Archive for the ‘Babesia’ Category

Transfusion-Transmitted Babesiosis in Nonendemic Areas

Cases of transfusion-transmitted babesiosis occurring in nonendemic areas: a diagnostic dilemma
LeBel, D. P., Moritz, E. D., O’Brien, J. J., Lazarchick, J., Tormos, L. M., Duong, A., Fontaine, M. J., Squires, J. E. and Stramer, S. L.
Transfusion, online first August 7, 2017.


Transfusion-transmitted babesiosis (TTB) has been rapidly increasing in incidence since the beginning of the 21st century. Asymptomatic individuals with Babesia infection are able to donate blood in the United States because of the lack of specific blood donation testing. Blood products collected in Babesia-endemic areas are distributed nationally; thus, clinicians in nonendemic states may fail to include babesiosis in the differential diagnosis of a patient who had a recent transfusion history and a fever of unknown origin.

We report the details of two cases of clinical transfusion-transmitted babesiosis and one asymptomatic infection identified in red blood cell recipients in two nonendemic states (South Carolina and Maryland), which, when combined with three recent additional cases in nonendemic states, totals six recipient infections in three nonendemic states.

Delayed diagnosis of transfusion-transmitted babesiosis places patients at risk for increased morbidity and mortality and may result in clinical mismanagement or unnecessary treatments. A peripheral blood smear should be reviewed in any patient with a recent transfusion and a fever of unknown origin. Prompt communication of the diagnosis among physicians is key to ensuring that patients with transfusion-transmitted babesiosis are treated expeditiously, and a transfusion service investigation is necessary to identify additional recipients from the same donor.

TTB is appearing in traditionally nonendemic states because of blood product distribution patterns. Clinicians should include TTB on the differential diagnosis in any patient presenting who had a recent transfusion history and a fever of unknown origin, regardless of where the transfusion took place.

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Transfusion-Transmitted Babesiosis Leading to Severe Hemolysis in Sickle Cell Anemia Patients

Transfusion-transmitted babesiosis leading to severe hemolysis in two patients with sickle cell anemia

Karkoska K, Louie J, Appiah-Kubi AO, Wolfe L, Rubin L, Rajan S, Aygun B.

Pediatric Blood & Cancer, online first, 2017 Aug 2.


The intracellular parasites Babesia microti and Babesia duncani can be transmitted by blood transfusion and cause severe life-threatening hemolytic anemia in high-risk patients, including those with sickle cell disease.

The rarity of the diagnosis, as well as its similar clinical presentation to delayed hemolytic transfusion reaction, may lead to a delay in diagnosis, as well as inappropriate treatment with steroids or other immunosuppressive agents.

The morbidity caused by this disease in especially vulnerable populations justifies the need for a universal blood-screening program in endemic areas.

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Ticks Found on Eyeball, Buttocks, and Penis

It’s High Time for Ticks, Which Are Spreading Diseases Farther
JULY 24, 2017

SOUTHAMPTON, N.Y. — This town is under siege from tiny invaders.

A doctor at Southampton Hospital recently pulled a tick off a woman’s eyeball. After a 10-minute walk outside, a mother reported finding a tick affixed to her 7-year-old daughter’s buttocks.

Another mother called the hospital in a “hysterical state,” according to the nurse who answered, because a tick had attached itself to her son’s penis.

Like many towns across the country, Southampton is seeing a tick population that is growing both in numbers and variety — at a time when ticks are emerging as a significant public health danger.

“Tick-borne diseases are a very serious problem, and they’re on the rise,” said Rebecca Eisen, a research biologist at the Centers for Disease Control and Prevention.

“Even though you may live in an area where you didn’t have ticks in the past or your parents don’t remember having ticks, the distribution is changing,” she added. “More and more people are at risk.”

With the expansion of the suburbs and a push to conserve wooded areas, deer and mice populations are thriving. They provide ample blood meals for ticks and help spread the pests to new regions.

Originally from the Southeast, the lone star tick, for example, is heading north; it can now be found in 1,300 counties in 39 states. The blacklegged tick, also called the deer tick, is expanding its territory, too. In a recent study, Dr. Eisen reported a nearly 45 percent increase since 1998 in the number of counties with blacklegged ticks.

