Babesiosis - Causes, Symptoms, Risk Factors, Treatment

Introduction:

Babesiosis is a rare illness that affects both men and women and people of any age. However, it is likely to occur in people above 50 years, people with a weakened immune system, and people whose spleen was removed. Approximately 200 cases of the illness were reported in the United States in 1980. Over 450 cases have been recorded in the medical literature. However, most cases remain unrecognized as some affected individuals may develop only a few of the associated symptoms and findings. Hence it is difficult to determine the accurate frequency of babesiosis in the general population.

What Is Babesiosis?

Babesiosis is a rare severe, and life-threatening condition caused by a microscopic parasite that enters the body through an infected tick bite. The parasite infects the body's red blood cells and causes hemolytic anemia, similar to malarial parasites, and causes intense pain due to the rupture of the red blood cells. However, unlike the malarial parasites, these parasites do not affect the liver.

What Causes Babesiosis?

Babesia parasites, also called Nuttalia, are the causative organism of babesiosis. Babesia parasites grow and multiply in the red blood cells of the infected person or animal and cause intense pain. Out of 100 plus species of Babesia, Babesia microti is the most common parasite strain that infects humans; other strains may include Babesia duncani, Babesia divergens, and Babesia venatorum. In addition, other babesia strains may infect horses, cattle, pigs, etc.

How Does Babesiosis Spread?

Babesiosis is often spread through infected Ixodes scapularis, the black-legged or deer tick. The white-tailed deer is often the carrier of deer ticks, but the deer is usually not infected. The ticks may rest on leaf litter, a low branch, or a blade of grass. If one comes in contact with them, the ticks may attach themselves to the person and climb to a patch of open skin. The young nymphs usually transmit the parasite and are often found during the spring and summer months. People may not realize being bitten by the tick and may not even notice it as it could be small as a poppy seed.

Babesiosis may also be spread through blood transfusion and from an infected mother to the child during pregnancy or delivery.

What Are the Risk Factors for Babesiosis?

• People with their spleen removed.

• People with chronic illnesses.

• People with weakened immune systems.

• Older adults with health issues.

• People staying near the woods.

• People who go hiking, trekking, and camping in the woods.

• Spring and summer climates are when the nymphs that spread the infection are most active.

What Are the Symptoms of Babesiosis?

Signs and symptoms of babesiosis may develop 1 to 8 weeks after being in contact with the parasite. This includes:

• Body ache.

• Chills.

• Fever.

• Fatigue.

• Headache.

• Loss of appetite.

• Profuse sweating.

• Joint and muscle pain.

Some of the less common symptoms of babesiosis include:

• Nonproductive cough.

• Nausea and vomiting.

• Sore throat.

• Pink eye.

• Photophobia.

• Arthralgia (joint pain).

• Weight loss.

• Emotional liability.

• Depression.

• Anorexia (loss of appetite).

• Retinal infarcts.

• Pharyngeal erythema.

The parasites may also cause hemolytic anemia, in which the red blood cells rupture faster than the body can make new cells, which may last from several days to several months. Symptoms include:

• Confusion.

• Dizziness.

• Heart murmur.

• Rapid heart rate.

• Swelling of the spleen.

• Dark-colored urine.

• Swelling of the liver.

• Pale skin.

• Weakness.

• Yellow-colored skin, mouth, and eyes.

Symptoms may worsen in immunocompromised people, people taking medication that weakens their immune system, elderly above the age of 50years, or who have had the spleen removed. However, some people may not notice any symptoms; a relapsing fever may sometimes indicate undiagnosed babesiosis.

How Is Babesiosis Diagnosed?

Babesiosis may be challenging to diagnose as the most common symptoms may be mistaken for flu. Additionally, the early stages of the illness can be detected by examining a blood sample under the microscope, but this will require significant expertise and time. And the smears can sometimes be negative if the parasite load in the blood is less and may need to be repeated.

Other tests like indirect fluorescent antibody test (IFA) and polymerase chain reaction (PCR) test can be done on the blood sample to determine the parasite.

What Is the Treatment for Babesiosis?

• Babesia is a parasitic infection and will need to be treated with antiparasitic drugs along with antibiotics, similar to the treatment of malaria. Atovaquone, along with Azithromycin for 7 to 10 days, is used to treat mild to moderate cases of babesiosis. Alternatively, Clindamycin along with Quinine can be used.

• For severe conditions, Azithromycin is given intravenously along with oral Atovaquone, or Clindamycin may be given intravenously along with oral Quinine. Blood transfusions may also be necessary for severe illnesses.

• Relapse of the disease after the treatment is not uncommon. However, if one does develop symptoms again, it needs to have retreated. In addition, immunocompromised people may require longer treatment durations to clear the infection.

What Are the Complications of Babesiosis?

The complications of babesiosis may include:

• Liver problems.

• Hemolytic anemia.

• Kidney failure.

• Heart failure.

• Very low blood pressure.

How to Reduce Your Risk of Getting Babesiosis?

Prevention of babesiosis can be done by avoiding exposure to ticks. Babesia microtia is transmitted to humans through Ixodes scapularis ticks. These may be found in grassy, bushy, or wooded areas.

• Walk on the clear central trail when walking through a grassy area where the ticks are often found.

• Wear protective clothing and gear to cover the body, leaving no open skin.

• Tuck the pants into the socks and do not leave any gaps for the ticks to crawl up.

• Use insect repellents containing DEET (N, N-Diethyl-meta-toluamide) and Permethrin to keep the ticks away.

• Check the body and the clothes after coming from outside thoroughly for ticks. Use Permethrin to kill the ticks in threaded clothing.

• If one notices a tick attached to the skin, remove it gently without squeezing it using a tweezer and clean the bite area.

Conclusion:

Babesiosis is a rare illness but could be severe and life-threatening. The deer ticks transmit it, and the causative organism is most commonly Babesia microti. The initial symptoms may seem like flu and sometimes go unnoticed. However, consult a healthcare professional if one experiences any signs of the condition.