uses thesame tick vector,
, as Lyme diseaseandehrlichiosis, and may occur in
conjunction with these other diseases. In endemic areas, the organism can also be transmitted by blood transfusion. In North America, the disease exists mostly in eastern Long-Island and its barrier island,Fire Island,and the islands off the coast of Massachusetts.
It is sometimes called"The Malaria of The Northeast."Cases of babesiosis have been reported in a wide range of European countries. Disease in Europeis usually due to infection with
, while in the United States
are the species most commonly associated with human disease. Babesiosishas also been observed in Korea.
Most cases of babesia infection are asymptomatic or include mild fevers and anemia and gounnoticed. In more severe cases, there are symptoms similar to malaria, with fevers up to 105°F /40°C, shaking chills, and severe anemia (hemolytic anemia). Organ failure may follow includingadult respiratory distress syndrome. Severe cases occur mostly in people who have had their spleen removed surgically. Severe cases are also more likely to occur in the very young, veryold, and persons withimmunodeficiency, such as HIV/AIDS patients. Some people with
babesiosis have additional tick-borne illnesses, such asLyme disease.
.A reported increase in babesiosis diagnoses in recent years is thought to be caused by morewidespread testing and higher numbers of people with immunodeficiencies coming in contactwith ticks, the disease vector .
Little is known about the occurrence of
species in malaria-endemicareas, where
can easily be misdiagnosed as
Babesia life cycle
parasites reproduce inred blood cells, where they can be seen as cross-shaped inclusions(4merozoitesasexually budding but attached together forming a structure looking like a"Maltese Cross")
parasites that cause malaria,
species lack an exo-erythrocytic phase, so the liver is usually not affected.
Babesia canis rossi
cause particularly severeforms of the disease that include a severe haemolytic anaemia, with positive erythrocyte-in-saline-agglutination test indicating an immune mediated component to the haemolysis. Commonsequelae include haemoglobinuria "red-water", disseminated intravascular coaguation (DIC) and"cerebral babesiosis" caused by sludging of erythrocytes in cerebral capilaries.
A high index of suspicion is necessary to diagnose babesiosis. Babesiosis develops only in patients who live in or travel to an endemic area or receive a contaminated blood transfusion
within the preceding 9 weeks, so this aspect of the medical history is vital.
Babesiosis may besuspected when a person with such an exposure history develops persistent fevers and hemolyticanemia. The definitive diagnostic test for babesiosis is the identification of parasites on aGiemsa -stainedthin blood smear .
So-called "Maltese cross formations" on the blood film areessentially diagnostic of babesiosis, since they are not seen in malaria, the primary differential