Babesiosis: A tick-ing time bomb

The following is taken from the Department of Health for the state of Rhode Island.

Babesiosis

Babesiosis is a potentially severe, and sometimes fatal tick-borne disease caused by an infection with a red blood cell parasite. A more severe and prolonged illness is more likely to be found in persons older than 60, those who have had their spleen removed, and those who are immunocompromised (e.g. persons with HIV infection or AIDS).

At-Risk Populations

Babesiosis is sometimes fatal, especially in the elderly, those with compromised immune systems, and those who have had their spleens removed.

Symptoms

Most people in the US who become infected with Babesiosis will experience no symptoms, but others could have fatigue, fever, malaise, jaundice, and anemia. Symptoms can last from several days to several months, and usually appear 1-4 weeks after infection. In asymptomatic individuals, the disease typically goes away on its own.

What was once believed to be only found in coastal communities within New England and the southern parts of the Northeastern states, has now been confirmed to be as far north both in geographic and altitude as the High Peaks areas of the Northern Adirondacks. The Adirondack Almanac published articles about Babesiosis on April 30, 2017 and May 1, 2019 .

From what I read, the treatment for Babesiosis is similar to Malaria, with also similar symptoms. In addition to the conventional way of being infected by a tick bite, Babesiosis can also be transmitted from one human to another via a blood transfusion. This is where I entered this story.  

Back in June I read the above articles in the Adirondack Almanack.  Being an avid outdoorsman, I know for myself how important it is to protect against ticks. I'm always extremely careful in my preparations to any outdoors on-trail or off-trail activities.  And upon my return I remove all clothes, inspect (as they like to go North), and shower.  But now reading about Babesiosis and the facts that the parasite feeds on red blood cells, can be transmitted via blood transfusions, and can be fatal to those who have had a splenectomy. Yikes!!! Strike three for me!

I brought this info to my hematologist to confirm our local blood bank is checking my blood supply for Babesiosis.  Her first reply was they must be.  How can they not, especially on Thalassemia patients.  My doctor followed up with the blood bank who confirmed they do not - and will not.  Their response was there aren't enough documented cases in this area, and they simply can't test for everything. 

So, no matter how cautious I was being with myself preventing tick bites, I had to really hope the kind and wonderful person donating their blood for me had been just as cautious. Because it would be a good chance they would not be aware of their own parasite infestation prior to donating blood. 

Fast forward to Sunday October 20, 2019.  I awoke with a fever of 101. Not terrible.  I've had fevers throughout my life, so after 53 years, 101 was like snow flurries in October - makes things a little uncomfortable, but short lived. Especially since I had no flu like symptoms.  No chills, aches, cough. My wife Liz knew there was something different about this.  My fever climbed through the day, and she knew due to the splenectomy, after a few hours of a high fever we should seek out a doctor.  She finally talked (scared) me into it.  

I was immediately admitted and started on a variety of IV antibiotics, and within the next three days some of the best doctors in our area would be assembled.  I had my Hematologist Dr. DeTraglia, an infectious disease doctor, endocrinologist, and Dr. Arul Kannan.  

My fever steadily climbed over two days, reaching 104.9 despite cooling technology and Tylenol.  Tuesday afternoon I was moved to the ICU due to an extremely high heart rate, heartbeat abnormalities and plummeting blood pressure - the next two days I was barely responsive.
The doctors had no idea what was causing my illness, and administered a variety of IV antibiotics trying to cover as many bases as possible. Fortunately, they started me on treatments for Babesiosis before knowing that was the problem.

Moving forward, we need to be alert to a recurrence of the parasite.
I will need to follow up with several doctors, including a cardiologist to see if my heart will return to normal.
This time, I survived. 

My goal in writing this is to have the CDC and/ or New York legislation get involved immediately.  All blood donations from donors in endemic areas need to be checked for Babesiosis.  I intend on sending this to our local politicians.  I'm sure seeing many responses will show the importance of this.  I can go thorough this again next month with possible a very different outcome.  So could anyone else receiving blood.  Cancer patients of all ages, accident victims, and anyone finding themselves or a loved one in need of a blood transfusion should be assured of the blood safety.  This one simple test will help accomplish that. 

Please spread the word.  Maybe you know people who can influence blood bank rules. 

Additional information attained 10/28/2019; 
Sandy Gilbert Hi Sam - I'm so sorry that you had to go through this... The FDA put out some recommendations for blood banks earlier this year on how to reduce the risk of transfusion-transmitted babesiosis. The recommendations are non-binding, but they do recommend that: "3. You must test each donation for evidence of Babesia using a licensed NAT3 when collected in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Wisconsin and Washington, D.C. (21 CFR 610.40(a)(3) and 610.40(b)). Testing must be performed year-round and in accordance with the instructions for use of the device (21CFR 610.40 (a)(3) and 606.65(e))." (see page 7 of document in link below): https://www.fda.gov/media/114847/download