Thomas Mather, director of the University of Rhode Island’s TickEncounter Resource Center, said it used to get reports of three or four lone star ticks in the greater Chicago area each year. Now, it is receiving up to 15.

When a tick species marches into a new region, it poses a double-barreled threat, said Jerome Goddard, extension professor of medical and veterinary entomology at Mississippi State University.

First, the species brings diseases from its original location. Second, the ticks pick up new pathogens from animals in their new ecosystem.

Physicians and patients in a tick’s new home may be less familiar with the diseases it carries. They can overlook symptoms or attribute them to a different cause, delaying effective treatment.

The best known threat is Lyme disease. Cases in the United States increased from about 12,000 annually in 1995 to nearly 40,000 in 2015. Experts say the real number of infections is likely closer to 300,000.

But scientists are finding ticks carry more than just Lyme: At least a third of known tick-borne pathogens were found in the last 20 years. Heartland virus and Bourbon virus, which can prove fatal, were discovered in just the last five years.

Powassan virus, a rare but dangerous pathogen that can cause permanent brain damage or death, can be passed from tick to human in just 15 minutes. It was discovered in 1958, and an average of seven cases are reported each year. Earlier this month, a resident of Saratoga County, N.Y., who had Powassan disease died.

Dr. Gary Wormser, founder of the Lyme Disease Diagnostic Center at New York Medical College, said the most worrisome tick-borne contagion he sees is babesiosis, which can cause malaria-like symptoms and require hospitalization. A few of his patients have died from it; several required intensive care.

Before 2001, babesiosis was not found in Westchester, N.Y. But Westchester Medical Center has diagnosed at least 21 cases in the past year.

A study of babesiosis in Wisconsin found a 26-fold increase in the number of cases between 2001 to 2003, and 2012 to 2015.

In places where the lone star tick is gaining prevalence, doctors also are seeing an increase in cases of alpha-gal syndrome, a strange allergy to red meat induced by tick bites.

Alpha-gal is a sugar molecule carried by the lone star tick. When the tick bites a human, it activates the immune system, which starts producing alpha-gal antibodies.

The body becomes wired to fight alpha-gal sugar molecules, which are abundant in red meat. Eating meat can trigger allergic reactions, from an itchy rash to anaphylactic shock.

Dr. Erin McGintee, an allergist and immunologist at ENT and Allergy Associates in Southampton, sees two to three cases of alpha-gal syndrome per week during tick season. Since diagnosing her first case in October 2010, she has seen more than 380 patients.

“The cases are definitely increasing over time,” she said.

That is no surprise to Karen Wulffraat, administrative director of Southampton Hospital’s Tick-Borne Disease Resource Center.

“The calls about lone star tick bites are increasing in number, even overtaking the blacklegged tick,” which is native to the Northeast, she said.

Cathy Ward and her husband bought a summer home in Southampton in 1984, and moved there permanently eight years ago.

Ms. Ward remembers taking her son Bill to the nearby wildlife refuge as a child, where he would fill his hands with birdseed and stand with his arms outstretched until birds came and perched on them.

Now when Bill Ward visits with his young daughter, Taylor, his mother tells them the refuge is off limits — it is a breeding ground for ticks.

“It wasn’t a concern when Bill was young,” Ms. Ward said. “Now you have to protect yourself all the time. You don’t know where you’re going to pick up a tick.”

She will not garden in the yard anymore, and has it sprayed for ticks annually. Despite that, her granddaughter got a tick while visiting during the Fourth of July weekend. The family found it before it had bitten her, but it was a shock nonetheless.

“It’s scary, because we don’t know which diseases they carry,” said Mr. Ward.

Brian Kelly, owner of East End Tick and Mosquito Control, has noticed the change, too. His company now sprays people’s lawns instead of just their bushes because lone star ticks are more aggressive than the native blacklegged ticks, and tend to venture further from the woods.

“People can walk across their lawn barefoot to get the newspaper and get a tick,” he said.

As human exposure to ticks continues to increase, it’s likely that even the rarest infections they carry will become more common, Dr. Goddard said.

