Everything You Should Know About Babesia

Medically reviewed by Jill Seladi-Schulman, PhD on July 26, 2017Written by Marjorie Hecht on July 26, 2017

Overview

Babesia is a tiny parasite that infects your red blood cells. Infection with Babesia is called babesiosis. The parasitic infection is usually transmitted by a tick bite.

Babesiosis often occurs at the same time as Lyme disease. The tick that carries the Lyme bacteria can also be infected with the Babesia parasite.

Symptoms and complications

The severity of the symptoms of babesiosis can vary. You may have no symptoms at all, or you may have slight flu-like symptoms. Some cases can cause serious, life-threatening complications.

A Babesia infection most often starts with a high fever and chills. Common symptoms include:

  • fatigue
  • severe headache
  • muscle aches
  • joint pain
  • abdominal pain
  • nausea
  • skin bruising
  • yellowing of your skin and eyes
  • mood changes

As the infection progresses, you may develop chest or hip pain, shortness of breath, and drenching sweats.

It’s possible to be infected with Babesia and not have any symptoms. A relapsing high fever is sometimes a sign of undiagnosed babesiosis.

Complications can include:

Causes of babesiosis?

Babesiosis is caused by infection with a malaria-like parasite of the species Babesia. The Babesia parasite can also be called Nuttalia.

The parasite grows and reproduces inside the red blood cells of the infected person or animal, often causing intense pain.

There are more than 100 species of the Babesia parasite. In the United States, Babesia microti is the most common strain to infect humans, according to the Centers for Disease Control and Prevention (CDC). Other strains can infect:

  • cattle
  • horses
  • sheep
  • pigs
  • goats
  • dogs

How it’s transmitted

The most common way to contract Babesia is a bite from an infected tick.

Babesia microti parasites live in the gut of the black-legged or deer tick (Ixodes scapularis). The tick attaches to the body of white-footed mice and other small mammals, transmitting the parasite to the rodents' blood. After the tick has eaten its meal of the animal’s blood, it falls off and waits to be picked up by another animal.

The white-tailed deer is a common carrier of the deer tick. The deer itself is not infected. After falling off the deer, the tick will typically rest on a blade of grass, a low branch, or leaf litter. If you brush up against it, it can attach to your shoe, sock, or other piece of clothing. The tick then climbs upward, seeking a patch of open skin.

You probably won’t feel the tick bite, and you may not even see it. That’s because most human infections are spread during spring and summer by ticks in the nymph stage. During this stage, the ticks are about the size and color of a poppy seed.

Besides a tick bite, this infection can also pass via contaminated blood transfusions or via transmission from an infected pregnant woman to her fetus.

Risk factors

People with no spleen or a weakened immune system are at greater risk. Babesiosis can be a life-threatening condition for these people. Older adults, especially those with other health problems, are also at higher risk.

The connection between babesiosis and Lyme disease

The same tick that carries the Babesia parasite can also carry the corkscrew-shaped bacteria responsible for Lyme disease.

Studies carried out in areas of southern New England, where Lyme disease is prevalent, found that 11 percent of people diagnosed with Lyme were also infected with Babesia. Researchers also found that the babesiosis often went undiagnosed.

According to the CDC, most cases of babesiosis occur in New England, New York, New Jersey, Wisconsin, and Minnesota. These are states where Lyme disease is also prevalent, though Lyme is also prevalent elsewhere.

The symptoms of babesiosis are similar to those of Lyme disease. Coinfection with Lyme and Babesia can cause the symptoms of both to be more severe.

How babesiosis is diagnosed

Babesiosis can be difficult to diagnose.

In the early stages, Babesia parasites can be detected by examination of a blood sample under a microscope. However, this method is reliable only in the first two weeks of the infection.

If you or your doctor suspects babesiosis, your doctor can do further testing. They may order an indirect fluorescent antibody test (IFA) on the blood sample. Molecular diagnostics, such as polymerase chain reaction (PCR), may also be used on the blood sample.

Treatment

Babesia is a parasite and won’t respond to antibiotics alone. Treatment requires antiparasitic drugs, such as those used for malaria. Atovaquone plus azithromycin is used to treat most cases and is usually taken for 7 to 10 days.

Clindamycin plus quinine is used in more severe cases. With severe illness, additional supportive measures may be taken.

It’s possible for relapses to occur after treatment. If you have symptoms again, they must be retreated.

How to reduce your risk

Avoiding contact with ticks is the best prevention against both babesiosis and Lyme disease. If you go into wooded and meadow areas where deer are present, take preventive measures:

  • Wear clothing treated with permethrin.
  • Spray repellent containing DEET on your shoes, socks, and exposed areas.
  • Wear long pants and long-sleeved shirts. Tuck your pant legs into your socks to keep ticks out.
  • Inspect your whole body after spending time outdoors. Have a friend look at your back and the backs of your legs, especially behind your knees.
  • Take a shower and use a long-handled brush on areas you can’t see.

A tick must attach to your skin before it can transmit the disease. Attaching usually takes some hours after the tick has contacted your skin or clothing. Even if the tick attaches, there is some time before it can transmit the parasite to you. You may have as long as 36 to 48 hours. This gives you time to look for the tick and remove it.

Still, it’s best to be cautious and check for ticks immediately after coming inside. Learn tips for proper tick removal.

Outlook

Recovery time from babesiosis varies by individual. There is no vaccine against babesiosis. The CDC recommends a 7- to 10-day treatment with atovaquone and azithromycin for nonsevere cases.

Some organizations concerned with the treatment of Lyme disease also specialize in babesiosis. You may wish to contact the International Lyme and Associated Diseases Society (ILADS) for information about doctors who specialize in babesiosis.

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