NOTE: THIS POST IS NOT INTENDED FOR MEDICAL ADVICE. IT IS FOR GENERAL INFORMATION PURPOSES ONLY!
What is Babesiosis?
Babesia microiti is a parasitic protozoan which penetrates red blood cells and causes the disease Babesiosis. It is also the second most prominent co-infection to Lyme disease, traveling in the same circles. In doing so, these co-infections generally results in a more intense or serious acute illness in those infected with Lyme disease alone. It also brings about a greater array of symptoms and a more prolonged recovery than with Lyme alone.
As shown on the adjacent graph ‘Co-infections,’ you can see Babesia is prevalent in 32% of case of Lyme disease followed closely by Bartonella. Babesia is the most common co-infection even considering it largely infects people on the East Coast, especially, in the islands of Nantucket and Martha’s Vineyard on the Eastern Coast of Massachusetts where B. microtii and B. duncani species are considered endemic.
The East coast is where I became infected with Lyme disease and the co-infections of Babesiosis, Bartonella, and Mycoplasma when I was first bitten, then was re-infected about six to nine months after my initial bout with Lyme disease. By the time I decided to relocate to Portland, Oregon I remember standing in my living room when I discovered a tick embedded in my scalp. It had to be dug out as it had completed burrowed inside my scalp, died, and scabbed over. Gross. I know.
Talk about a warm welcome to the West Coast. But what was worse, I couldn’t find anyone who would treat me with antibiotics so Lyme disease had turned into a chronic infection by the time I discovered the tick during, late summer 2005. While this parasite remains largely in ticks found on the east coast, its range, like lyme disease, has spread across the country to the West Coast and Canada Just as migratory birds are to blame in part for the vector borne illnesses quick progression across the country west and into the deep southern states.
Because Babesia invades red blood cells similar to that of Malaria, it is often called the Northern hemisphere’s equivalent to Malaria and worldwide has emerged among other zoonotic disease or a diseases transmitted from animals to humans.
There are approximately 100 known species of Babesia, which infect livestock and rodents, while there are only three known species to cause human Babesiosis: B. microtii, and B. duncani (formerly WA-1 first identified in Washington State, but now is as widespread throughout the United States as the former B. microtii), and B. divergens (the European equivalent).
This parasite reproduces inside the red blood cells primarily through asexual budding. Research has documented as many as 66% of Lyme patients show serologic evidence of B. microtiis and is considered to be the most common co-infection transmitted by the black-legged tick Ixodes scapularis or I. pacificus, the causative agent of Lyme disease.
Over the course of the last 20-years human Babesia infections have increased, and suspicion for this disease should be considered when a tick bite has been found, even if a Bull’s-eye rash is not noted at the site of the bite. Babesia infection may be transmitted with or without Lyme disease and it is not known to be associated with a Bull’s-eye rash. This is how a former colleague of mine contract Babesiosis, he had and continues to be bitten with ticks. That said, I warned him, he should keep an eye out for certain Lyme related symptoms. No sooner had I said these very word, he was hospitalized for Lyme disease and received two weeks of IV antibiotics and released with a two months supply of oral Doxycycline. He had picked up Lyme disease. This regardless of the negative tests he had received before. Between 40%-60% of the Lyme tests conducted the way the CDC requires produce false negative test results.
My friend is one of the lucky ones who lives and works in the field along the mid Hudson River Valley in New York state where ironically, I picked up Lyme too. But it shows doctors how the disease can impact people differently. He initially presented as Babesia and could easily receive treatment and medicine in a timely fashion and now is back in remission. He also told me he always finds ticks on himself some embedded while others not. And he constantly has to fight off lyme disease. He also said he has Lyme arthritis. A part from that, he is has no other symptoms at any given time and takes antibiotics when needed along with Cumin and Turmeric for pain. However, he recently took a trip with his daughter to Ecuador where it was hot and humid. He told me he was miserable as his symptoms came back but he struggled through it and continues to not allow Lyme run his life. Again, he is one of the lucky ones.
Between 40 and 60% of all Lyme tests test false negative. Meaning, even though people test negative according to the CDCs ridiculous testing protocols, these people exhibiting symptoms more than likely have Lyme disease. This is why it is so important for those who’ve been bitten by a tick to keep the tick and see a Lyme Literate ND or MD as soon as possible. The tick can be tested at various Universities and labs across the country or one of the labs listed below to decide what infections the tick carries. This also helps in treatment to know exactly what to treat for and in my friend’s case Babesiosis.
