Babesia duncani

When I was first diagnosed and learning about Lyme Disease and all of it's co-infections four years ago, I had hardly any luck in doing an internet search for information on Babesia duncani, a less commonly seen strain of Babesia. I found a lot of articles full of technical medical jargon, but I was looking for something that the lay person could understand. Eventually, with the demands of long-term treatment, I gave up and haven't really thought much of Babesia duncani in the last four years.

Babesia is a protozoan infection of the red blood cells. It is a malaria-like infection, and in fact is so similar to malaria that it is hard to distinguish between the two under a microscope without proper training. The symptoms, appearance and actions under the microscope of Babesia duncani are very similar to those of Babesia Microti. Upon infection of a host, these little invaders cause lysis or rupture of the host's red blood cells. As the infection takes hold, the little parasites reproduce as quickly as possible and as red blood cell depletion increases, they actually begin to deprive their host of oxygen -- which causes extreme, debilitating fatigue among other possible symptoms.

The following list is from an article by Dr. James Schaller, Exciting News About Babesia:

Babesia Signs and Symptoms
"Babesiosis can cause many different signs and symptoms. Here are the most common that should raise suspicion:

	High fever to persistent low fever
	Slowed thinking
	Listlessness
	Decreased appetite
	Chills Sweats Headache Fatigue Muscle aches
	Joint aches/Pain Depression Anxiety/Panic
	Nausea Vomiting Cough
	Shortness of breath
	Air hunger or unsatisfying deep breaths
	Dark urine
	Enlarged liver (under your right rib cage)
	Enlarged spleen (under your left rib cage)
	Yellow hue on eyes, hands and skin (Jaundice)
	Enlarged lymph nodes (also in Lyme or Bartonella)
	Significant memory change
	Profound psychiatric illnesses
	Struggle organizing
	Daytime sleep urgency despite nighttime sleep
	Waves of generalized itching
	Balance problems with dizziness
	Severe chest wall pains
	Random stabbing pains
	Weight loss or gain Sensitivity to light
	Sleep in excess of 8-1/2 hours per day
	You have received blood from another person

Since Babesia lives within red blood cells, it can cause slugging of the red blood cells and make them slightly deformed. Injury and death can result from slugging blood vessels, lungs and kidneys."

With my recent relapse, I've found myself back in the mode of trying to learn everything I can about the many facets of this illness. Last week, as my husband and I were trying to research various physicians, clinics and treatment protocols, we dug out my file folder of test results from four years ago. My LLMD was extremely thorough in doing my labs, and I have copies of everything we did. As I was looking over them, I noticed for the first time, that there is a brief description given about each result, including information about the infection and how the test works.

Here is the information, word for word, provided by IGeneX Labs on my printed test results: "Babesia duncani, formerly WA-1, is a Babesia-like piroplasma associated with cases of Babesiosis in the Pacific Northwest. The first case of Babesiosis acquired by B duncani was in South-Central Washington State (Quick et al 1993, Ann Intern Med, 119:284).

When I read this, I about fell off my chair. I grew up in Portland, Oregon, where I learned from a young age to appreciate the beauty of the Pacific Northwest through fishing, hiking, camping, spelunking and backpacking. I absolutely loved being outdoors, we spent untold time in the woods, and I spent plenty of time out in nature in the State of Washington, too.

The reason that I was so floored by this information was because I was bitten by a tick in New England, during a late-summer 6-weeks-long trip. I had gotten a large, solid, red rash a few days after returning home, (I was told by the doctor that it looked like a spider bite or allergic reaction and he was not concerned about it,) and I can easily track all of my major symptoms and decline in physical health from that point. I had never considered that I could ever have contracted any sort of tick borne infection in the Pacific Northwest, I don't ever recall having a tick bite, and yet, there it was on my test results.

