how to prevent and treat Babesia infection.
What are the leading causes of Babesiosis?
DR. OMAR MORALES: Mainly it is transmitted by a tick bite. Most of the time, it goes unnoticed since the tick can be carried by house pets and is usually as small as a poppy seed—generally localized in the back of the neck, groin area, arm pits, legs and abdomen and doesn’t necessarily create pain or discomfort at the bite zone. It also can be spread by blood transfusions and at birth from an infected mother to her baby.
What is the connection between Babesiosis and Lyme disease?
OM: It is indisputable that Lyme Disease is actually a broad catch-all phrase for Lyme as well as its many co-infections including Babesia which is believed to be present along with Lyme in up to 40 percent of the time.
What can you do to prevent Babesia infection?
OM: Currently, most blood banks do not screen donated blood for babesia, causing an imminent danger for the current US blood supply. Awareness is still a major challenge as most people ignore the fact that more than 300,000 cases a year in the US alone have been identified to be infected with Lyme disease—from those cases more than a third are also infected with Babesia and could unknowingly participate in blood drives or other activities that could increase dissemination among the healthy population.
In your experience, what are the typical early signs and symptoms of Babesiosis?
OM: Similar to Malaria, it often starts with fever and chills. As the infection progresses, patients may develop fatigue, headache, drenching sweats, muscle aches, chest pain, hip pain and shortness of breath (“air hunger”). Babesiosis is often so mild it is not noticed but can be life-threatening to people with no spleen, the elderly, and people with weak immune systems. Complications include very low blood pressure, liver problems, severe hemolytic anemia (a breakdown of red blood cells), and kidney failure.
Clinically, Babesiosis appears to have a wide spectrum of disease severity. Most patients experience a viral-like illness that can last weeks to months but a significant minority of patients are entirely asymptomatic. Is it possible to diagnose a patient who is not showing any symptoms?
OM: Traditionally the PCR (polymerase chain reaction) test can detect babesia DNA in the blood. Other tests, such as The FISH (Fluorescent In-Situ Hybridization) assay, can detect the ribosomal RNA of Babesia in thin blood smears. In its acute phase, Babesia can sometimes be simply observed under a conventional microscope which is a quick and efficient technique when done properly. This is my personal favorite method for its lower cost and accessibility in the medical office. It is very similar to Malaria, both clinically and under the microscope as well, as they are both blood-borne intracellular organisms with similar pathogenesis.
What should one do if they think they might have Babesiosis?
OM: Contact an expert. Unfortunately, many infectious disease doctors may find themselves not very familiarized with the treatment of conventional or, even worse, severe Babesiosis as it is considered to be more of a tropical disease and defined as restricted mostly to certain locations. It is reported mostly in developing countries thus local experienced physicians can sometimes be limited.
What treatment is generally offered?
OM: Seven to 10 days of oral antimicrobials and, in the worst cases, anti-malarial therapy (treatment for malaria). In my experience, this is generally not effective in severe cases and the parasite has a rebound effect from these therapies, causing the patient to feel sick for months and sometimes even years.
How does the red blood cell transfusion process offered at Lyme Mexico Clinic work to treat the Babesia infection?
OM: As Babesia is limited to only infecting red blood cells and nothing else, this approach works without fail based on a simple principal: “reduce the parasite percentage in the blood by selectively exchanging infected blood cells by apheresis for healthy sterilized blood cells without the parasite, then a short course of antimicrobials will finish the job once and for all” as observed in multiple studies on Babesiosis conducted and published in the International Journal of Infectious Diseases. This approach is also considered as a first line of therapy in the American Association for Apheresis Guidelines based on cases not responsive to conventional treatment and in critical circumstances. Treated patients have indeed benefited by replacing their infected red blood cells for healthy donated cells provided by donors. I have personally seen this in a multitude of cases treated under my care, where conventional therapy has abandoned them and radical options, such as this one, has been the only solution—providing a quick and effective method to clear the patient’s infested cells of parasites and curing them from the Babesia ailment. In short, these patients who have been suffering for years and unresponsive to antimicrobial therapy are able to regain their ability to function and become a working, capable member of society just after a few red blood exchanges. I am convinced that when the candidate is selected properly, the donated blood is screened accordingly and passed through the required prerequisites, and then further processed through a pathogen inactivation protocol, we are not only able to provide a healthy and aseptic cure for Babesia, but a lasting result free of side effects.
This article is presented by T1.