More ticks carrying babesiosis parasite, raising risk of serious illness

Before last month, 73-year-old Albert Patalano had never heard of babesiosis.

Now, he’s eager to let others know about this dangerous tick-borne illness — not as common as Lyme disease, but potentially far more serious.

“People should be aware,” the Waterford resident said Friday, now well on his way to full recovery after a near-fatal bout with the infection that began in mid-July.

Randall Nelson, chief epidemiologist for the state Department of Public Health, noted that while the number of babesiosis cases statewide has fluctuated from year to year, the decadelong trend shows an increase.

In 2013, there were 248 cases reported, and 170 last year.

The majority of cases, he noted, are in New London County, although there have been growing numbers in other parts of the state, as well.

The number of cases thus far in 2015 is not yet available.

“We have seen a geographic spread, as well as an increase in overall transmission,” Nelson said Friday.

Kirby Stafford, chief entomologist with the Connecticut Agricultural Experiment Station, said it appears that a greater percentage of black-legged ticks, the same type that carry Lyme disease bacterium, are carrying babesia microti, the microscopic parasite that causes babesiosis.

The experiment station’s most recent results show about 13 percent of ticks tested carry babesia, said Goudarz Molaei, research scientist there.

Results from an earlier batch of tests this year showed 3.6 percent of ticks statewide, and about 6 percent in New London County, carried the parasite.

Before this year, the experiment station’s tick testing program only tested for Lyme bacterium, so “we have no baseline,” Stafford noted.

It was expanded this year to include Anaplasma phagocytophilum, the bacterium that causes anaplasmosis — also called ehrlichia — and babesia.

Of the three infections, babesiosis (pronounced bab-EE-zee-o-sis) is potentially the most serious.

“Lyme is not a fatal disease, but babesiosis can kill you,” Stafford said Thursday.

On July 12, Patalano was feeling feverish and went to his regular primary care doctor. Though he had no visible marks from a tick bite, the doctor tested him for Lyme disease.

Before he heard back about the results, however, his symptoms worsened, so his wife, Janet, took him to the emergency department at Lawrence + Memorial Hospital in New London.

There, doctors had his blood checked for both for Lyme and babesiosis. It turns out he was infected with both the Lyme disease bacterium and the protozoa that causes babesiosis.

“I don’t know how I got the tick bite,” Patalano said. “I had no marks. But the next thing I know, they were helicoptering me to Yale-New Haven Hospital.”

Patalano said he lost consciousness for three days, and when he woke up at Yale he found he had been intubated and put on a ventilator.

“My kidneys had started to fail,” he recalled.

After two weeks at Yale, where his treatment included intravenous antibiotics, he was discharged to a rehabilitation facility, where he spent the next week and a half before returning home.

“I had to learn how to walk again,” he said, “I’m walking well now.”

Dr. Deirdre Cronin, emergency department physician at L+M, said she and other doctors there are routinely testing for babesiosis as well as Lyme disease whenever they suspect a patient has a tick-borne illness.

“There’s definitely been an increase (in babesiosis cases) over the last five years,” she said. “It can be quite severe, especially in people who are immune-compromised or don’t have a spleen.”

Symptoms can range from mild-to-moderate fatigue, fever and overall not feeling well, to people “saying they feel awful, like they’ve been hit by a truck,” she said.

The parasite infects red blood cells, sometimes causing severe anemia.

“It can cause a lot of destruction in a hurry,” said Nelson, the state epidemiologist.

Most people, Cronin said, don’t have to be hospitalized, recovering after a few weeks on antibiotics and other medications, usually some combination of quinine, clindamycin, atovaquone and azithromycin.

Cronin noted that doxycycline, the antibiotic usually prescribed for Lyme and ehrlichia, does not combat the babesiosis bug.

“This is an intracellular parasite, like the one that causes malaria,” she said. “It’s New England’s version of malaria.”

She advised patients being tested for Lyme disease to ask their doctors to also test them for babesiosis.

“Bringing it up to their physician is a good idea,” she said. “It is diagnosed by a simple blood test.”

Dr. Paqui Motyl, medical director of urgent care for The William W. Backus Hospital, said she and other doctors are testing for babesiosis more often.

“Especially when I see a patient coming in with cyclical drenching sweats,” she said, noting that that is also a telltale symptom of malaria.

She also orders tests for babesiosis whenever a patient has anemia.

She noted that the infection is most dangerous for people over 50, those without spleens or who have had cancer treatments or are taking other medications that suppress their immune systems.

“It’s a good thing to be screened for it,” she said.

Stafford said the main reservoir of the parasite is white-footed mice. A tick bites an infected mouse, then bites a human and transmits it to the person.

Nelson said the growing risk of getting babesiosis is another reason people should take precautions such as using insect repellent and wearing protective clothing when outdoors.

“The bottom line from a public health perspective is that we have to prevent tick bites the best we can,” he said.

j.benson@theday.com

Twitter: @BensonJudy

Babesiosis cases in Connecticut:

2014:

Total statewide: 170

New London County: 61

2013:

Total statewide: 248

New London County: 62

2012:

Total statewide: 107

New London County: 45

2011:

Total statewide: 52

New London County: 10

2010:

Total statewide: 82

New London County: 34

2009:

Total statewide: 85

New London County: 43

2008:

Total statewide: 127

New London County: 57

2007:

Total statewide: 156

New London County: 64

2006:

Total statewide: 102

New London County: 52

Source: state Department of Public Health

Information on preventing tick bites can be found on the state Department of Public Health's website.

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