Despite the passage of time, human beings are still not immune to parasite attacks. Hygiene and all the advances in the field of medicine have meant that we can cure or have an antidote for most of these living creatures, but if we notice any symptoms we must be quick to go to the doctor to find out what is causing these pains. One of these parasites, which is the subject of today’s article, is the babesia. This protozoan causes babesiosis, a rare but very serious infection that can be particularly dangerous in specific cases.
Its presence has been confirmed in the USA, Europe and Asia, where cases of babesia infections have been reported. It is therefore essential that laboratories and hospitals have a predetermined protocol and can perform the necessary analyses and tests to identify the parasite as quickly as possible and provide appropriate treatment.
What is babesia?
Babesia is a genus of microscopic parasites that infect the red blood cells of animals and humans, causing the disease known as babesiosis. These protozoa are transmitted mainly by the bite of ticks, especially those of the genus Ixodes, which are also responsible for transmitting other diseases, such as Lyme disease. As mentioned above, babesiosis can affect both animals and humans, although it is much more common in animals, especially cattle, dogs and other mammals.
Human infection is more common in areas where ticks are common. Although many people may develop no or only very mild symptoms, in severe cases it can cause high fever, fatigue, anaemia and other problems related to the destruction of red blood cells, which is precisely the element that this tick attacks.
What are the symptoms of babesiosis?
As mentioned above, symptoms can vary in severity from mild or asymptomatic to severe, depending on the patient’s health status, immune system and other factors. Symptoms appear between the first and fourth week after the bite of an infected tick, but may take longer to appear in people with a weakened immune system. The most common are:
- Fever (moderate to high).
- Chills.
- Extreme fatigue and weakness.
- Headache
- Muscle and joint aches
- Excessive sweating
- Anaemia (caused by destruction of red blood cells)
- Jaundice (yellowing of the skin and eyes).
- Dark urine
- Nausea or abdominal discomfort.
Development of infection
For babesia to become contagious, a number of conditions and time periods must occur. The process is usually as follows:
Transmission
The cycle begins when an infected tick (usually of the genus Ixodes) bites a person and transfers the babesia parasite.
Invasion of red blood cells
Once in the body, the parasite enters the red blood cells and begins to reproduce, destroying them. This results in the destruction of red blood cells, leading to anaemia and other symptoms.
Immune reaction
The body’s immune system responds to the attack by generating symptoms such as fever, chills and fatigue due to the release of inflammatory substances.
Progression
In healthy people, symptoms may be mild and the infection may resolve on its own, but in people with weakened immune systems (which we will explain below), the disease can become severe and even fatal if left untreated.
Serious complications
In dangerous cases, babesiosis can lead to complications such as respiratory failure, kidney failure, liver failure, heart problems and/or coagulopathy.
At-risk groups
The groups most vulnerable to babesiosis are those with compromised immune systems or pre-existing medical conditions that hinder their ability to fight infection. Among the most susceptible are:
People without a spleen (splenectomy).
The spleen plays a key role in filtering damaged or infected red blood cells. People who have lost or have a dysfunctional spleen are more vulnerable to serious infections and complications of babesia infection.
Immunosuppressed people
People with weakened immune systems, such as patients with cancer, HIV/AIDS or who are under immunosuppressive treatments (chemotherapy, post-transplant drugs, corticosteroids…) are more likely to develop severe forms of babesiosis.
Elderly people
Babesiosis tends to be more severe in people over 50 years of age, as the immune system weakens with age and the risk of serious complications increases.
People with chronic diseases
Those with chronic conditions such as liver, kidney or heart disease are more likely to develop complications from this parasite.
Blood transfusion recipients
Although rare, it is possible to contract babesiosis through infected blood transfusions. Recipients may be at risk if the donor was previously infected with babesia.
