Babesiosis

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KEY POINTS

• Babesiosis is an infection caused by the bite of a deer tick. It is a rare disease that does not cause symptoms for most people.
• Babesiosis is treated with medicines. Follow the full course of treatment prescribed by your healthcare provider.
• Wear long-sleeved shirts and long pants and use insect repellant to avoid ticks. If you find a tick attached to your body, you need to remove it.

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What is babesiosis?

Babesiosis is an infection caused by the bite of a blacklegged tick (also called deer tick) infected with the Babesia parasite. The tick is so small that you may not notice the tick or its bite.

Babesiosis is rare, but can be very serious and life-threatening in people who:

• Are elderly
• Do not have a spleen
• Have kidney or liver disease
• Have a weakened immune system from cancer treatment, diseases such as HIV/AIDS, or from taking steroid medicines or medicines to prevent organ transplant rejection. The immune system is your body’s defense against infection.

What is the cause?

Deer ticks are found in woodlands, grasslands, marshlands, and at the seashore. Ticks may climb on humans from animals, leaves, or low-lying brush. Ticks cannot jump or fly.

People usually become infected during the spring and summer when they are more likely to be exposed to ticks. Hikers, campers, hunters, and people living in wooded or rural areas have a higher risk for babesiosis. In the US, the infection is more common in the Northeastern states and upper Midwest.

In rare cases, babesiosis may be spread by blood transfusion, or from a mother to her unborn baby.

What are the symptoms?

Many people do not have any symptoms. If you do have symptoms, they may be similar to the flu:

• Feeling very tired or drowsy
• Pain or stiffness in muscles and joints
• Headache
• Chills and fever
• Heavy sweating
• Nausea
• Loss of appetite

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have a blood test.

How is it treated?

If you do not have symptoms, you do not need treatment. If you have symptoms, or if you have a weakened immune system or other condition that puts you at high risk, you may be treated with medicine.

If you are pregnant or nursing and have babesiosis, you may pass the disease to your baby. Although this happens rarely, you should call your healthcare provider right away if you are pregnant or nursing and are bitten by a tick or have symptoms.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your healthcare provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent babesiosis?

• In areas of thick underbrush, try to stay near the center of trails.
• When you are outdoors, wear long-sleeved shirts tucked into your pants. Wear your pants tucked into your socks or boot tops if possible. A hat may help, too. Wearing light-colored clothing may make it easier to spot a small tick before it reaches your skin and bites. The blacklegged tick is so small that you may not notice the tick or its bite. It may help if while you are outside, check for ticks every 4 hours and remove any ticks on clothing or exposed skin.
• Use approved tick repellents on exposed skin and clothing. Don’t use more than recommended in the package directions. Do not put repellent on open wounds or rashes. When using sprays, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face, but not near your eyes or mouth. Then wash the spray off your hands.
  • Adults should use repellent products with no more than 35% DEET. Children older than 2 months can use repellents with no more than 30% DEET. Don’t put DEET on a child’s hand or other body part they are likely to put in their mouth. DEET should be applied just once a day. Wash it off your body when you go back indoors. Some products contain more than 35% DEET. The higher concentrations are no more effective than the lower concentrations, but they may last longer. Read the label carefully before applying.
  • Picaridin may irritate the skin less than DEET and appears to be just as effective.
  • Spray clothes with repellents because ticks may crawl from clothing to the skin. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. You can buy clothing and hats pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
• Treat household pets for ticks and fleas. Check pets after they've been outdoors.
• Brush off clothing and pets before entering the house.
• After you have been outdoors, undress and check your body for ticks. They usually crawl around for several hours before biting. Check your clothes, too. Wash them right away to remove any ticks.
• If you find a tick attached to your body, you need to remove it.
  • Grasp the tick with tweezers or fingers (covered with gloves or a tissue) as close to the skin as possible. Gently pull the tick straight away from you until it releases its hold. Use a slow gentle pulling motion. Pulling the tick out too quickly may tear the body from the mouth, leaving the mouth still in the skin. If you are unable to remove the tick completely, you may need to see your healthcare provider. Do not twist the tick as you pull, and try not to squeeze its body.
  • After you have removed the tick, thoroughly wash your hands and the bite area with soap and water. Put an antiseptic such as rubbing alcohol on the area where you were bitten.
  • Put the tick in a sealed plastic bag and keep it in the freezer. Identification of the tick may help your provider diagnose and treat any symptoms. If you do not have any symptoms of disease after 1 month, you can throw away the tick.
• Shower and shampoo after your outing.
• Inspect any gear you have carried outdoors.
• If you spend much time hiking, you may want to include a pair of tick tweezers in your first-aid kit. You can buy them at sporting goods stores.