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Babesia: What Is It, How Is It Treated, and What Role Can Integrative Medicine Play?

Jonathan Vellinga, MD -

There are few things better for your physical and mental health than spending time in the Great Outdoors. Unfortunately, even Mother Nature can pose some significant health risks if you’re not careful. Among the most concerning of these pathogens today is the increasing prevalence of tick-borne illnesses, from Rocky Mountain Spotted Fever to Lyme Disease.


Babesia: What Is It, How Is It Treated, and What Role Can Integrative Medicine Play?

Indeed, data derived from global epidemiological trackers, incidence reports, and case studies alike have provided empirical evidence to support what healthcare providers and medical researchers have long suspected: potentially life-threatening tick-borne illnesses are rapidly becoming endemic throughout the world, including the United States (1, 2, 3, 12).


One relatively little-known but increasingly common tick-born pathogen is the parasite Babesia, a protozoan that attacks red blood cells in humans and can lead to a serious, even fatal, malaria-like infection known as Babesiosis, particularly in vulnerable individuals (4). So, how does Babesia affect humans, how is it treated, and what role can integrative medicine play in both prevention and recovery?


What Is Babesia and How Is It Contracted?


Babesia is the second most prevalent blood parasite found in tick-bitten mammals in the United States, with more than 100 species of the microbe having been identified thus far (5). Significantly, a wide variety of mammalian species is susceptible to infection through the bite of an infected tick, including not only humans, but also dogs, sheep, deer, goats, and cattle. Currently, it’s not quite clear whether the parasite can be transmitted to humans through contact with other mammalian hosts (6).


What is clear, however, is that there are three primary ways for a human to become infected with the Babesia parasite. By far the most common of these is direct transmission through the bite of a tick carrying the pathogen. Other less common vectors of transmission to humans are through blood transfusions and childbirth, with the mother passing the infection to her child through the placenta (1).


While incidences of human Babesia infections are on the rise worldwide, the parasite remains difficult to detect through conventional blood screenings. Historically, Babesia infection is detected through a blood smear, a procedure that is both time-consuming and highly specialized (7). Because of the inherent challenges of diagnosing the infection, infected patients risk being misdiagnosed or experiencing treatment delays until their symptoms progress to potentially life-threatening severity or debilitating chronicity.


The protozoan can be found in ticks and their mammalian hosts throughout the world, from Europe to Asia to North America. Though the parasite occurs throughout the entire US, it is thought to be endemic in certain regions, including the northeast and New England, the Upper Midwest, and the West Coast (8, 9).


The Effects of Human Babesiosis


One of the most significant challenges in addressing Babesia infections in humans, in addition to the rapid increase in infections among human and other mammalian hosts, is the often immense variation in the course of the Babesiosis infection from one patient to another. Indeed, while many who have been infected with the parasite show few symptoms, if any, and are able to clear the pathogen without even knowing they’ve been infected, others can become gravely ill.


The principal risk of a Babesia infection in humans often rests in the individual’s ability to mount an effective immune response to the parasite. Thus, healthy adults with robust immune systems may never notice any physiological symptoms associated with the parasite. On the other hand, seniors, the immunocompromised, and individuals who have undergone splenectomies are at significant risk for developing severe Babesiosis and even of dying from the infection (1,10).


In vulnerable patients, the symptomology of Human Babesiosis is very much like the symptoms associated with malarial infection. In fact, the similarity is often so great that healthcare providers may be hard-pressed to accurately distinguish between the two (12). It’s not difficult to understand why: both originate from parasitic protozoans that inhabit and feed off of the red blood cells of the host.


In symptomatic cases of human Babesiosis, patients may experience fever, chills, fatigue, headache, muscle aches, cough, shortness of breath, respiratory distress, and an especially dangerous form of anemia called hemolytic anemia, in which the body’s red blood cells are destroyed faster than the bone marrow can replenish them. In extreme cases, the fever and blood loss associated with human Babesiosis are so significant that the patient cannot rally. This may result in organ failure and, possibly, death.


The Connection Between Babesia and Lyme Disease


Lyme Disease is one of the most prevalent and also among the least understood tick-borne diseases in the United States, affecting nearly 500,000 people, according to recent CDC estimates. However, studies suggest that there is often a strong correlation between Lyme Disease and Babesia.


Though Babesia and Lyme Disease are caused by different organisms, they are often transmitted through the same species of tick (13). Research is mounting that most ticks are host to multiple microbial infections simultaneously and that the bite of a single tick may introduce both the Lyme Disease and Babesia parasites (among others) into the human host. These non-Lyme organisms also transmitted by ticks are referred to as “coinfections” (14).


Current estimates suggest that as many as 1-in-5 Lyme Disease patients may also be infected with Babesia. That’s pretty alarming because there’s also strong evidence to show that the concurrence of Babesia and Borrelia-Burgdorferi, the microbe responsible for Lyme, can have synergistic effects, meaning that the severity of each disease is amplified by the presence of the other. Patients with Babesia and Lyme Disease often experience significantly more severe disease and worse outcomes than those experiencing a single infection (15, 16, 17).


Conventional Treatments for Human Babesiosis


As has been seen, patients who have been infected with the Babesia parasite can differ widely both in the trajectory and outcome of the infection. However, while many people who are infected with Babesia may require no treatment, those who are experiencing symptoms of acute Babesiosis infection, such as fever and chills, need prompt medical attention to arrest or slow the progression of the disease.


The standard course of treatment for human Babesiosis is a combination of antimicrobial (antibiotic) therapies. These are intended to kill the Babesia parasite. The most common drug combinations for Babesiosis include medications like atovaquone, azithromycin, hydroxychloroquine, or clindamycin (18).


Though these therapies have been shown to have some substantial efficacy in some patient populations, they are by no means either foolproof or harmless. Potential side effects of these antibiotics include allergic reactions, nausea, and vomiting (18).

Clindamycin and quinine appear to be particularly poorly tolerated by some patients and may lead not only to the adverse events described above but also to neurological impacts, including mild to moderate hearing loss and tinnitus (18). Frail and immunocompromised patients may not be able to tolerate these conventional regimens and may require supportive care and alternative therapies.


In addition to challenges in patients’ ability to tolerate conventional Babesiosis treatments, studies suggest that the long-term efficacy of these regimes is limite