Jaws (This time in the Woods)

The movie Jaws increased our awareness of summertime shark attacks. After Jaws we were introduced to a common summer predator that hunts us on land...Lyme disease. Allow me now to present to you the latest summer predator that those of us who venture outdoors should be aware of...Babesiosis.

Your physician may recall that babesiosis as a rare infection that causes "malaria-like" symptoms. Most American doctors have never diagnosed babesiosis, however that is about to change. In the northern, northeastern, central and pacific U.S this potentially fatal disease, carried by ticks, is increasingly being diagnosed. Your health and life may depend on your knowing how to avoid and recognize babesiosis. Here are the basic facts you need to know.

Like Lyme disease, babesiosis can be contracted during a summertime walk across a grass field, or through the woods. An infected person generally complains of any of the following: fatigue, fever, joint or muscle pain, headache, chills, loss of appetite, neck stiffness or shortness of breath. In the past these non-specific complaints were most likely tolerated or, if the sufferer visited a physician, diagnosed as a "viral syndrome". Occasionally an evaluation for Lyme disease would be ordered, but the search for a cause usually ended there. If the person improved then no one ever knew the diagnosis. If things got worse then a delay in diagnosis was common, sometimes with catastrophic results.

For reasons not clear to infectious disease experts, the parasite that causes babesiosis (B. microti) is increasingly found in ticks, and in the blood of people exposed to ticks. The disease is most prevalent in New York, Rhode Island and Massachusetts. Healthy people under the age of 50 generally recover from babesiosis without treatment, the diagnosis only made in retrospect by blood testing. For those over age 50, and for people with chronic illnesses, unrecognized babesiosis can lead to death.

Diagnosis
As with Lyme disease, more than half of people diagnosed with babesiosis have no recollection of a tick bite. A history of being in an endemic area weeks prior to illness, and any of the vague symptoms associated with the disease, should be enough to prompt an evaluation for babesiosis. The diagnosis is confirmed with blood tests, including finding the parasite during a microscopic examination of red blood cells.

Treatment
Only symptomatic people, or those with blood tests that remain positive for more than three months, require antibiotic therapy. Combinations of antibiotics are generally effective in curing babesiosis.

Prevention
Ticks transmit the parasite that causes babesiosis, and avoiding ticks is the only way to prevent the disease. There is no vaccine, and "preventative" antibiotics following tick exposure are too complicated and dangerous to be used. The best ways to avoid tick borne infection are to:

-Avoid tick habitats
-Tuck long pants into socks during potential exposure
-Apply DEET-containing insect repellent to skin during potential exposure
-Wear light colored clothing, perform tick exams following potential exposure, and remove ticks if discovered
-Remove any attached tick(s) with a tweezers by pulling straight up from the most forward portion of the tick

Conclusions
More people suffer annually from babesiosis than from shark bites. Fortunately, both conditions are relatively rare. Unfortunately babesiosis is becoming more common in several regions of the US (especially on Block Island, Martha's Vineyard, Nantucket and other northeast vacation spots). Because Lyme disease and babesiosis are both caused by ticks, the same precautions required to prevent Lyme disease apply to the prevention of babesiosis. Anyone who has been exposed to a known tick area, and who develops a generalized illness several weeks after exposure, should be seen by a physician. Infection with Lyme disease, babesiosis, and other diseases of summer can only be prevented, discovered and successfully treated with a healthy dose of awareness.
6/30/2011 8:51:17 AM
Stuart Hochron, MD
Practices Internal Medicine and Pulmonary Medicine in Woodbridge, New Jersey and Jersey City, New Jersey
View Full Profile Website: http://stuarthochronmd.com/

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