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Babesiosis

Disease Details

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Description: Babesiosis is a tick-borne infectious disease caused by microscopic parasites that infect red blood cells, leading to symptoms ranging from mild flu-like illness to severe, life-threatening conditions.
Type: Babesiosis is a parasitic disease primarily caused by Babesia microti and other Babesia species. It is transmitted through the bite of an infected tick, particularly the black-legged tick (Ixodes scapularis). Babesiosis is not typically considered a genetically transmitted disease, meaning it is not passed down from parent to offspring through genetic inheritance.
Signs And Symptoms: Half of all children and a quarter of previously healthy adults with Babesia infection are asymptomatic. When people do develop symptoms, the most common are fever and hemolytic anemia, symptoms that are similar to those of malaria. People with symptoms usually become ill 1 to 4 weeks after the bite, or 1 to 9 weeks after transfusion of contaminated blood products. A person infected with babesiosis gradually develops malaise and fatigue, followed by a fever. Hemolytic anemia, in which red blood cells are destroyed and removed from the blood, also develops. Chills, sweats, and thrombocytopenia are also common symptoms. Symptoms may last from several days to several months.Less common symptoms and physical exam findings of mild-to-moderate babesiosis:

In more severe cases, symptoms similar to malaria occur, with fevers up to 40.5 °C (105 °F), shaking chills, and severe anemia (hemolytic anemia). Organ failure may follow, including adult respiratory distress syndrome. Sepsis in people who have had a splenectomy can occur rapidly, consistent with overwhelming post-splenectomy infection. Severe cases are also more likely to occur in the very young, very old, and persons with immunodeficiency, such as HIV/AIDS patients.A reported increase in human babesiosis diagnoses in the 2000s is thought to be caused by more widespread testing and higher numbers of people with immunodeficiencies coming in contact with ticks, the disease vector. Little is known about the occurrence of Babesia species in malaria-endemic areas, where Babesia can easily be misdiagnosed as Plasmodium. Human patients with repeat babesiosis infection may exhibit premunity.
Prognosis: Babesiosis generally has a good prognosis, especially in healthy individuals. Symptoms can range from mild to severe, and asymptomatic cases are also common. However, the prognosis may be poorer for immunocompromised individuals, the elderly, and those with other significant health conditions. Severe cases can lead to complications such as hemolytic anemia, organ failure, and even death if not properly treated. Early diagnosis and treatment with appropriate antimicrobial therapy improve outcomes significantly.
Onset: Babesiosis typically has an onset of symptoms one to four weeks after a tick bite. In some cases, especially for those with weakened immune systems or without a spleen, the incubation period could be longer. Symptoms can range from mild to severe and include fever, chills, sweats, headache, body aches, loss of appetite, nausea, and fatigue.
Prevalence: Babesiosis is a tick-borne disease primarily caused by Babesia microti in the United States. The prevalence of babesiosis varies by geographic location, with higher rates reported in the northeastern and upper midwestern regions of the United States. The true prevalence is not well-documented, but it is considered an emerging infectious disease with increasing reported cases. Blood transfusion-associated transmission has also been identified as a concern. Risk factors include outdoor activities in areas with high tick populations and compromised immune systems.
Epidemiology: Babesiosis is a vector-borne illness usually transmitted by Ixodes scapularis ticks. B. microti uses the same tick vector as Lyme disease, and may occur in conjunction with Lyme. The organism can also be transmitted by blood transfusion. Ticks of domestic animals, especially Rhipicephalus (Boophilus) microplus and R. (B.) decoloratus transmit several species of Babesia to livestock, causing considerable economic losses to farmers in tropical and subtropical regions.In the United States, the majority of babesiosis cases are caused by B. microti, and occur in the Northeast and northern Midwest from May through October. Areas with especially high rates include eastern Long Island, Fire Island, Nantucket Island, and Martha's Vineyard.
The Centers for Disease Control and Prevention now requires state health departments to report infections using Form OMB No. 0920-0728. In 2014, Rhode Island had an incidence of 16.3 reported infections per 100,000 people.In Europe, B. divergens is the primary cause of infectious babesiosis and is transmitted by I. ricinus.Babesiosis has emerged in Lower Hudson Valley, New York, since 2001.In Australia, one locally-acquired case of B. microti has been reported, which was fatal. A subsequent investigation found no additional evidence of human Babesiosis in over 7000 patient samples, leading the authors to conclude that Babesiosis was rare in Australia. A similar disease in cattle, commonly known as tick fever, is spread by Babesia bovis and B. bigemina in the introduced cattle tick Rhipicephalus microplus. This disease is found in eastern and northern Australia.
Intractability: Babesiosis is generally not considered intractable. It is a treatable disease caused by the Babesia parasite, typically transmitted through tick bites. Treatment often includes antimicrobial medications such as atovaquone combined with azithromycin or clindamycin combined with quinine. Early detection and treatment usually lead to successful management of the disease. However, severe cases can occur, particularly in individuals with compromised immune systems, and these may require more intensive medical intervention.
Disease Severity: Babesiosis severity can range from mild to severe. While many individuals may be asymptomatic or experience flu-like symptoms such as fever, chills, and fatigue, severe cases can lead to hemolytic anemia, organ failure, and even death, particularly in individuals who are elderly, immunocompromised, or have other underlying health conditions. Nanotechnology is not typically associated with the treatment or study of babesiosis.
Healthcare Professionals: Disease Ontology ID - DOID:9643
Pathophysiology: Babesia parasites reproduce in red blood cells, where they can be seen as cross-shaped inclusions (four merozoites asexually budding, but attached together forming a structure looking like a "Maltese cross") and cause hemolytic anemia, quite similar to malaria.
Unlike the Plasmodium parasites that cause malaria, Babesia species lack an exoerythrocytic phase, so the liver is usually not affected.In nonhuman animals, Babesia canis rossi, Babesia bigemina, and Babesia bovis cause particularly severe forms of the disease, including a severe haemolytic anaemia, with positive erythrocyte-in-saline-agglutination test indicating an immune-mediated component to the haemolysis. Common sequelae include haemoglobinuria "red-water", disseminated intravascular coagulation, and "cerebral babesiosis" caused by sludging of erythrocytes in cerebral capillaries.In bovine species, the organism causes hemolytic anemia, so an infected animal shows pale mucous membranes initially. As the levels of bilirubin (a byproduct of red blood cell lysis) continue to increase, the visible mucous membranes become yellow in color (icterus) due to the failure of the liver to metabolize the excess bilirubin. Hemoglobinuria is seen due to excretion of red-blood-cell lysis byproducts via the kidneys. Fever of 40.5 °C (105 °F) develops due to release of inflammatory byproducts.
Carrier Status: Carrier status does not apply to babesiosis in the same way it applies to genetic conditions. Babesiosis is a parasitic infection transmitted primarily through the bite of an infected black-legged tick (Ixodes scapularis). In some cases, the parasites (Babesia) can also be transmitted through blood transfusions or from an infected mother to her baby during childbirth.