People in endemic areas
Those who spend a lot of time in areas where ticks that transmit Babesia are common (in forests or rural areas in the northeastern and north-central US, for example) are at increased risk of infection. These groups should be especially wary of tick bites and seek early medical attention if they develop symptoms of babesiosis or discover a tick bite.
Treatment
Treatment for babesiosis usually involves a combination of antimicrobial drugs , as the infection is caused by a parasite. The most recommended is a combination therapy of two drugs, atovaquone (antiparasitic) and azithromycin (antibiotic). This regimen is usually effective and is, in fact, the most commonly used in mild to moderate cases of babesiosis.
In more severe cases, especially if the patients are immunocompromised or have severe symptoms, the combination of clindamycin (antibiotic) and quinine (antiparasitic) can be used. The only drawback is that, although effective, the latter approach tends to cause more side effects in the patient, so it is reserved for severe infections.
Treatment usually lasts 7-10 days in mild to moderate cases, but may be longer in immunocompromised or complicated cases. It is important that, whatever decision is made, the process is always supervised by a doctor.
Other measures that the health care professional in charge may take depending on the situation and the patient’s condition is a blood transfusion. In very severe cases of babesia infection, where there is massive destruction of red blood cells, a blood transfusion may be necessary to replace those infected.
Screening tests
Several diagnostic tests can be used to detect babesia infection by looking for the presence of the parasite in the patient’s red blood cells or blood. Early diagnosis is the key to starting treatment and avoiding serious complications. The most common methods are:
Microscopic examination of blood (blood smear).
The testing laboratory will take a sample of the patient’s blood and examine it under a microscope for the direct presence of babesia in the red blood cells. To do this, a laboratory technician will stain the blood sample with special dyes to highlight the parasite. If ring or cross-shaped structures are seen within the red blood cells, infection is confirmed. This is why it can be so difficult to detect infection when the infection is very mild, as there will be few parasites and it will be difficult to distinguish them.
Polymerase chain reaction (PCR)
The PCR test, which may be familiar from the pandemic, detects Babesia parasite DNA in blood. This technique amplifies small amounts of its DNA, making it the perfect type of test for even mild infections. It is much more accurate than the blood smear in low intensity infections.
Serological tests
These tests detect antibodies produced by the immune system in response to babesia infection. A blood sample is taken and tested for the presence of specific antibodies against the parasite. These also include the indirect immunofluorescence assay (IFA).
The only drawback is that they can take several weeks to show positive results, as the body needs time to produce antibodies. However, they are useful for confirming past or chronic infections.
Liver and kidney function tests
These tests assess the impact of the infection on the organs, especially the liver and kidneys. The blood will need to be tested for abnormal levels of liver enzymes, bilirubin and other substances. In cases of babesiosis, these will be altered due to the destruction of red blood cells.
Blood culture
Rarely, the patient’s blood may be cultured in the laboratory to observe parasite growth. A blood sample will be taken and placed in a special environment to allow the parasites to grow and be detected. The reason for the low use of this technique is the slowness in obtaining results .
Although all tests can help in detecting the parasite, doctors often use a combination of several, such as blood smear and PCR, to confirm the diagnosis, especially in patients with mild symptoms or in areas where babesiosis is endemic.
Healthcare professionals will always consider patients’ history of tick exposure, travel to endemic areas and risk factors . These increase the clinical suspicion of babesiosis. Early detection will always improve the prognosis and allow for more effective treatment. Hence the importance of having a laboratory you can trust, capable of offering all types of tests and advice so that the service to the patient is the fastest and most convenient for them. That is why at Ambar Lab we not only have the possibility of carrying out more than 3,000 tests in our laboratories, but we also provide support in the management of your business and the development of new projects. We are your
because we cover from the most basic to the most sophisticated analyses considered as a reference. We carry out tailor-made R&D projects with national and international clients in which, during the necessary time, we merge with your business and we offer you all our knowledge to solve your challenges. If you want to know more about our services, just get in touch with our team, who will answer all your questions in a more personalised way.