Babesiosis infections are often missed because the symptoms are incorrectly believed to be caused by Borrelia infection. Babesia infections, even mild ones, may recur long after treatment and cause severe illness. This phenomenon has been reported to occur at any time, including up to several years after the initial infection. This is in part what occurred with me. I will go into more details about this either in a blog post and definitely as a book chapter in my forthcoming memoir (Gladiator in Pajamas: My Life With Lyme).
Babesia infection can not only be transmitted through a tick bite but it can be acquired by a contaminated blood products, such as blood transfusions and plasma.
Symptoms of Babesia/Babesiosis
As mentioned above, Babesia invades the red blood cells. Initially, patients who acquire this disease develop unexplained anemia, which does not respond to iron or folate,hb common with general anemia. But as the disease develops it gives rise to more common symptoms including: night sweats, air hunger, shortness of breath, severe headaches, fever, chills, body aches, loss of appetite, nausea, and/or fatigue and eventually causes haemolytic anemia from the destruction of red blood cells. For a more detailed list of symptoms see here.
Serologically, low hemoglobin, hematocit and/or red blood cell count, as well as low ferritin and transferrin, may go with this disease.
Babesiosis can be a severe, life-threatening disease, particularly in people who:
- do not have a spleen;
- have a weak immune system for other reasons (such as cancer, lymphoma, AIDS, or Lyme disease);
- have other serious health conditions (such as liver or kidney disease, Lyme disease);
- are elderly; or
- two confirmed human cases occurred where the disease crossed the placental wall and cause the disease in the fetus. Very similar to that of Lyme disease which also indicates Babesia has the ability to cross the blood brain barrier. More research is necessary to prove this theory. But when it quacks like a duck, and walks like a duck, it usually is a duck.
- Currently, doctors are not required to report cases of people infected with Babesia to the CDC. Accordingly, no records exist to show how many real cases are present in the US. Worse, because the blood supply used for blood transfusions are not screened for Babesia, carriers pose a risk to the blood supply as this infection has been documented to be passed on by blood transfusions. Yet another means for this co-infecton of Lyme disease and Lyme disease proper to infect humans.
Testing
Most Allopathic doctors don’t and won’t test for Babesia even when Lyme disease is suspected. However, LLNDs, however, who regularly test for Lyme disease will also test for Babesia the most common co-infector at the same time.
Keep in mind it is possible for lab results to test positive for Babesia and not Borrelia or Lyme disease even if the person also has been infected with this spirochetal bacterium. Labs used by Allopathic doctors who are not Lyme Literate, will send blood work to their labs and most of these labs use outdated and inaccurate testing methodologies as they are not equipped to test for these pathogens or if they are updated, they do not use the proper protocols for their tests, which results in either no results of false negative test results. This doesn’t mean the patient doesn’t have Babesia. If the patient has the above the symptoms, it is highly likely they have been infected. Babesia can also be hidden inside the cystic and bio-film colonies associated with Lyme disease, which are not identified by most labs.
There are three highly reliable labs in the US who can test for Babesia and Lyme disease, DNA Connexions in Colorado Springs, Colorado; IGeneX in Palo Alto, California; and Immunosciences, in Los Angeles, California. DNA Connexions is by far the least expensive option and provides the most bang for your buck, if you will.
DNA CONNEXIONS
The following are the pathogens DNA Connexions can test for:
- Borrelia burgdorferi – Bb F7, Bb Osp A, Bb OspB, Bb Osp C;
- Babesia microti, B. divergens, B. duncani
- Bartonella bacillformis, B. henselae, B. quintana, B. recurrentiis
- Ehrlichia chaffeensis, and
- Anaplasma phagocytophilium
The cost for the complete panel varies. This lab offers the most accurate testing for the best price. You can also request the specific tests on the CONNEXIONS website.
IGeneX
The costs of testing may have changed since last year so it is best to contact them directly but the following will provide a general guideline
- Basic Lyme disease panel: WB IgG, WB IgM & lyme IFA.
- Initial Lyme disease panel: WB IgG, WB IgM, lyme PCR serum and whole blood.
- Complete co-infection panel: approx. prices vary for all tests but here is the link to the price sheet for both Lyme and co-infections.
Immunosciences
I left out the prices as they change. The best thing is to contact the company directly for current pricing.