Since babesiosis is not a genetic condition, the concept of being a "carrier" doesn't directly apply. Instead, individuals can become infected if they are bitten by an infected tick or receive contaminated blood. Nan refers to something not being a number, which is not applicable here.
Mechanism: Babesiosis is an infectious disease caused by protozoan parasites of the genus Babesia, typically transmitted by the bite of an infected tick, most commonly Ixodes scapularis. Here's a brief overview:

**Mechanism:**

1. **Transmission:** The primary mode of transmission is through the bite of an infected tick, though it can also be transmitted via blood transfusion, organ transplantation, or from mother to baby during pregnancy or delivery.
2. **Infection:** Upon entering the bloodstream, Babesia parasites invade red blood cells (RBCs).
3. **Replication:** Inside RBCs, the parasites multiply asexually. This leads to the destruction of the RBCs when the parasites are released into the bloodstream to infect new RBCs.
4. **Immune Response:** The immune system responds to the infection, leading to symptoms like fever, chills, anemia, and hemolysis due to the destruction of infected RBCs.

**Molecular Mechanisms:**

1. **Adhesion and Invasion:** Babesia parasites use specific receptors to attach to and invade RBCs. For example, Babesia divergens uses a protein called Bd37 to bind to RBC surface receptors.
2. **Intracellular Survival:** Once inside RBCs, Babesia parasites evade the host's immune system and create a favorable environment for replication. They modify the host cell's cytoskeleton and surface properties to avoid detection and destruction.
3. **Nutrient Acquisition:** The parasites digest host hemoglobin for nutrients such as amino acids. They may also alter host cell metabolism to meet their nutritional needs.
4. **Immune Evasion:** Babesia parasites express various surface proteins that help them evade the host's immune response. They may also induce the production of anti-inflammatory cytokines to suppress host immune functions.
5. **Protection from Oxidative Stress:** The parasites have mechanisms to protect themselves from oxidative stress generated by the host's immune response, including antioxidant enzymes like superoxide dismutase and catalase.

