Humans are certainly not the only creature to be living on this earth. There are many other living things, including small ones that we may not realise or see with the naked eyes, that are able to affect human health. Small organisms may be small in size but humans should never underestimate the ability of certain species that are able to cause great misery in humans. In this DoctorOnCall’s article, we will be learning about one of the many infections caused by microscopic organisms known as babesiosis.
Babesiosis is a disease that is caused by a parasite called Babesia species. The parasite itself has been found in many animals but only few are able to be found in people. The common one is Babesia microti. This specific species usually infects white-footed mice and other small mammals. Babesiosis in humans is usually caused by this species but in some cases, other Babesia species may be the cause for the infection.
Babesiosis is a rare infection but once it affects humans, it can be life threatening. It mainly affects the red blood cells. The main way Babesia enters the human body is through bites of infected ticks. Babesia microti is spread by Ixodes scapularis ticks, which are commonly called blacklegged ticks or deer ticks. The parasite is spread by the young nymph stage of the tick. Nymphs are mostly found during the warm seasons such as spring and summer and typically located in areas with woods, brush or grass. Infected people might be unable to recall a tick bite as the nymphs are very small, about the size of poppy seeds. Patients will have symptoms as fast as 1 to 4 weeks following a tick bite. Apart from bites, a person may get Babesiosis through being a recipient of a contaminated blood transfusion or transmission from an infected mother to the baby during pregnancy or delivery. Those receiving contaminated blood transfusion may experience symptoms as fast as 1 to 9 weeks after the transfusion and may be up to 24 weeks before there are any symptoms.
Many people infected with this disease do not feel sick and many do not have symptoms. Some may actually have flu-like symptoms such as fever, headache, chills, body aches, loss of appetite, nausea or fatigue. Remember that babesiosis affects red blood cells? People with babesiosis can have symptoms associated with anaemia, most specifically haemolytic anaemia (low level of red blood cells due to destruction of red blood cells). Symptoms of haemolytic anaemia in general are dark-coloured urine, weakness, yellow tinge to the skin or to the white eyes, pale skin and swelling of the spleen or liver. However, there are certain group people that will have great chances of experiencing severe babesiosis. This includes those with advanced age (aged 50 and above), impaired immune function and asplenia (absence of spleen). In severe cases, it can cause low numbers of thrombocytes (thrombocytopenia), severe breathing problems such as acute respiratory distress, kidney failure, liver problems and even death.
Thus, it is important for those who have symptoms of babesiosis to get checked by a doctor, especially those with high risk for developing severe babesiosis. Babesiosis is usually diagnosed by examining blood under microscope and to look for Babesia parasites inside the red blood cells. It is easier to detect those with babesiosis when they have symptoms. Doctors may even get the blood tested by a specialised reference laboratory to confirm diagnosis such as PCR analysis or antibody test. Blood test is usually done to not only test for babesiosis, but also to eliminate other possible causes of the diseases that produce similar symptoms to babesiosis such as Lyme diseases or anaplasmosis.
Those without symptoms typically do not need any treatment unless parasites are seen on the blood examinations for more than 30 days. Treatment is usually needed for those with symptoms. Doctors usually prescribed oral medications such as atovaquone to kill the parasites and often combine them with azithromycin antibiotics. Another combination is quinine with antibiotic clindamycin. Treatment course ranges from 7 to 10 days. In severe cases, patients might need to get hospitalised and receive medications via intravenous.
The best way to avoid getting babesiosis is to take preventative measures. Prevention is very important for those at high risk for severe babesiosis. When possible, it is best to avoid areas infested with ticks, especially during warm months. This means to stay away from overgrown grasses and leaf piles. It is best to wear long pants tucked into the socks and long-sleeve shirt when being in places suspected of infested ticks. Wearing-light colour clothes can help to identify the tick easily. It is recommended to use bug repellent that has DEET on skin and clothing to steer away possible ticks. Last but not least, before going indoors after being in the outside environments, do check clothing and pets for ticks. You may use a full-length mirror or handheld one once inside the house to check for possible ticks.
