Tag Archives: babesiosis

deer tick on grass

Have You Heard of the Tick-Borne Disease Babesiosis?

by Jennifer Crystal

Lyme disease isn’t the only illness you can get from a tick bite

Babesiosis, a tick-borne infection caused by the parasite Babesia (most commonly, Babesia microti, though there are other species like Babesia duncani and Babesia divergens), is a malaria-like infection of the red blood cells. A 2019 report by the American Academy of Pediatrics states, “Although cases of tickborne babesiosis have been diagnosed in the U.S. since 1966, this disease only became nationally notifiable in 2011. A report of the first five years of babesiosis surveillance from the Centers for Disease Control and Prevention (CDC) shows an alarming increase in incidence.”[i]In his book Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease, Richard I. Horowitz, M.D. speaks to this alarming prevalence: “Other studies are now showing evidence of a worldwide epidemic of babesiosis: It is now spreading to parts of the United States, Europe, and Asia…the scientific literature has shown that the number of positively diagnosed cases of babesiosis in New York state alone has increased twenty times.”[ii]

While increased Lyme literacy has improved awareness of babesiosis, many people still look at me like I have three heads when I say I have this infection. The name is indeed strange and difficult to pronounce; one of my graduate school professors said, “Can we just call it babelicious? That’s easier.” Whether you refer to it as babesiosis, Babesia, babelicious, or, as my friends have adopted, babs, it’s important that you understand what this illness is, how it is transmitted, what the symptoms are (and what they actually feel like), and what treatment options are available.

Babesia microti as seen in infected red blood cells via microscope

The tiny parasite Babesia is most commonly transmitted by a tick bite—meaning you can get Lyme and babesiosis, as well as other co-infections, all from the same tick. However, you do not have to have Lyme disease to get Babesiosis. Babesia can also be transmitted via blood transfusion or from mother to fetus. It depletes the red blood cells of oxygen, causing patients to experience air hunger, lightheadedness, weakness, shortness of breath, and post-exertional fatigue akin to what marathon runners describe as “hitting a wall”. Other common symptoms include high fever, night-sweats, headaches, chills, and hypoglycemia. Dr. Horowitz writes that babesiosis can also cause “a hemolytic anemia (due to red blood cells breaking down), jaundice, thrombocytopenia (low platelet count), congestive heart failure, and renal failure.”ii

What does it actually feel like to have babesiosis? While every case is different and not all patients experience every symptom, I can share my own 20+ year battle with this infection. After finding a splotchy red rash on my arm in the summer of 1997, the first symptom I experienced was hypoglycemia. After a busy morning teaching water-skiing, swimming, and canoeing at the summer camp where I worked, I collapsed in the dining hall from what I thought was dehydration but was actually low blood sugar. Beyond testing for diabetes, no one thought to look into the cause of my sudden hypoglycemia or to test for tick-borne infections. Instead, I continued to suffer low blood sugar reactions and sudden lightheadedness for years, and learned to always carry a snack with me.

As the tick-borne infections Lyme, babesiosis, and ehrlichiosis ran through my body unchecked over the next eight years, I developed smashing migraines that left me nauseous and crying on the bathroom floor. I now know that my brain was not getting properly oxygenated, causing my extreme pain. I lived in Colorado at the time, so doctors told me I had altitude sickness.

Babesiosis can exacerbate Lyme and other infections; not knowing I had any of them, they all were getting worse, the symptoms overlapping and manifesting more frequently. Flu-like symptoms, coupled with intense bouts of fatigue, came on-and-off for years. Despite being a gym rat and a life-long skier, I could no longer keep up with my friends on the slopes, experiencing low blood sugar, dehydration, and fatigue that would sometimes send me to bed for a day or two afterwards. By the end of my second year in Colorado, I’d developed asthma and needed to use an inhaler.

In 2003, I got mononucleosis that slipped into chronic Epstein-Barr virus—I couldn’t fight it because of the underlying tick-borne diseases—and in 2005 those diseases were finally diagnosed. By that point I was experiencing fevers that could have been associated with any of those illnesses, and occasional nightsweats.

