According to a recent study, cases of babesiosis rose by an average of 9% annually between 2015 and 2022, with nearly half of the affected individuals co-infected with another tick-borne illness, such as Lyme disease.
Researchers at Penn State Health Milton S. Hershey Medical Center and Penn State College of Medicine found that rates of babesiosis, a tick-borne parasitic disease, increased significantly in the United States. Additionally, four out of ten patients were found to have co-infections with other tick-borne illnesses.
“These findings suggest that clinicians should be vigilant about the possibility of co-infection in patients presenting with babesiosis,” said Paddy Ssentongo, an infectious disease fellow and lead author of the study. “Ticks can carry other pathogens that cause Lyme disease as well as anaplasmosis and ehrlichiosis.”
Understanding Babesiosis and Its Rising Prevalence
Babesiosis, often dubbed the “American malaria,” is caused by the Babesia parasite and is transmitted through bites from black-legged ticks. It primarily affects individuals in Northeastern and Midwestern states. Much like malaria, the parasite infects red blood cells and can lead to both mild and severe symptoms. The U.S. Centers for Disease Control and Prevention (CDC) states that while some people may be asymptomatic, others may experience flu-like symptoms. The disease can be particularly serious for older adults and individuals with weakened immune systems.
According to the CDC, the prevalence of babesiosis has been on the rise. Ssentongo noted that climate change could play a role, as shifts in environmental conditions impacting tick populations and their hosts can lead to an increased incidence of tick-borne diseases.
The research team utilized data from TriNetX, a large clinical database encompassing over 250 million individuals, to analyze the current prevalence of babesiosis and Babesia co-infections. They identified 3,521 patients diagnosed with babesiosis between October 2015 and December 2022.
While evaluating the impact of co-infections, the researchers observed no significant differences in complications or health outcomes between patients diagnosed solely with babesiosis and those with co-infections. Notably, they found a higher mortality risk in patients with babesiosis alone compared to those with co-infections.
Evaluating the Effects of Co-Infection on Mortality
“Interestingly, having both babesiosis and Lyme disease did not correlate with an increased mortality risk,” Ssentongo noted. “This observation prompts speculation that concurrent infections might enhance the immune response.”
The differences in outcomes may also relate to the treatment received for co-infections. The study found that patients with co-infections were more frequently prescribed doxycycline, which targets Lyme disease and related ailments. This raises an intriguing question about doxycycline’s potential effectiveness against the Babesia parasite.
Current guidelines for treating babesiosis depend on the severity of the case and generally involve a combination of the antibiotics azithromycin and atovaquone. In critical cases, red blood cell exchange may be an option; however, this method’s survival benefits have not been extensively studied.
“At our facility, we often include doxycycline in the treatment regimen for babesiosis while simultaneously investigating for Lyme disease, and we have seen improved outcomes,” Ssentongo shared. “Though there are case reports supporting doxycycline’s effectiveness against babesiosis, further research is needed to clarify the mechanisms that underlie the impact of co-infections on treatment success.”
Despite the complexities surrounding treatment, Ssentongo emphasizes that the best strategy is to prevent tick-borne illnesses altogether.
“If you reside in areas where babesiosis is endemic, mainly in the Northeast and Midwest, it’s paramount to take precautions, especially during the summer months,” Ssentongo advised. “Adopt tick-bite prevention measures: wear protective clothing, apply tick repellents, and thoroughly check for ticks after outdoor activities.”
Reference: “Beyond Human Babesiosis: Prevalence and Association of Babesia Coinfection with Mortality in the United States, 2015–2022: A Retrospective Cohort Study” by Paddy Ssentongo, Natasha Venugopal, Yue Zhang, Vernon M Chinchilli, and Djibril M Ba, published on October 8, 2024, in Open Forum Infectious Diseases.
Interview: Understanding the Rising Threat of Babesiosis and Lyme Disease Co-Infection
Time.news Editor: Welcome, everyone! Today, we have Dr. Paddy Ssentongo, an infectious disease fellow at Penn State Health and the lead author of a recent study that has shed light on the alarming rise of babesiosis in the U.S. Thank you for joining us today, Dr. Ssentongo.
Dr. Paddy Ssentongo: Thank you for having me! I’m excited to share our findings.
Time.news Editor: Your study indicates that babesiosis cases have risen by about 9% annually since 2015. Can you explain what babesiosis is and why it’s sometimes referred to as “American malaria”?
Dr. Ssentongo: Absolutely. Babesiosis is caused by the Babesia parasite, which is transmitted primarily through the bites of black-legged ticks. Much like malaria, this parasite infects red blood cells and can result in a range of symptoms from mild flu-like conditions to severe complications, especially in vulnerable populations such as older adults or those with weakened immune systems.
Time.news Editor: That’s quite concerning! You mentioned in your study that nearly 40% of patients with babesiosis were also co-infected with other tick-borne illnesses, like Lyme disease. How should clinicians approach this phenomenon?
Dr. Ssentongo: Clinicians need to maintain a high level of vigilance when diagnosing babesiosis, particularly given the likelihood of co-infection. As we know, ticks can carry multiple pathogens, and it’s crucial for healthcare providers to be aware of the possibility of these concurrent infections in patients presenting with symptoms.
Time.news Editor: Interesting. Given the rising incidence of babesiosis, could climate change be influencing tick populations? How does this tie into the increase we’ve been seeing?
Dr. Ssentongo: Yes, climate change is likely a significant factor. Changes in environmental conditions, such as temperature and humidity, impact both tick populations and their host animals. These shifts can lead to a greater incidence of tick-borne diseases, including babesiosis. Warmer climates may allow ticks to thrive in areas previously unsuitable for them, thus expanding their range and increasing exposure risk for humans.
Time.news Editor: You found fascinating results when analyzing the health outcomes of patients with and without co-infections. Can you elaborate on that?
Dr. Ssentongo: Certainly. Our study showed that there were no significant differences in complications or health outcomes between patients diagnosed with only babesiosis and those with co-infections. In fact, those with babesiosis alone exhibited a higher mortality risk. This prompted us to consider that having a co-infection, like Lyme disease, might somehow enhance the immune response to the Babesia infection.
Time.news Editor: That’s quite a breakthrough! Your findings also indicated certain treatment patterns, particularly with doxycycline. What role does doxycycline play in treating these infections?
Dr. Ssentongo: Doxycycline is commonly used to treat Lyme disease and can also be effective against some other tick-borne infections. Our research observed that patients with co-infections were more often prescribed doxycycline. This raises the intriguing question of whether this treatment might have a protective effect against the Babesia parasite, though we need further research in this area to understand this dynamic fully.
Time.news Editor: As we conclude, what preventive measures would you recommend for individuals living in high-risk areas?
Dr. Ssentongo: Preventive measures are crucial. This includes using insect repellent, wearing long sleeves and pants while in wooded or grassy areas, performing tick checks after being outdoors, and promptly removing any ticks found on the body. Awareness is key—especially in areas where tick populations are known to be prevalent.
Time.news Editor: Thank you, Dr. Ssentongo, for sharing this invaluable information. The rising threat of babesiosis and its co-infections is indeed something we all need to be mindful of.
Dr. Ssentongo: Thank you for having me! It’s been a pleasure to discuss this important public health issue.
Time.news Editor: And thank you to our audience for tuning in. Stay safe and informed!