So that's when I began to really try to think of different things that had happened in my life prior to 2003. Strange rashes, possible tick exposure, really bad "flus" or other illnesses. To my surprise, as I specifically tried to recall these things, I remembered several times, when I was much less informed about TICK BORNE DISEASES (TBD,) where I had not only had tick exposure, but also strange rashes. Once, after backpacking in a beautiful place in South-Central Washington State called Siouxon Falls, near Amboy, Washington, we pulled three huge, ugly and fully engorged ticks off our dog, that had accompanied us on the excursion. A week or two later, (I'm not sure exactly how long it was since this happened in 1998) I got a strange, multi-lesion rash that was first diagnosed as chicken pox, then shingles...even though I had had the chicken pox as a little child and both doctors stated that it didn't really look like traditional CP or shingles. I also had similar rashes three times over a one year period while I was living in Coeur d'Alene, Idaho (just a stone's throw from the Washington State line) in 2002. Each time I would have a significant case of fever & chills, with the rashes appearing the following day.

In addition to Lyme Disease, there are MANY tick borne diseases that can cause significant problems all on their own. These include: Babesiosis, Erlichiosis, Anaplasmosis, Rocky Mountain Spotted Fever, Relapsing Fever, Tularemia, Bartonella, Q Fever, Tick Paralysis, Tick Borne Encephalitis and Colorado Tick Fever, among others. Each is transmitted by a tick bite, but many times, multiple infections are transmitted in one tick bite.

Together in any combination, these illnesses make the diagnosis and treatment of any single infection much more difficult. It is important to be extremely vigilant in photographing and reporting ANY rash or lesion to your doctor. I never took pictures of any of my rashes, and now I really wish I had. Make sure that you also record the date of the rash, any symptoms in the days leading up to or coinciding with the rash appearing, and any travel, outdoors excursions, yard work or known tick exposure (this is extremely important, and the doctor may not ask!) along with any other pertinent information.

Also check out: Babesia & Lyme Disease, a post from earlier this month.

Babesia and Lyme Disease

When I was first diagnosed with Lyme Disease, I also tested positive for six other co-infections commonly carried by the same ticks that spread Lyme. Co-infections are separate, potentially serious infections that can be parasitic, bacterial, viral, etc., and are often transmitted to you via the same bite that gave you Lyme Disease. Co-infections make Lyme even more complicated and difficult to treat, because many times they can be responsible for causing bigger problems in the body, or exacerbating the problems already caused by Lyme Disease. Additionally, because it's working so hard dealing with all these different infections, the immune system can become overwhelmed and unable to effectively protect the body from any of them. When I first started treatment, my doctor explained that sometimes it's necessary to identify and treat your co-infections before you can have success in treating Lyme Disease.

In my case, we were concerned specifically with my worst symptom, severe and debilitating fatigue. When I use the word fatigue, I'm not talking about being tired, although you do experience sleepiness as well, because of the insomnia and other problems caused by Lyme. But debilitating fatigue has little to do with being tired. When I use the words debilitating fatigue, I'm talking about not being able to function. It's a constant feeling of having lead weights attached to your arms and legs, making it extremely difficult to move. When it was discovered that I had two different strains of Babesia, my doctor knew that while Lyme Disease does in fact cause debilitating fatigue all on its own, the level of fatigue I was experiencing was probably made worse by the Babesia infection. So we worked to clear up the Babesia.

What is Babesia?

 Many people have never heard of Babesia, but it is a relatively common tick borne infection in the world of Lyme Disease. Babesiosis is a parasitic protozoan infection. Babesia Microti is the most common species, and most cases worldwide are reported in the United States. Simply put, Babesia is an infection of the red blood cells. Upon infection, these little invaders cause lysis or rupture of the host's red blood cells. Red blood cells are essential, because they are responsible for transporting oxygen & other nutrients throughout the body. As the infection takes hold, the little parasites reproduce as quickly as possible and as red blood cell depletion increases, they actually begin to deprive their host of oxygen -- which causes extreme, debilitating fatigue.

Transmission of Babesia

While most cases of Babesia are caused by infected tick bites, there are documented cases of transmission via blood transfusion. I was surprised to read that it is actually THE most common disease transmitted via blood transfusion. By the way, this is a HUGE problem because so many infected people out there have no idea they have it...and may continue to do their civic duty by donating blood. So far, blood banks are not screening for it, although there are some experimental screening tests being used. Blood banks also don't screen for Lyme Disease.

