Babesiosis is the name of an infectious disease that occurs around the world. It is caused by babesia, which is a parasite.

What is a babesiosis?

Babesiosis is a relatively rare infectious disease that occurs around the world. They are transmitted by ticks, through which the actual causer, the babesia, get into the body of humans or animals. These intracellular small parasites, belonging to the genus Babesia, attack the red blood cells (erythrocytes) of the affected person.

The name babesiosis goes back to the Romanian pathologist Victor Babes (1854-1926), who first described Babesia in 1888 when they caused hemoglobinuria in Romanian cattle. The infection resulted in tens of thousands of cattle dead. In 1889 the genus Babesia bigemina was identified by the American pathologist Theobald Smith (1859-1934) as the cause of the cattle disease Texas fever. He later found out that the protozoon was transmitted by ticks.

It was not until 1956 that the first case of Babesia was registered in humans. In that year, a patient died in Yugoslavia who no longer had a spleen and suffered from an infection with a fulminant course. Since further cases of illness with babesia were repeated in people who no longer had a spleen, the doctors initially assumed that only such patients were at risk of the disease.

While the genus Babesia divergens is primarily responsible for diseases on the European continent, infections in the USA are mostly caused by Babesia microti. Overall, babesiosis is one of the rare diseases. It is particularly dangerous for people who suffer from immunodeficiencies such as AIDS or who have had to undergo a splenectomy. Because the course and symptoms of babesiosis are similar to malaria, the disease is also called malaria’s little sister.

Causes

Babesiosis is caused by babesias, which are one of the unicellular spore animals. The parasites are transmitted to humans by ticks belonging to the genus Ixodes, such as the common wood tick (Ixodes ricinus). This type of tick is particularly widespread in Central Europe. In some cases, however, the Babesia transmission took place through blood transfusions.

These were infected with the Babesia. There is a risk that people who suffered from babesiosis will still carry the pathogen after their disease has been cured by donating blood and pass it on to other people in this way.

For several decades it was mistakenly assumed by doctors that babesiosis can only break out in people whose spleen has been surgically removed.

Therefore, people without a spleen are considered to be more prone to infection. However, over the years, infections have also appeared in people who still had a spleen. However, there is usually resistance to babesia when the spleen is still present.

Just like the causative agents of malaria, the Babesia belong to the protozoa. They attack the red blood cells in the human organism, which leads to hemolysis, the extent of which depends on the density of the parasites. Babesia can reproduce asexually within the erythrocytes. However, there are only two divisions.

Symptoms, ailments & signs

The symptoms that occur in babesiosis are similar to the symptoms of malaria. So they last for a certain time, then slowly go back and show up again later. The incubation period of babesiosis is between one and four weeks.

Typical first signs are loss of appetite, fatigue, nausea, malaise and weight loss. After a few days, the patients suffer from continuously increasing high fever, heavy sweating, chills, intense headaches and aching limbs. In addition, jaundice, severe anemia and even kidney failure possible.

Diagnosis & course

Babesiosis is diagnosed by detecting the pathogen. For this purpose, the doctor takes a blood smear from the patient, which is then examined microscopically. The babesia can be made visible within the infected red blood cells. Due to the high number of pathogens, the diagnosis is not classified as difficult.

As an alternative, it is also possible to grow the parasites. This method can be used to detect infections that often go undetected in the blood smear due to a low density of pathogens. Because of the low number of cases in humans, an exact prediction of the course of babesiosis is not possible.

So far, no systematic investigations have been carried out. Serious or even fatal courses are rarely seen and mainly affect people whose immune system is weakened.

Complications

The complications of babesiosis are similar to symptoms of malaria. In the worst case, this can lead to patient death if the disease is not treated. Immediate medical treatment is therefore necessary in babesiosis to prevent consequential damage and serious complications.

In most cases, a very high fever occurs after the babesiosis is transmitted. The temperature of the patient can reach up to 42 degrees Celsius and thus rises to a life-threatening condition. In addition to the high fever, there is loss of appetite, fatigue, diarrhea and headache.

Often there is also severe weight loss, which generally has a negative effect on the health of the body. In addition to these symptoms, there is also inflammation on the skin, which is painful and can spread over the entire body. Limbs are paralyzed, so that the patient is severely restricted and in many cases can no longer move.

Antibiotics are used in the treatment. These do not lead to any further symptoms and the treatment is in most cases without complications.

When should you go to the doctor?