“This really has a human toll that a lot of people don’t recognize,” he said.


Artesunate on Short Term Memory in Lyme Borreliosis

Lyme borreliosis is associated with memory deficits. While this may be related to cerebral infection by Borrelia bacteria, it may also be caused by concomitant co-infection by Babesia protozoa. The anti-malarial artemisinin-derivative artesunate has been shown to be effective against a number of Babesia species and to have efficacy against human cerebral malaria. We hypothesised that concomitant administration of artesunate in Lyme borreliosis patients would help alleviate the severity of self-reported short-term memory impairment. This hypothesis was tested in a small pilot study in which patients were treated with both an intravenous antibiotic and oral artesunate (20 mg four times per day); treatment was associated with a reduction in the severity of short-term memory difficulties (P ≃ 0.08). In light of these findings, we recommend that a formal randomised, placebo-controlled study be carried out.


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More on Lyme:

Start Treatment if TBI’s are Suspected  Cleveland Clinic Journal of Medicine. 2017 July;84(7):555-567


  • Tickborne illnesses should be considered in patients with known or potential tick exposure presenting with fever or vague constitutional symptoms in tick-endemic regions.
  • Given that tick-bite history is commonly unknown, absence of a known tick bite does not exclude the diagnosis of a tick-borne illness.
  • Starting empiric treatment is usually warranted before the diagnosis of tickborne illness is confirmed.
  • Tick avoidance is the most effective measure for preventing tickborne infections.


The article delineates symptoms, transmission, reservoirs, testing, and treatment of the following TBI’s:  Rocky Mountain Spotted Fever, Rickettsiosis, Ehrlichioses, Babesiosis, Tickborne relapsing fever, Borrelia miyamotoi, Southern Tick-associated Rash illness, Tularemia, and Tickborne viral infections.



I need to address the following statements at the end of the article:

“Knowledge of the geographic locations of potential exposure is paramount to determining which tickborne infections to consider, and the absence of a tick bite history should not exclude the diagnosis in the correct clinical presentation.

Clinicians need to tread carefully here.  Many patients have been denied testing and treatment due to a map.  These maps should be viewed with the same suspicion as the testing.  




Until you tell the fox, squirrel, bird, deer, lizards, and hundreds of other reservoirs to stay put, ticks will be traveling everywhere along with the pathogens they carry.  Since Lyme Disease (borrelia) has been found in every continent except for Antarctia (it will be found there too), you can assume that means ticks are there too.  

I’m glad the authors stated this:

In addition, it is important to recognize the limitations of diagnostic testing for many tickborne infections; empiric treatment is most often warranted before confirming the diagnosis.”132_fail316x316

For those of us in this war, this “empiric treatment” by mainstream medicine is new.  Patient after patient has had to wait for test results before doctors will treat them.  Often, since the testing is so poor, it comes back negative and the patient is sent packing, even if the patient has every symptom in the book.  The next step is for authorities to admit and acknowledge that diagnosis of Tick borne infections is a clinical one.  This means doctors need to learn a whole lot more.  For docs willing to learn, please see:

Even the CDC is stating to treat empirically: CDC spokesperson at end of video.

Another very important point needs to be made.  The CDC has pushed this one pathogen for one tick mantra for too long.  Many patients are co-infected making cases infinitely more complex and challenging to treat.  Lyme literate doctors trained by ILADS understand this and treat accordingly.  Until mainstream medicine realizes and admits people can have numerous pathogens, and treat for them, people will not get better.


One last point is that mycoplasma, Bartonella, and other pathogens are not included here but are quite common in patients.  Both of these pathogens are persistent and adept at surviving.  More research needs to be done on these co-infections.

Please see:  If ticks are co-infected, so are patients.



Wolbachia – The Next Frankenstein?

Transmission electron micrograph of Wolachia within an insect cell

Credit:  Public Library of Science/Scott O’Neill

The latest in the effort for world domination over bugs and the diseases they carry is Wolbachia, a Gram-negative bacterium of the family Rickettsiales first found in 1924 and in 60% of all the insects, including some mosquitoes, crustaceans, and nematodes (worms). For those that like numbers, that’s over 1 million species of insects and other invertebrates. It is one of the most infectious bacterial genera on earth and was largely unknown until the 90’s due to its evasion tactics. It’s favorite hosts are filarial nematodes and arthropods.