Immunoserology of Lyme Panel Against tick-borne antigens-
- Borrelia burgdorferi (IgG, IgM) 86618 x 2
- OspA + OspC Peptides (IgG, IgM) 86618 x 2
- OspE Peptide (IgG, IgM) 86618 x 2
- Leukocyte Function Associated Antigen (IgG, IgM) 86618 x 2
- Immunodominant Protein (IgG, IgM) 86618 x 2
- Variable Major Protein (IgG, IgM) 86618 x 2
Borrelia Subspecies Antibodies
- Bb sensu stricto (IgG, IgM)
- B. garinii (IgG, IgM)
- B. afzelii (IgG, IgM)
Lyme Co-Infection
- Babesia (IgG, IgM)
- Ehrlichia (IgG, IgM)
- Bartonella (IgG, IgM)
Immunoserology of Lyme Panel against tick-borne antigens –
- Lyme-Specific Antibodies Borrelia burgdorferi (IgG, IgM) 86618 x 2
- OspA + OspC Peptides (IgG, IgM) 86618 x 2
- OspE Peptide (IgG, IgM) 86618 x 2
- Leukocyte Function Associated Antigen (IgG, IgM) 86618 x 2
- Immunodominant Protein (IgG, IgM) 86618 x 2
- Variable Major Protein (IgG, IgM) 86618 x 2
Borrelia Subspecies Antibodies
- Bb sensu stricto (IgG, IgM) 86618 x 2
- B. garinii (IgG, IgM) 86618 x 2
- B. afzelii (IgG, IgM) 86618 x 2
Lyme Co-Infection
- Babesia (IgG, IgM) 86618 x 2
- Ehrlichia (IgG, IgM) 86666 x 2
- Bartonella (IgG, IgM) 86618 x 2
Western Blot Assay
- B. burgdorferi (IgG, IgM) 84181 x 2
- ELISA test for Borrelia burgdorferi IgM and IgG
- Western blot for B. burgdorferi IgM and IgG
Treatment Options
Like testing for Lyme disease, determining whether you have a Babesia infection is not as easy as it sounds. To garner a reliable test result the best time to obtain such information is within the first two weeks when the infection remains in the bloodstream. In the past Babesia has always been difficult to treat. The recommended therapy up to 1998, consisted of Clindamycin plus quinine, concomitantly. However, a growing number of recent studies and clinical documentation have demonstrated this combination to be unacceptable, as nearly half of patients treated have had to stop treatment due to serious side effects, many of which were disabling.(Source) Furthermore, even in patients who could tolerate these drugs, there was a failure rate which approached 50%.(Ibid)
Because of these dismal statistics, the current regimen of choice for Babesiosis is the combination of Atovaquone (Mepron or Malarone), 750 mg bid, plus a Erythromycin-type drug, such as Azithromycin (Zithromax), Clarithromycin (Biaxin), or Telithromycin (Ketek) in standard doses. This combination was initially studied in animals, and then applied to humans with good success. Fewer than 5% of patients have to halt treatment due to side effects, and the success rate is clearly better than that of Clindamycin plus quinine.
The duration of treatment with Atovaquone combinations for Babesiosis varies depending on the degree of infection, duration of illness before diagnosis, the health and immune status of the patient, and whether the patient is co-infected with Borrelia burgdorferi. Typically, a three-week course is prescribed for acute cases, while chronic, longstanding infections with significant morbidity, and co-infections need a minimum of four months of therapy. Relapses have occurred, and re-treatment is occasionally required. I am now on month two, of therapy. At this time it is unknown how long I will need to be on my current protocol. I see my LLND next week and should know more then.
Some of the less desirable side affects during therapy include diarrhea, mild nausea, the expense of Atovaquone (over $600 per bottle enough for three weeks of treatment), and rarely, a temporary yellowish discoloration of the vision. I have issues with my vision but have yet to have a yellowish discharge. I have blood draws every month to check my liver panels and amylase levels which have been recommended by my LLND, during my prolonged course of therapy because liver enzymes may elevate. Since I have had this infection for sixteen years, at this time it is unknown how long I will need to be treated.
Because I am allergic to so many antibiotics I am merely taking Malarone on a pulsing dose Monday through Wednesday twice per day and off for four days. This drug is potent and knocks me out for the first three days or four days of the week. By Friday I feel almost human but Sunday, symptoms have returned and I feel horrible. I am not sure how long I should or will be symptomatic.