Those affected with babesiosis should see a doctor immediately. Medical clarification is recommended as soon as the first signs of the infectious disease appear. For example, anyone who suffers from loss of appetite, nausea or unexplained weight loss should discuss these symptoms with their family doctor. Fever symptoms that appear after a few days indicate an infection that requires treatment. Immediate medical attention is required if severe symptoms such as jaundice, anemia, or kidney failure occur.

An emergency doctor must be alerted depending on the severity of the symptoms. Although the disease is rarely fatal, secondary symptoms can only be prevented through rapid treatment. People who suffer from the symptoms mentioned after a tick bite should also see a doctor.

Babesiosis is usually transmitted by ticks and other parasites. So if the symptoms appear shortly after a walk in the country or after contact with animals, it may be babesiosis. A doctor must diagnose the disease and, if necessary, initiate treatment immediately.

Treatment & Therapy

In the first few years, babesiosis was treated with common anti-malarial drugs. However, since these were unsuccessful, they were no longer used. A combination of cindamycin and quinine was later tried with success, which significantly reduced the number of pathogens. However, recent studies have shown that quinine is ineffective against Babesia divergens.

The babesiosis medication is taken for seven days, with close monitoring by the doctor. But even after the treatment, the patient may suffer from symptoms such as a slight fever, tiredness and malaise for a few weeks or months. If the number of babesia in the blood is high or if there is an immunodeficiency, an exchange transfusion is recommended.

Outlook & forecast

The prognosis of babesiosis depends on the patient’s state of health, the diagnosis and the earliest possible start of treatment. Without medical treatment, the pathogens spread continuously in the body.

They inexorably weaken the organism and trigger various complaints. The risk of organ failure or fatal disease progression increases. In severe cases, kidney failure or a breakdown of the immune system occurs. Both of them have a very high risk of death.

With medical treatment, symptoms are usually relieved within a few days or weeks. The aftereffects of the disease may persist for a few months. The patient usually only recovers slowly until there is no symptom. During the recovery period, the sick person has to protect himself sufficiently from overexertion or new illnesses. He risks a relapse and a lengthening of the healing path.

The prospect of a cure worsens overall in people with previous illnesses and a weakened organism. If there is a drug intolerance, the healing process is also significantly prolonged. The alternative active ingredients are less efficient, which leads to a delay in recovery. A healthy lifestyle helps to improve prospects. Sufficient sleep, the use of relaxation techniques and the avoidance of pollutants are particularly supportive.

Prevention

The best preventive measure against babesiosis is protection against tick infestation. This is how tick bites usually cause the infection.

Aftercare

Regular follow-up care is important after treatment for babesiosis. In the first few weeks after the end of therapy, the sick person has to go to the family doctor every two to four weeks. The doctor can monitor the healing process by taking an anamnesis and drawing blood if necessary.

If the outcome is positive, the frequency of medical examinations can be reduced. After three months, aftercare is no longer necessary, provided that the babesiosis subsides without further complications. Nevertheless, you should still consult your general practitioner for routine examinations in the first few months after the end of treatment.

Especially in the case of serious illnesses, which are often associated with permanent skin and organ damage, a comprehensive physical examination must take place every two months. Babesiosis requires lengthy antibiotic therapy. The prescribed medication must be slowly tapered off during follow-up care.

As long as there are no complications and the babesiosis has completely subsided, follow-up care lasts between one and three months. The patient should consult with the doctor during therapy and arrange the necessary follow-up appointments in good time. Babesiosis can occasionally lead to permanent skin changes. In order to avoid any effects on the mental state, therapeutic advice is recommended.

You can do that yourself

Babesiosis in humans is mainly treated with antibiotics. Accompanying this, relaxation, drinking a lot and getting enough sleep are recommended. In the early stages, the disease can be treated well through physical restraint and the administration of medication.

Some medicinal plants from nature help against headaches and muscle aches. The antiseptic Angelika, which is best used immediately after infection, or the decongestant St. John’s wort, which can be used at a later stage, have proven themselves. The use of alternative remedies should always be discussed with the responsible doctor. Used responsibly, rosemary, juniper and lavender can also help to provide rapid relief from symptoms.

However, mild fever, nausea, and fatigue may occur weeks or months after treatment. Effective antidotes are exercise, a healthy diet, and regular medical checkups. The medical advice not only provides information about the risks of babesiosis.

The doctor can also usually give practical tips on how to prevent insect bites. If babesiosis occurs in connection with borreliosis, further consultations are sometimes useful. Participation in self-help groups is recommended for severe physical or emotional complaints.