Wolachia obtains nutrients through symbiotic relationships with its host. In arthropods it affects reproductive abilities by male killing, parthenogenesis, cytoplasmic incompatibility and feminization. However, if Wolbachia is removed from nematodes, the worms become infertile or die. These abilities are what make it so appealing for insect controlcytoplasmic incompatibility, which essentially means it results in sperm and eggs being unable to form viable offering.  (Nifty slide show here)

It also makes it appealing for use in human diseases such as elephantiasis and River Blindness caused by filarial nematodes, which are treated with antibiotics (doxycycline) targeting Wolbachia which in turn negatively impacts the worms. Traditional treatment for lymphatic Filariasis is Ivermectin but they also use chemotherapy to disrupt the interactions between Wolbachia and nematodes. This anti-Wolbachia strategy is a game-changer for treating onchocerciasis and lymphatic filariasis.

Lyme/MSIDS patients often have nematode involvement.  Both Willy Burgdorfer, the discoverer of the Lyme bacterium, as well as Richard Ostfeld, an animal ecologist found nematode worms in ticks. Since then, some provocative research involving nematodes, Lyme/MSIDS, dementia, and Alzheimer’s has been done.  Yet, according to many, Wolbachia is the next eradicator of Dengue Fever and possibly Malaria, chikungunya, and yellow fever because it stops the virus from replicating inside mosquitoes that transmit the diseases. The approach is also believed to have potential for other vector-borne diseases like sleeping sickness transmitted by the tsetse fly.  Evidently, Wolbachia does not infect the Aedes aegypti mosquito naturally, so researchers have been infecting mosquitoes in the lab and releasing them into the wild since 2011. The article states it hopes that the method works and expects infection rates in people to drop and hopes that the mosquitoes will pass the bacterium to their offspring, despite it disappearing after a generation or two of breeding and needing to “condition” the microbes to get them used to living in mosquitoes before injecting them. They also state Wolbachia is “largely benign for mosquitoes and the environment,” and “To humans, Wolbachia poses no apparent threat.” Their work has shown that the bacterium resides only within the cells of insects and other arthropods. They also state that tests on spiders and geckos that have eaten Wolbachia mosquitoes are just fine and show no symptoms. An independent risk assessment by the Commonwealth Scientific and Industrial Research Organizatioin (CSIRO), Australia’s national science agency, concluded that, “Release of Wolbachia mosquitoes would have negligible risk to people and the environment.”

Interestingly, trials are underway in Vietnam, Indonesia, and now Brazil.

They state that scaling up operations to rear enough Wolbachia mosquitoes is too labor-intensive and in Cairns they are going to put Wolbachia mosquito eggs right into the environment. Evidently, other researchers are wanting to release genetically modified (GMO) mosquitoes that carry a lethal gene, and they’ve done it, and it’s causing an uproar:  As of July 14, 2017, Google’s bio-lab, Verily Life Sciences,  started releasing Wolbachia laced mosquitoes in California as part of project, Debug Fresno to reduce the mosquito population.  Numerous studies show unexpected insertions and deletions which can translate into possible toxins, allergens, carcinogens, and other changes.  Science can not predict the real-life consequences on global pattens of gene function.

So, why question the use of Wolbachia as a bio-control?

For Lyme/MSIDS patients, 3 words: worms and inflammation.

Dogs treated for heart worm (D. immitis) have trouble due to the heart worm medication causing Wolbachia to be released into the blood and tissues causing severe Inflammation in pulmonary artery endothelium which may form thrombi and interstitial inflammation. Wolbachia also activates pro inflammatory cytokines. Pets treated with tetracycline a month prior to heart worm treatment will kill some D. immitis as well as suppress worm production. When given after heart worm medication, it may decrease the inflammation from Wolbachia kill off.

The words worms and inflammation should cause every Lyme/MSIDS patient to pause. Many of us are put on expensive anthelmintics like albendazole, ivermectin, Pin X, and praziquantel to get rid of worms and are told to avoid anything causing inflammation due to the fact we have enough of it already. We go on special anti-inflammatory diets and take systemic enzymes and herbs to try and lower inflammation.