Understanding these mechanisms is crucial for developing targeted treatments and interventions for babesiosis.
Treatment: Treatment of asymptomatic carriers should be considered if parasites are still detected after 3 months. In mild-to-moderate babesiosis, the treatment of choice is a combination of atovaquone and azithromycin. This regimen is preferred to clindamycin and quinine because it has fewer side effects. The standard course is 7 to 10 days, but this is extended to at least 6 weeks in people with relapsing disease. Even mild cases are recommended to be treated to decrease the chance of inadvertently transmitting the infection by donating blood. In severe babesiosis, the combination of clindamycin and quinine is preferred. In life-threatening cases, exchange transfusion is performed. In this procedure, the infected red blood cells are removed and replaced with uninfected ones.Imidocarb is a drug used for treatment of babesiosis in dogs.
Extracts of the poisonous, bulbous plant Boophone disticha are used in the folk medicine of South Africa to treat equine babesiosis. B. disticha is a member of the daffodil family Amaryllidaceae and has also been used in preparations employed as arrow poisons, hallucinogens, and in embalming. The plant is rich in alkaloids, some of which display an action similar to that of scopolamine.
Compassionate Use Treatment: Compassionate use treatments for babesiosis typically involve access to investigational drugs when standard treatments are ineffective or unavailable. One such investigational drug that has been considered for compassionate use is tafenoquine.

Off-label treatments for babesiosis often include the combination of atovaquone and azithromycin, which are not specifically approved by regulatory agencies for babesiosis but are commonly used due to their efficacy. Alternatively, clindamycin and quinine can be used, particularly in severe cases.

Experimental treatments may involve new antiparasitic medications undergoing clinical trials. These are not widely available outside of research settings but may be accessible through clinical trial participation or expanded access programs.
Lifestyle Recommendations: For babesiosis, lifestyle recommendations include:

1. **Avoid Tick-Infested Areas:** When possible, steer clear of areas known for high tick populations such as tall grasses and dense woods.

2. **Use Protective Clothing:** Wear long-sleeved shirts, long pants, and tuck your pants into your socks to reduce skin exposure.

3. **Apply Tick Repellents:** Use insect repellents with active ingredients such as DEET, permethrin, or picaridin on skin and clothing.

4. **Perform Tick Checks:** After spending time outdoors, thoroughly check your body, clothes, and pets for ticks. Promptly remove any ticks found.

5. **Shower After Outdoors:** Showering within two hours of coming indoors can help wash away unattached ticks.

6. **Maintain Yard:** Keep your yard well-maintained by mowing grass regularly, removing leaf litter, and creating barriers with wood chips or gravel between lawns and wooded areas.

7. **Monitor for Symptoms:** Be aware of symptoms such as fever, chills, fatigue, and muscle aches. Seek medical attention if these symptoms arise after potential tick exposure.

These actions can significantly reduce the risk of contracting babesiosis.
Medication: The primary treatment for babesiosis involves a combination of medications. Common regimens include atovaquone with azithromycin or, for more severe cases, clindamycin with quinine. Treatment typically lasts 7 to 10 days. Always consult a healthcare provider for appropriate diagnosis and treatment recommendations.
Repurposable Drugs: For babesiosis, repurposable drugs include atovaquone, azithromycin, clindamycin, and quinine.
Metabolites: Babesiosis is an infection caused by protozoa of the genus Babesia, primarily Babesia microti in the United States. The disease affects red blood cells, and its metabolites are similar to those found in malaria due to the intraerythrocytic lifecycle of the pathogen. Key metabolites include:

1. Hemoglobin breakdown products such as heme.
2. Lactate, due to the anaerobic metabolism within red blood cells.
3. Reactive oxygen species (ROS) as byproducts of cellular stress.
4. Parasitic nucleic acids from the replication of Babesia.

These metabolites can influence the pathophysiology of the infection and contribute to symptoms like hemolytic anemia and fever.
Nutraceuticals: There is limited evidence supporting the effectiveness of nutraceuticals in the treatment or prevention of babesiosis. Babesiosis is primarily treated with prescription medications such as atovaquone and azithromycin or, in severe cases, clindamycin and quinine. Nutraceuticals have not been sufficiently studied in this context. For any alternative or complementary treatment, it is crucial to consult with a healthcare professional.
Peptides: In the context of babesiosis, which is a tick-borne disease caused by Babesia parasites, peptides can be relevant in several areas:

1. **Diagnostic Tools**: Peptides derived from Babesia antigens can be used in serological tests to detect antibodies in infected individuals.
2. **Therapeutic Targets**: Studying Babesia-specific peptides can help in developing targeted treatments.
3. **Vaccine Development**: Peptides from Babesia can be potential candidates for vaccine formulations to induce protective immunity.

Nanoscale technologies (nan) can enhance these areas by improving the delivery and efficacy of diagnostic tools, treatments, and vaccines. For example, nanoparticle-based delivery systems can increase the stability and bioavailability of therapeutic peptides.