Treatment failures can occur and are generally associated to inadequate Atovaquone levels. Therefore, patients often are given higher dosing when they show no improvements or are not suppressed into remission with this regimen. Often patients are told to take Artemisia (wormwood) obtained from reputable labs. At one juncture I was given IV Artemisia (which was compounded by a reputable compounding pharmacy.) I showed great improvements and then the supply was cut off and I no longer was able to get it and my health began to rapidly decline.
While Artemisia is a non-prescription herb, it must only be ingested or used in an IV setting when the source drug is from a reputable source. This herb is readily available all over the internet, but knowing which one is a from a safe source is key. Taken in the wrong way it can be dangerous. I will say that when I was having IV treatments once or twice a week, I began to feel better, and then the FDA confiscated the Artemisia source from the compounding pharmacy.
All offices country-wide were informed to turn over their stock of the drug over to the FDA. It was speculated they got wind it was being used successfully to treat Lyme disease and certain co-infections and the CDC and FDA conspired to put a halt to its use for this purpose. This was merely speculation among the staff of my old clinic I once used. Regardless, this drug really seemed to help with both my Lyme symptoms and the Babesia. However, if you decide to use it make sure your doctor approves the source of Artemisia is a clean source, and you are carefully monitored.This holds true for the supplier of oral Artemisia.
I have read several journal articles and papers that suggest Metronidazole or Bactrim could be added to increase efficacy, but there is minimal clinical data on how much more effective this will be as they are too large to cross the blood brain barrier. And considering both Babesia and Bartonella catch a ride inside the red blood cells and cross the blood brain barrier it is necessary to find a drug that will cross over the blood brain barrier.
Being sick in general is not something anyone of us choose to be especially those of us with Lyme disease, but to also have Babesia, or one of the other common co-infections is like being repeatedly punched in the stomach. They are all hard on our bodies and make treatment of Lyme disease so much more difficult. Always make sure your doctor tests for these pathogens as it becomes an important part of our care. Treatment in which we are either cured or suppressed into remission should occur before treating Lyme, or if the patient can handle it simultaneous to Lyme treatment. It makes it easier on the body.
Best of luck to those using any form of treatment for Babesiosis. It is far from being a pleasant illness. In fact, it rates right up there with Lyme disease. And sometime I think it might be worse. But the two illnesses together are nearly unfathomable to manage. I almost consider some aspects of this illness are worse. Again, my opinion, but living with disease and with a long string of symptoms for the past 16 years is not only difficult but tiring. Add to it more than one co-infections and your symptoms increase 10-fold. Then add a secondary infection and you have even more problems. I will address some of these conditions in a future posts as I do not wish to detract away from Babesia.
As for Babesia and Lyme disease it is good to finally see some mention of ticks and Lyme disease in the news let’s hope this trend continues long past Lyme Disease Awareness Month for those who are battling these illnesses and those who are dying for lack of proper care at some point during their disease, or to those who have become sicker and are now they are bedridden. I know this as fact, because I am one of them. Had I received proper medical care in the early phases of my illness and not years after the fact, I might be well now instead of being bedridden.
This is the fate of those of us with Babesia considering we are no privy to adequate health care coverage. Because the Center for Disease Control (CDC) and Infectious Disease Society of America (IDSA) do not believe there chronic Lyme disease is a disease they have instructed the insurance industry to deny all claims about Lyme disease. I never thought this would be a problem since we have such great insurance until they did. And it was for an IV antibiotic. Since then they deny pretty much anything they feel like denying. Talk about ridiculous. This has to change. Our entire medical industry is corrupt and must go through a very thorough investigation to ensure everyone can be covered for Lyme disease and their respective co-infections. As of now I believe there are about six states who have finally passed laws forcing medical insurance to cover Lyme related costs for as long as the patients doctor seems fitting. This also included a caveat for doctors as well allowing them to practice or diagnose and treat patients with chronic Lyme disease without fear of repercussions (e.g., suspended license, loss of license, or forced into early retirement for diagnosing and treating Lyme disease). This is should be the norm and not the exception, wouldn’t you agree?
NOTHING HERE SHOULD BE CONSIDERED MEDICAL ADVICE. IF YOU HAVE BEEN BITTEN BY A TICK, OR OTHER BLOOD SUCKING INSECT, OR ARE SICK WITH ANY DISEASE OR SYMPTOMS DISCUSSED HEREIN, PLEASE SEEK HELP FROM A LLND OR LLMD.