Seems to me, many MSIDS/LYME patients when treated with anthelmintics, will have Wolbachia released into their blood and tissues causing wide spread inflammation, similarly to dogs.

And that’s not all.

According to a study by Penn State, mosquitoes infected with Wolbachia are more likely to become infected with West Nile – which will then be transmitted to humans.“This is the first study to demonstrate that Wolbachia can enhance a human pathogen in a mosquito, one researcher said. “The results suggest that caution should be used when releasing Wolbachia-infected mosquitoes into nature to control vector-borne diseases of humans.” “Multiple studies suggest that Wolbachia may enhance some Plasmodium parasites in mosquitoes, thus increasing the frequency of malaria transmission to rodents and birds,” he said.  The study states that caution should be used when releasing Wolbachia-infected mosquitoes into nature.

So besides very probable wide spread inflammation, and that other diseases may become more prevalent due to Wolbachia laced mosquitoes, studies show Wolbachia enhances Malaria in mosquitos. Lyme/MSIDS patients are often co-infected with Babesia, a malarial-like parasite that requires similar treatment and has been found to make Lyme (borrelia) much worse. It is my contention that the reason many are not getting well is they are not being treated for the numerous co-infections.  Some Lyme/MSIDS patients have Malaria and Lyme.

Regardless of what the CDC states, all the doxycycline in the world is not going to cure this complicated and complex illness.

Lastly, with Brazil’s recent explosion of microcephaly, the introduction of yet another man-made intervention (Wolbachia laced mosquitos) should be considered in evaluating potential causes and cofactors. And while the CDC is bound and determined to blame the benign virus, Zika, there are numerous other factors that few are considering – as well as the synergistic effect of all the variables combined. Microcephaly could very well be a perfect storm of events.

I hate bugs as much as the next person, but careful long-term studies of Wolbachia are required here.  “Despite the intimate association of B. burgdorferi and I. scapularis, the population structure, evolutionary history, and historical biogeography of the pathogen are all contrary to its arthropod vector.

In short, borrelia (as well as numerous pathogens associated with Lyme/MSIDS), is a smart survivor.

While borrelia have been around forever with 300 strains and counting worldwide, epidemics, such as what happened with Lyme Disease in Connecticut are not caused by genetics but by environmental toxins – in this case, bacteria, viruses, funguses, and stuff not even named yet.

Circling back to Wolbachia.

Hopefully it is evident that many man-made interventions have been introduced into the environment causing important health ramifications: Wolbachia laced mosquitoes and eggs, GMO mosquitoes including CRISPR, and in the case of Zika in Brazil, whole-cell pertussis vaccinations (DTap) for pregnant women up to 20 days prior to expected date of birth, a pyriproxyfen based pesticide applied by the State in Brazil on drinking water, as well as aerial sprays of the insect growth regulators Altosid and VectoBac (Aquabac, Teknar, and LarvX, along with 25 other Bti products registered for use in the U.S.) in New York (Brooklyn, Queens, Staten Island, and The Bronx) to combat Zika. “We feel it’s critical that the scientific community consider the potential hazards of all off-target mutations caused by CRISPR, including single nucleotide mutations and mutations in non-coding regions of the genome … Researchers who aren’t using whole genome sequencing to find off-target effects may be missing potentially important mutations. Even a single nucleotide change can have a huge impact.”

All of this is big, BIG business.

Is the introduction of Wolbachia another puzzle piece in the perfect storm of events causing or exacerbating human health issues?

The jury’s still out, but it’s not looking good – particularly for the chronically ill.

2600% Increase in Babesia in 12 Years in Wisconsin

CDC Reports 2600% Increase in Tick-Borne Babesiosis Infections in Wisconsin in 12 Years

It is not just a bad summer for ticks — it has been a bad decade for the spread of tick-borne infections. New surveillance from the CDC reports rapid expansion and increase in cases of babesiosis, a sometimes life-threatening disease, in Wisconsin.The CDC compiled the new report from surveillance conducted every three years during the period between 2001 through 2015. During that time, electronic surveillance came online to provide faster, more thorough, case reports. While a boost in case counts as monitoring methods improve is sometimes due to under-reporting, the CDC says the increase in Wisconsin is due to an actual uptick in cases — not just better reporting.

