Lyme Disease and Related Tick-Borne Infections - Babesiosis

Babesiosis

The tick that carries Lyme disease and ehrlichiosis also can carry babesiosis. Babesiosis is aparasite called protozoa. It has been detected in about 10% of Lyme disease patients, and has been reported in Massachusetts, New York, Connecticut, Rhode Island, New Jersey, Minnesota, Wisconsin, Georgia, California, and Washington.

When babesiosis is acquired from ticks, the infection occurs only in the summer. However, unlike in Lyme disease, blood transfusions have also been known to transmit babesiosis, so it can also occur other times of the year. The disease is still very rare, but people in tick-infested areas should be aware of it.

Symptoms of Babesiosis

Symptoms of babesiosis occur 1 to 4 weeks after a tick bite and are similar to those of malaria. Most cases are very mild and nearly unrecognizable. More severe symptom may resemble those in malaria and include the following:

• Headache
• Fever and chills, with night sweats
• Nausea and vomiting
• Muscle aches
• Anemia

Complications of Babesiosis

In healthy people, babesiosis generally causes only mild and temporary problems, but research indicates that the infection might persist in some people and is spreading faster than previously reported. In rare cases, it can be severe and even life threatening, particularly in elderly people or those with chronic health problems or compromised immune systems. In such cases, the infection can cause altered mental states, anemia and other blood abnormalities, very low blood pressure, respiratory distress, and kidney insufficiency. Coinfection with Lyme disease may also increase its severity. Unfortunately, it also very difficult to diagnose.

Treatment of Babesiosis

Babesiosis is a protozoa, not a bacteria. It does not respond to conventional antibiotics. Standard treatment at this time is clindamycin (an antibiotic) and quinine sulfate. About 25% of patients cannot tolerate quinine, however. Adverse effects associated with quinine include hearing loss, tinnitus, stomach upset, diarrhea, and dizziness.

One study suggested that a combination of atovaquone and azithromycin was as effective as clindamycin and quinine and had fewer side effects. The most common adverse effects were rash and diarrhea. Other combinations used are atovaquone, an antimalarial drug, and azithromycin, an antibiotic. Blood transfusions may also be helpful in some patients.