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Pokhara University
School of Health and Allied Sciences

Pokhara University
Babesiosis
“Red water fever”
Narayan Adhikari
Third Semester, B Pharm Roll no: 13
Pokhara University, Dhungepatan, Lekhnath, Kaski , Nepal

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Overview
 Introduction
 Epidemiology
 Life-cycle
 Symptoms
 Complications
 Diagnosis
 Prevention and Control
 Treatment
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INTRODUCTION
 Babesiosis is a rare infectious disease caused by
single-celled micro-organisms (protozoa) belonging
to the Babesia family.
 It is believed that the Babesia protozoa are usually
carried and transmitted by ticks (vectors).
 Babesiosis occurs primarily in animals; however, in
rare cases, Certain Babesia species are known to
cause babesiosis infection in humans (e.g., Babesia
microti), and the deer tick is a known vector.
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Contd…
 Babesia infection can range in severity from
asymptomatic to life threatening. The infection is
both treatable and preventable.
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EPIDEMIOLOGY
People get infected with Babesia parasites in
several ways:
• The main way is through the bite of an infected tick
—during outdoor activities in areas where babesia is
found.
• A less common way is by getting a transfusion from a
blood donor who has a Babesia infection but does
not have any symptoms. (No tests have been
licensed yet for screening blood donors for Babesia)
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• Rare cases of congenital transmission—from an
infected mother to her baby (during pregnancy or
delivery)—have been reported.
• NOTE :Babesia parasites are not transmitted from
person-to-person like the flu or the common cold.
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TICK
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Incubation period
 It is the period between exposure to an infection
and the appearance of first symptoms.
 It lies between 1-6 weeks
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LIFECYCLE
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 The life cycle begins when an infected tick
sporozoites enter into a mouse feeding on blood.
 Sporozoites in the RBCs reproduce asexually by
budding and differentiated into male and female
gametes which cannot be distinguished by light
microscopy.
 Male gametes are once again ingested by tick and
undergoes sporogony to produce sporozoites.
 Babesia sporozoites are introduced into the human
when the infected tick bites a human for blood meal.
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• Sporozoites then enter into erythrocytes where they
undergoes asexual reproduction by budding.
• Parasites multiply within the blood and diseases
begins to clinically manifest itself.
• Once the lifecycle completed within human is only
transmitted human-to-human by blood transfusions.
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SYMPTOMS
 Many people who are infected with Babesia
microti feel fine and do not have any symptoms.
Some people develop nonspecific flu-like symptoms,
such as fever, chills, sweats, headache, body aches,
loss appetite, nausea or fatigue, muscle aches
(myalgia).
 Because Babesia parasites infect and destroy red
blood cells, babesiosis can cause a special type of
anemia called hemolytic anemia. This type of anemia
can lead to jaundice (yellowing of the skin) and dark
urine.
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 Babesiosis can be a severe, life-threatening disease,
particularly in people who:
 do not have a spleen;
 have a weak immune system for other reasons (such
as cancer, lymphoma, or AIDS);
 have other serious health conditions (such as liver or
kidney disease); or
 are elderly.
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COMPLICATION
 a low and unstable blood pressure;
 severe hemolytic anemia (hemolysis);
 a very low platelet count (thrombocytopenia);
 disseminated intravascular coagulation (also known
as “DIC” or consumptive coagulopathy), which can
lead to blood clots and bleeding;
 malfunction of vital organs (such as the kidneys,
lungs, and liver); or
 death.
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DIAGONOSIS
In symptomatic
people, babesiosis
usually is diagnosed
by examining blood
specimens under a
microscope and
seeing
Babesia parasites
inside red blood
cells.
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FIGURE: Babesia parasites in red
blood cells on a stained blood
smear. (CDC Photo: DPDx)

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PREVENTION AND CONTROL
• No vaccine is available to protect people against
babesiosis. However, people who live, work, or travel
in tick-infested areas can take simple steps to help
protect themselves against tick bites and tick-borne
infection.
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 During outdoor activities in tick habitats, take
precautions to keep ticks off the skin.
 Walk on cleared trails and stay in the center of the
trail, to minimize contact with leaf litter, brush, and
overgrown grasses, where ticks are most likely to be
found.
 Minimize the amount of exposed skin.
 Apply repellents to skin and clothing.
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TREATMENT
Drug Adult dosage (usually treat for at least 7-10 days)
Atovaquone 750 mg orally twice a day
along with
Azithromycin On the first day, give a total dose in the range of 500-1000 mg orally;
on subsequent days, give a total daily dose in the range of 250-1000
mg
or
Clindamycin 600 mg orally 3 times a day
or
300-600 mg intravenously 4 times a day
along with
Quinine 650 mg orally 3 times a day
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References
• Walker BR and Ralston SH (2010) Davidson’s Principles and
Practice of Medicine (21st Ed.), Elsevier, Edinburg, pp 453-
455
• URL-1:
http://www.medicinenet.com/deep_babesiosis/article.html

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THANK YOU!!!
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