Once I started treatment for babesiosis (along with antibiotics for Lyme and ehrlichiosis), those nightsweats increased, but that was a good sign. It was a form of Jarisch-Herxheimer reaction; my body was sweating out the dead parasites. I often woke in a puddle, my pajamas fully soaked, and sometimes had to change sheets twice a night. At my worst point, I couldn’t ride thirty seconds on a stationary bike without “hitting a wall”.

While Lyme Literate Medical Doctors (LLMDs) have varying opinions about the treatment and prognosis of babesiosis infections, the general consensus I heard at the International Lyme and Associated Diseases Society (ILADS) conference in 2019 was that there is no cure. Some doctors are having great luck, with patients reporting complete eradication of symptoms for both babesiosis and Lyme disease, with the antimicrobial drug Disulfiram (commonly known as Antabuse); however, more research is needed, and the drug has serious side effects. More commonly, doctors use anti-malarial drugs such as Mepron, Malarone, or Coartem to treat babesiosis, often pulsing these treatments over weeks or even months as the patient’s Babesia load decreases. Still others supplement these medications with homeopathic remedies such as artemisinin or cryptolepsis.

This is not a complete list of babesiosis treatments; Dr. Horowitz talks about others in his book, and your LLMD may have other ideas. I have been on different anti-malarial medications, paced at different intervals, and on different homeopathic drops, throughout my journey. Unfortunately, it doesn’t help for me to share my protocol, because it is ever-changing, and because no two cases of tick-borne illness are alike. Here’s what I can tell you for sure: babesiosis symptoms can get better. If you are being treated for Lyme disease and haven’t been tested for babesiosis or other co-infections, you may only be fighting half the battle. Whether you have a known or suspected case of Lyme, it’s critical that you talk to your doctor about other tick-borne diseases, too.

[i] http://dx.doi.org/10.15585/mmwr.ss6806a1.

[ii] Why Can’t I Get Better? Solving the Mystery of Lyme & Chronic Disease. Horowitz, Richard I., MD. New York: St. Martin’s Press, 2013 (135, 136).

Related Posts:
Differentiating Between Babesia and COVID-19 Air Hunger
New test for Babesia approved by the FDA
What is Air Hunger, Anyway?
Tainted Transfusions: Why Screening Blood is More Important Than Ever

jennifer crystal_2

Opinions expressed by contributors are their own.

Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her at [email protected].

Tainted Transfusions: Why Screening Blood is More Important Than Ever

by Mayla Hsu, Ph.D., GLA Science Officer

The importance of screening for babesia in our blood supply is the focus of a new study published in the New England Journal of Medicine.


The last thing anyone wants from a blood transfusion is to get sick from an infectious microbe. Currently, the American Red Cross and other blood collection agencies screen for blood-borne pathogens like HIV and hepatitis viruses. But there is a malaria-like parasite called Babesia microti that can make us sick, and is not routinely screened for.

Spread by the same biting ticks that transmit Lyme disease, babesiosis can be self-limiting and asymptomatic in healthy adults. However, in the immunosuppressed–the elderly or those co-infected with Lyme disease–the illness, which is characterized by recurrent fevers and pain, can become severely debilitating and is potentially fatal. When blood from such infected patients is examined with a microscope, the parasite can be seen replicating inside red blood cells.

A new study published in the New England Journal of Medicine has shown that screening for babesia-infected blood is useful in reducing transfusion-acquired babesiosis. This research, conducted by the American Red Cross, analyzed blood donation samples obtained in Connecticut, Massachusetts, Minnesota, and Wisconsin, all states with high incidence of Lyme disease and babesiosis.


They found that after analyzing 89,153 blood samples, 335, or 0.38%, were positive for babesiosis, and these donations were removed from the blood supply. During the study period, which was from June 2012 to September 2014, there were 29 recorded cases of transfusion-acquired babesiosis. These came from blood that was not screened, and follow-up of the specific donor samples showed later that the source blood tested positive for Babesia.

