Babesia are intracellular parasites that can result in an infection akin to malaria and are carried by ticks, which then transfer the infection to people. Here are some insights into the diagnosis and natural treatment of this increasingly common infection.
Babesia are microscopic parasites which are types of protozoans and there are more than one hundred species of them. Most Babesia infections that are transmitted to humans are due to at about a dozen species: Babesia microti and Babesia duncani (Babesia WA-1) are the most common ones in the United States, Babesia divergens which more commonly causes disease in Europe, as well as occasional human cases from types of Babesia that are more common in animals such as B. bovis ( the parasite that causes Texas cattle fever) B. equi, and B. caucasia.2, 3. Some of the species types found to infect people have not yet been given their own name and others, like Babesia microti, are not just one species but a group of similar unidentical subtypes. 2
What is Babesiosis?
"Babesiosis" is the condition of being infected by the Babesia protozoa; it can have a wide range of presentation including hemolytic disease like malaria, where a host's red blood cells become infected and damaged by the protozoa. This is why symptoms include fatigue, anemia and shortness of breath. Babesiosis is known to range in severity from asymptomatic to life threatening and can be spread through tick bites, as well as blood transfusions.
Diagnosis of Babesiosis
Despite multiple types of laboratory direct and indirect detection, diagnosing Babesia remains difficult. The numerous species and multiple genotypes that can be found during infection, as well as the variety of different shapes the organisms take on, all make clear diagnosis challenging. Tests may not sensitive to the wide range of species and genotypes now known to exist. The Center for Disease Control and Prevention (CDC) even state: "[t]he extent of cross-reactivity between Babesia species is variable. A negative result with B. microti (considered an East Coast endemic infection) antigen for a patient exposed on the West Coast (and hence presubably infected by B. duncai) may be a false-negative reaction for Babesia infection".1 And not all laboratories will offer all testing options. For example, at this writing Quest Diagnostics offers only IgG antibody testing for B. duncani , which is an antibody reactive principally in historic infections, and does not permit testing of IgM antibodies, which are harbingers of current infections.
Blood Smear Analysis & Babesia FISH
The classic and primary approach to diagnosing a Babesia infection has been to microscopically examine the red blood cells (blood smear analysis) and literally look for the structure of the reproducing parasitic cells, using stained blood films. Many Babesia form what is called a Maltese cross, similar to a 'plus' sign, and spotting these confirms the diagnosis. But other forms will take other shapes when replicating inside cells, and may not be as obvious. "The observation of parasites within Giemsa- or Wright-stained blood films ... lacks the sensitivity required by some asymptomatic and chronic cases (and) ... it is generally impossible to distinguish Babesia species morphologically from each other".4
The Babesia Fluorescent In-Situ Hybridization (FISH) assay is designed for the detection of ribosomal RNA of Babesia parasites directly in a blood smear. The test’s high degree of specificity is provided by nucleic acid probes, which bind to RNA sequences of the Babesia. The FISH assay provides a significant increase in sensitivity and specificity over standard Giemsa-stained smears for the presence of intraerythrocytic parasites (piroplasts) in red blood cells (RBCs).5
Indirect Fluorescence Assay (IFA)
Given some of the limitations to blood smears, antibody testing is often performed. These tests should be helpful in detecting infected individuals with very low levels of parasitemia; however, in practice, this is often not the case. For example, when four laboratories had their testing analyzed collectively, the results showed a lackluster range from 69%-100% positive predictive value.6 And that was testing for only one kind of babesia; IFA, cannot detect multiple species in one test It can also take a few weeks for antibody production to get underway, so testing too soon after a bite may lead to a false negative, when relying on antibody testing!
Quantitative Polymerase Chain Reaction (qPCR)
Quantitative Polymerase Chain Reaction (qPCR), also called 'real-time PCR', is a direct way of trying to find Babesia and is considered much more sensitive than microscopy blood smears. This is a way to detect Babesia DNA in whole blood and often involves amplification of Babesia-specific DNA; when positive there is no question as to whether the infection is current or not. However, in practice it is often not successful at diagnosing the illness and is not covered by some health insurance companies.
Natural Treatments for Babesiosis
When it comes to treating chronic tick-borne illnesses, there is no one cookie-cutter prescription that works for every patient. Every person has their own constitutional weaknesses and infections will often 'lean into' these concerns, aggravating them. That being said, there are some remedy options which tend to work well against this parasitic protozoa for babesia treatment.
Cryptolepis sanguinolenta, a scrambling thin-stemmed shrub found in Africa, has traditionally been used in the treatment of malaria, diarrhea, and respiratory conditions.7 Malaria? That's right. No wonder then that it was one of the top performers in the 2021 publication from when test tube comparisions were made between dozens of herbal medicines commonly-used as therapeutic agents against Babesia duncani to see which herbs best inhibited the parasite.8
Scutellaria baicalensis, also known as 'baical skullcap' or 'Chinese skullcap' was another herb featured in the same study, and actually scored the highest inhibition activity against B. duncani growth, accomplishing an 84%.8 It is also antiviral, anti-inflammatory, neuroprotective, protective of the lungs and more.
A third consideration with widespread use against malaria and the Plasmodium falciparum organism which causes it, is shame-weed, or Mimosa pudica.9,10 It is this longstanding use against malaria which got attention for this plant to be used against Babesia infections. Mimosa pudica has also been used for treating leprosy and, interestingly, has been the subject of decades of research on "learning in plants" among comparative psychologists, plant biologists, and those studying habituation, sensitization, and classical conditioning.11
The Challenge of Babesiosis When It Is Not the Only Illness to Treat
Parasitic infections, such as Babesia, are frequently found in patients with persistent Lyme disease and MSIDS. This is especially true when dealing with chronic conditions, that have been able to entrench into a person's immune system. In such cases, these symptoms may not respond to classical antibiotic therapy for Lyme disease alone. Hence if a person is diagnosed with Lyme disease and treated accordingly but not tested and treated for other co-infections, such as babesiosis, and many of their symptoms do not go away, there may be more undesirables to identify and unearth. The cumulative impact of multiple infections on the immune system also makes successful treatment more challenging.
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References:
*image credits: Centers for Disease Control and Prevention (CDC). DPDx - Laboratory Identification of Parasites of Public Health Concern: Babesiosis. 2017. Accessed 07-30-22.
Chen, X., (2017). Detection of Kobe-type and Otsu-type Babesia microti in wild rodents in China's Yunnan province. Epidemiology and Infection,145(13), 2704-2710. doi:10.1017/S0950268817001686.
Ron M. Walls MD, in Rosen's Emergency Medicine: Concepts and Clinical Practice, 2018.
Ord, Rosalynn Louise, and Cheryl A Lobo. “Human Babesiosis: Pathogens, Prevalence, Diagnosis and Treatment.” Current clinical microbiology reports vol. 2,4 (2015): 173-181. doi:10.1007/s40588-015-0025-z.
Shah, Jyotsna S et al. “A Fluorescence in Situ Hybridization (FISH) Test for Diagnosing Babesiosis.” Diagnostics (Basel, Switzerland) vol. 10,6 377. 6 Jun. 2020, doi:10.3390/diagnostics10060377.
Krause, P J et al. “Diagnosis of babesiosis: evaluation of a serologic test for the detection of Babesia microti antibody.” The Journal of infectious diseases vol. 169,4 (1994): 923-6. doi:10.1093/infdis/169.4.923.
Osafo, Newman et al. “Phytochemical and Pharmacological Review of Cryptolepis sanguinolenta (Lindl.) Schlechter.” Advances in pharmacological sciences vol. 2017 (2017): 3026370. doi:10.1155/2017/3026370.
Zhang, Yumin et al. “Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani.” Frontiers in cellular and infection microbiology vol. 11 624745. 8 Mar. 2021, doi:10.3389/fcimb.2021.624745.
Abramson, Charles I, and Ana M Chicas-Mosier. “Learning in Plants: Lessons from Mimosa pudica.” Frontiers in psychology vol. 7 417. 31 Mar. 2016, doi:10.3389/fpsyg.2016.00417.
The content and any recommendations in this article are for informational purposes only. They are not intended to replace the advice of the reader's own licensed healthcare professional or physician and are not intended to be taken as direct diagnostic or treatment directives. Any treatments described in this article may have known and unknown side effects and/or health hazards. Each reader is solely responsible for his or her own healthcare choices and decisions. The author advises the reader to discuss these ideas with a licensed naturopathic physician.