There may be a “babe” in the word babesiosis. But this tickborne disease is not that innocent. In fact, a new Morbidity and Mortality Weekly Report (MMWR) from the Centers from Disease Control and Prevention (CDC) released on March 17 has warned about a bunch of increases in the number of reported babesiosis cases. From 2011 to 2019, eight states in the Northeastern U.S.—namely, Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont—saw significant “upticks.”
What happened in 2011 besides Kim Kardashian’s 72 day-marriage? That was the year that the CDC established babesiosis as a nationally notifiable condition. This meant that state health departments had to begin reporting any such cases to the CDC. From that year through 2019, the CDC received a total of 16,456 reported babesiosis cases from 37 different states. Vermont had the largest increase during this span, going from two cases in 2011 to 34 cases in 2019 for a 1,602% increase. Maine came in second, going from nine to 138 for a 1,422% increase. New Hampshire was third, with a 13 to 78 or 372% increase, followed by Connecticut (74 to 328, which amounted to a 338% increase). As a result, the number of states where babesiosis is considered by the CDC to be endemic has gone from seven—Connecticut, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, and Wisconsin—to 10, with Maine, New Hampshire, and Vermont being the three newcomers.
Before you begin muttering “babesiosis gonna get me, babesiosis gonna get me,” and hoarding toilet paper, keep in mind that babesiosis remains a relatively rare disease. From 2011 through 2019, New York state had the largest number of reported cases, a total of 4,738, which averaged out to 526.4 reported cases per year. Second place was Massachusetts with 4,136 reported cases for 459.6 a year, followed by Connecticut with 2,200 at 244.4 per year. This means that the number of cases per 100,000 people in the population ranged from 0.32 for Vermont in 2011 to 18.0 for Rhode Island in 2015. Those aren’t exactly Covid-19 levels.
Nevertheless, such increases in babesiosis should still leave you ticked-off, so to speak, at least to some degree. The exploding tick population—meaning the greatly increasing tick population and not ticks exploding like eggs or hot dogs in a microwave—had lead to increases in all sorts of tickborne illnesses. Babesiosis is yet another reason to take precautions when you are in an area that may have ticks. That means covering up your legs no matter how sexy they may be and staying away in general from underbrush and long grass no matter how sexy you may feel. It’s a good idea to apply tick repellent as well.
Now, babesiosis is not pronounced “babe-see-osis” or “babe see oasis.” Instead, it’s pronunciation is more like “buh-bee-zee-oh-sis.” This disease results when Babesia parasites—most commonly the Babesia microti kind—get into your bloodstream and end up in your red blood cells.
How can this parasite get into you bloodstream? Well, most often the culprit is the blacklegged tick, otherwise known as the deer tick or Ixodes scapularis. And, oh “deer,” does this tick suck. When this tick is carrying Babesia and it bites you, the result can really bite. The parasite can get into your blood where it can then cause a range of possible illnesses. In some cases, you may end up having no symptoms. In other cases, you may have a fever, muscle aches, joint pain, and headache. But that’s not all that can happen. More severe problems may emerge, such as low platelet counts, kidney failure, and acute respiratory distress syndrome. Oh, and that whole death may occur. You are more likely to suffer more severe problems if your immune system is weak or you don’t have a spleen. This is yet another reason why if anyone asks to borrow your spleen, you should say no.
Ticks ain’t the only way you can get this nasty parasite. Others ways include being transfused with contaminated blood, receiving an organ transplant from someone infected with the parasite, or being passed the virus through the placenta when you are in a womb. Naturally, this last method should only happen to fetuses since it would be very odd for an adult to be in a womb.
Getting Babesia through a blood transfusion can be particularly problematic as you may be more likely to develop more severe disease than if you were to get the parasite through a tick bite. That’s why the U.S. Food and Drug Administration (FDA) in 2019 began recommending that donated blood be screened for Babesia in the following 14 states and one jurisdiction where Babesia risk is high enough to be a potential problem: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin, and the District of Columbia.
Fortunately, there are effective antibiotic treatments for babesiosis. Typically, you shouldn’t take antibiotics when you don’t have symptoms. However, if you either have severe symptoms or are at risk for severe or relapsing infection, you can take atovaquone along with azithromycin or clindamycin along with quinine for at least seven to 10 days. Of course, don’t start such antibiotics before being actually diagnosed with babesiosis. Never assume that you have babesiosis until a doctor examines a sample of your blood under a microscope and finds Babesia parasites inside your red blood cells.
As alluded to earlier, these upticks in babesiosis have been part of a more general troubling trend that’s really bugging the U.S. The number of reported tickborne disease cases in this country has surged by 25% from 40,795 in 2011 to 50,856 in 2019. This upward trend really, really bites and is likely to continue until more is done to control ticks and tickborne disease. After all, climate change—you know that thing that some political leaders continue to claim doesn’t exist—has been manifesting in warmer and warmer temperatures that, in turn, have favored the spread of ticks. Meanwhile, the lack of public health funding has made it difficult for health departments to do anything about this. All of this has resulted in the “ticking” time bomb that we have today.