When focused on Connecticut and Massachusetts, the researchers found that for screened blood, there were no transfusion-transmitted babesiosis cases in 75,331 blood donations. In contrast, with unscreened blood, there were 14 cases of babesiosis in 253,031 donations. This showed that blood donation screening was effective in preventing babesiosis transmission via blood transfusion.

Every year, about 1800 cases of babesiosis are reported to public health authorities, with 95% of cases in only 7 states. However, this is likely to be an undercount, due to low medical awareness and misdiagnosis of the disease. Presently, there is no Babesia blood donation screening test that has been approved by the Food and Drug Administration. This study and others like it will hopefully lead to such a test, by showing the vital importance of protecting our blood supply from a dangerous pathogen.

What Failure to Control Ticks in Uganda Teaches Everyone

by Hannah Staab

Tick populations across Africa have negatively impacted many communities by carrying and spreading one of the most frequent bacterial diseases in Africa, tick-borne relapsing fever (TBRF).


In addition to infecting humans, ticks in Africa are known to spread disease amongst cattle, resulting in both agricultural and economic consequences. Uganda is one of the countries hardest hit by the presence of ticks and tick-borne diseases (TBD), with over 30% of the calf crop lost to TBDs  such as theileriosis, babesiosis, and anaplasmosis.  Farmers have used acaricides, pesticides that target ticks and mites, as a tool to combat the diseases they carry. But recently many farmers have been reporting more instances of acaricide failure.  Acaricide failure places a tremendous financial burden on the Ugandan farmers; not only does it lead to a high loss of their cattle to TBD, but the costs of the acaricides themselves account for about 90% of an average farmer’s total disease control budget, making non-functional acaricides a major budgetary loss for farmers. The frequent occurrence of acaricide failure has raised the possibility that certain ticks are becoming resistant to them.

A study conducted by Vudriko et al. in 2016 set out to uncover the reason behind the increasing reports of acaricide failure in Uganda.  Of the 54 farms tested, 94.4% of them had complaints of acaricide failure, which prompted questions about tick resistance as well as acaricide application methods. To address these questions, Vudriko et al. examined the acaricide application techniques used by farmers and also tested the tick larvae they found on the cattle for acaricide resistance. The results showed that 93.5% of the larvae population they tested was resistant to at least one acaricide. The resistant larvae were identified as Rhipicephalus genus ticks. This was the first study in Uganda to report the emergence of multi-acaricide resistant ticks. Ticks’ resistance to multiple acaricides increases the danger of cattle being infected with TBD, because these ticks can survive even a combination of tick-attacking techniques.

Vudriko et al. also found that many farmers were guilty of misusing their acaricides.  When certain acaricides started to fail, farmers often try to find a quick fix by mixing chemicals, and creating their own acaricide application methods. These farmer-created errors could be partially to blame for the dramatic rise in multi-acaricide resistance. When a mixture of acaricides is applied surviving ticks carry a gene that allow them to resist all of the acaricides in that mixture. After they reproduce, future generations of ticks, harboring the resistance genes, will be resistant to multiple acaricides.


Tick-borne diseases are the number one constraint of cattle production in Uganda. Acaricide failure has been spreading through farms, causing more and more cattle to fall ill with disease, and costing farmers time and money. The development of multi-acaricide resistant ticks could have possibly been delayed or even avoided if farmers had not taken tick control into their own hands. Therefore it is important to educate farmers around the world on how to properly manage and control ticks. Since a large portion of the ticks are now resistant to current acaricides, alternative tick control options are needed.

Witnessing how tick-borne diseases have affected Ugandan cattle farming demonstrates the impact ticks can have on society. In addition to spreading tick-borne diseases to humans across the world, ticks that prey on cattle have implications not only for the food supply but for economic growth in many countries.

The case of acaricide failure on farms in Uganda is a reminder of the importance of tick prevention, and following strict protocols when controlling tick populations. As climate change continues to make an increasing amount of habitats suitable for tick growth and reproduction globally more farms will start running into the problem of tick-borne disease among their cattle. Further research on this topic is necessary to help farmers and those of us who rely on their food around the world.


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