Total confirmed babesiosis case counts (N = 294) initially reported directly and electronically through the Wisconsin Electronic Disease Surveillance System (WEDSS),* Electronic Laboratory Report (ELR) — Wisconsin, 2001–2015.Image via MMWR

What Is Babesiosis and Why Should You Be Concerned?

The black-legged tick Ixodes scapularis transmits the Babesiosis bacteria. This is the same tick that spreads Lyme disease, anaplasmosis, and recently the more immediately deadly Powassan virus.

These ”black-legged ticks”, Ixodes scapularis, are capable of spreading babesiosis, Lyme disease, anaplasmosis, and Powassan disease, this small arthropod packs powerful poison.Image by Jim Gathany/CDC

Babesia microti, a relative of the parasite that causes malaria, causes the babesiosis infection. While some people have no symptoms when infected, in others, the illness can be fatal. Symptoms of babesiosis include fatigue and weakness, nausea, diarrhea, and often a high fever. More severe complications include kidney damage and heart failure.

Because babesiosis is spread by I. scapularis, the geographic range of the infection is expanding along with the tick. While ticks are the agent, or “vector,” that spreads the bacteria, rodents like white-footed mice are the reservoir culprits who carry the disease. Ticks are infected when they feed on mice, and in turn, ticks infect white-tailed deer, that then become the primary hosts for tickborne infections carried by black-legged ticks.

The blacklegged tick (Ixodes scapularis) is widely distributed in the northeastern and upper midwestern United States.Image via CDC

Here are some of the findings of the new babesiosis report:

  • The length of time between infection to symptoms can be about two weeks, with 96% of cases reported between April and October.
  • Between 2001 and 2015, there were 430 cases reported in Wisconsin. Of those, laboratory testing confirmed 68%. For the victims with confirmed cases, 158, or 65%, were hospitalized, and three people died as a result of the infection.
  • Of the 108 patients with probable babesiosis, 24% were hospitalized, and none died.
  • Wisconsin did not begin screening its blood supply for the babesiosis parasite until 2016. Before that, three cases of the infection spread through transfusion with contaminated blood.

The threat is rising. Between the years of 2001–2003 and 2004–2006, there was a 400% increase in the mean annual incidence of babesiosis cases. The rate rose incrementally after that until it jumped again between 2007–2009 and 2010–2012 with a 235% increase.

Overall, the incidence rose 2600% between 2001–2003 (o.03 mean annual incidence) and 2013–2015 (0.80 mean annual incidence).

Number and incidence of reported confirmed babesiosis cases by 3-year interval and percentage confirmed using polymerase chain reaction (PCR) — Wisconsin, 2001–2015. Mean annual incidence is the average number of cases per 100,000 residents in a single year.Image by MMWR, July 7, 2017/66(26);687–691

The number of counties reporting the incidence of babesiosis rose from 20 to 46 between 2011 and 2015.

Geographic distribution of confirmed cases of babesiosis per 100,000 residents by county of residence — Wisconsin, 2001–2005, 2006–2010, and 2011–2015.Image by MMWR, July 7, 2017/66(26);687–691

This report and physical observations of ticks on hunter-harvested deer, support the finding that the range of the black-legged tick has expanded rapidly, and will continue to do so with a warming climate and clearance of forest stands. As essential the ticks, so go the infections they transmit to humans.

Study authors write: “Babesiosis cases in Wisconsin are increasing in number and geographic range. These trends might be occurring in other states with endemic disease, similar suburbanization, and forest fragmentation patterns, and warming average temperatures.”

If you have reason to believe a tick could have bitten you, and experience symptoms, contact your doctor. Prompt treatment is important. The best defense to tick infection is offense — use repellent containing DEET, stay clear of tick territory, wear long sleeves, and pants — and most important, shower and check for ticks each time you return from time in the wild — or just your backyard.

With warming temperatures, ticks are getting worse — readiness is the best way for you, and family members, to avoid infection.


**For more on Babesia: