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Lyme Co-Infections: What Is Babesiosis?

Spring is finally here. As the temperature climbs and the days lengthen, leaves are unfurling and flowers are beginning to bloom. After a long and bleak winter, the northern half of the world is suddenly exploding with color.

Unfortunately, the arrival of spring means another kind of explosion is happening: the tick population is suddenly increasing as recently-laid eggs start to hatch. Particularly problematic for humans are black-legged ticks, also known as deer or Ixodes ticks, which can transmit Lyme disease and other infections with a single bite.

What is Lyme disease and how is it transmitted?

Lyme disease is a bacterial infection caused by the bacterium Borrelia burgdorferi. Certain types of rodents, birds, and deer act as vectors for Borrelia burgdorferi, meaning they are carriers of this and other disease-causing bacteria. When a black-legged tick bites and feeds off of one of these disease vectors, it becomes infected with Borrelia burgdorferi and can then transmit it to humans, causing Lyme infection.

What are the symptoms of Lyme disease?

Lyme disease is typically divided into two stages: early and late. Also known as acute Lyme disease, the early stage is characterized by these symptoms:

  • Erythema migrans, an expanding red rash that may resemble a bullseye or target
  • Headaches and neck stiffness
  • Joint pain and swelling
  • Fever
  • Fatigue
  • Weakness or paralysis of facial muscles
  • Lightheadedness or fainting
  • Heart palpitations or chest pain

Ideally, Lyme disease is diagnosed and treated during the acute phase. If the disease isn’t caught early enough (or if treatment is unsuccessful), Lyme disease can enter the chronic stage. Some symptoms of chronic Lyme disease are:

  • Fatigue
  • Muscle aches
  • Joint pain and stiffness
  • Headaches
  • Memory loss
  • Trouble concentrating
  • Muddled thinking, also known as “brain fog”
  • Neuropathy (including nerve pain, numbness, or tingling)
  • Sleep problems
  • Changes in mood
  • Digestive issues
Infectolab - lack of concentration
Patients with chronic Lyme disease may have trouble concentrating.

Because many practitioners aren’t well trained when it comes to spotting Lyme symptoms, and because these symptoms mimic those of common illnesses like influenza, Lyme disease can be extremely difficult to diagnose and treat. And this difficulty is often exacerbated by the presence of Lyme co-infections.

What are Lyme co-infections?

Black-legged ticks can carry a number of different disease-causing bacteria along with Borrelia burgdorferi, the bacterium that causes Lyme disease. This means that in a single tick bite, a person can be infected with Lyme and a host of other illnesses at the same time. These illnesses are called Lyme co-infections, and they are believed to affect over 50% of Lyme patients.

Since even Lyme-savvy physicians aren’t always aware of their existence, these co-infections often fly under the radar. Let’s take a closer look at one of the most common Lyme co-infections: babesiosis.

What is babesiosis?

Babesiosis is a malaria-like infection caused by Babesia, protozoans that act as parasites on red blood cells. Black-legged ticks are carriers of Babesia, which is why babesiosis is a co-infection that often occurs along with Lyme disease. Babesia can also be transmitted from mother to child or through an infected blood transfusion, since most blood banks don’t currently screen for Babesia.

Symptoms of babesiosis may resemble those of Lyme infection and include:

  • Fever
  • Anemia
  • Jaundice
  • Chills
  • Fatigue
  • Muscle aches
  • Drenching sweats
  • Shortness of breath

Babesiosis is known as “canine malaria” in dogs, but it’s rarely diagnosed in humans because of the inconspicuousness of its symptoms. In a healthy individual, babesiosis may be so mild as to go unnoticed. However, in a person with complications like a weakened immune symptom (which can happen as a result of chronic Lyme disease), babesiosis can become quite severe.

How do you test for babesiosis?

Although it may be detectable under a microscope within the first two weeks of infection, babesiosis can be most effectively diagnosed using a Babesia ELISpot. The ELISpot is a tried, tested, and reliable method that has been used for years to detect Lyme and its co-infections (like babesiosis).

The newest ELISpot incarnation, LymeSpot Revised, can deliver detailed information about infections, including whether they are active or latent. LymeSpot Revised makes it possible to determine whether patients’ problems are being caused by their infection, inflammation, or an autoimmune process.

How is babesiosis treated?

Babesiosis is typically treated using a combination of antibiotics and anti-malarial medication. For babesiosis patients with compromised immunity, atovaquone combined with higher doses of azithromycin (600–1000 mg per day) has successfully been used.

Infectolab - antibiotics
Babesiosis is typically treated with antibiotics and anti-malarial medication.

As with other Lyme co-infections, babesiosis needs to be diagnosed and treated separately from Lyme disease. It is only when practitioners specifically address each co-infection (while also treating Lyme disease) that a patient has the best chance of making a full recovery.

The arrival of spring and, consequently, disease-carrying ticks, means that physicians and patients alike need to be able to spot symptoms of Lyme disease and Lyme co-infections like babesiosis. When we know what to look for, we’re more likely to catch these illnesses before they become severe.