In my opinion, it goes without saying: if you have been diagnosed with Lyme Disease and/or any of it's co-infections, you have a moral and ethical obligation NOT to donate blood, plasma or organs. Additionally, I was also told by my doctor that I should remove the "DONOR" designation from my driver's license. If you have Chronic Lyme Disease, where the spirochetes have had the opportunity to make themselves comfortable in all areas of your body - including all your organs - you could pass it on to the recipient of any donation.

Lifecycle of Babesia

Symptoms of Babesia

The symptoms of Babesia seem to be as generalized and vague as those of Lyme Disease. They are listed as flu-like symptoms, including fatigue, fever, malaise, chills & sweating. Most LLMD's describe Babesia as being a "Malaria-like" infection, and in fact, the two look so alike under the microscope that it is said to take a well-trained eye to recognize the differences and diagnose correctly. At my first visit with my LLMD, she informed me that the strange fevers in the evening and night sweats I reported were probably a result of Babesia...that was a revelation to me, since I had been to several doctors about those specific symptoms and each had looked at me like I was crazy. In the early stages of my illness, over the first year or two, I would frequently have low-grade fevers that would come on in the evening and last only a couple of hours. It generally happened 3 or 4 times a week. I also had frequent night sweats, where I would wake to my bedding & clothing being drenched. When my Lyme doctor was not only NOT surprised to hear of these strange symptoms, but also very familiar with them, I almost started to cry right there in her office. I was so relieved to finally have an explanation for so many of the strange and life-altering symptoms I'd been experiencing. The destruction of red blood cells by the Babesia is also a very easy explanation as to why, whenever I've had blood work done over the past 10 years, I'm always told I'm severely anemic. Not surprisingly, none of the doctors that rattled back to me all my "normal" blood tests ever thought there was a need to look into what might be causing the severe anemia.

Red Spots of Babesia

Another strange but seemingly common symptom or side effect reported by those diagnosed with Babesia are tiny red spots or dots called petechiae. They seem to show up mainly on the trunk and thighs. Many report first seeing them while on treatment, and some believe that it is actually a herx reaction to treatment. There doesn't seem to be much information into how or why these little dots appear, but they do seem to be very common among those undergoing treatment for Chronic Lyme Disease and Babesia. This certainly has been my experience. It's important to note, that lots of people have a few of these little spots here and there, and that doesn't mean you've got Babesia. I had a few before all of this started. But in my experience, at least, these spots showed up in droves all over my chest, belly and back while I was on treatment for Lyme & Babesia. Examples are pictured below.

Babesia is a complex illness in and of itself, and as a co-infection, only adds difficulty to the puzzle that makes up Chronic Lyme Disease. Current treatment recommendations include oral and IV clindamycin and oral quinine. My doctor prescribed a combination of medications for the duration of my treatment, and I found much relief from my Babesia symptoms while I was on Mepron, (Atovaquone) an anti-malarial drug. It was magical for me, however it was extremely expensive, so we also tried Alinia as a less-expensive alternative, and I had pretty good results with that as well. You can read more about my experience here. If you have not been tested for co-infections, but have experienced some or all of the symptoms listed above, it's worth a discussion with your LLMD. If you're going to an LLMD, chances are they've already discussed it with you!

For additional information on Babesia, visit http://aldf.com/Babesiosis.shtml

A Not-So-Quick Update

I know this blog is probably not very interesting to most of you, but I think it's really important for me to write about all the different things I'm experiencing throughout this process, since it's so easy to forget what's been happening from one week to the next. Even just reading back over the last few posts, it's interesting to be able to recognize progress.

This week I've realized that this stuff has really affected my ability to carry on conversations...yes, I know...I'm really good at talking. If we're talking on the phone you may think I'm off my rocker in saying that, since I can still talk. :) It's not so much the talking, but the content that's a problem right now. I've always been a great conversationalist, but it's a lot harder for me right now to talk about things much beyond the days events or what might be happening tomorrow. It's hard for me to put together my thoughts and really articulate what I'm thinking. Most of you have probably noticed at one point or another that I also have difficulty finishing sentences. These are all symptoms of Lyme, and the doctor told me that the treatments would affect "higher brain function" even more for awhile, but I was hoping that I wouldn't necessarily have to deal with that.

I have also noticed that I have a hard time with word retrieval, and I get confused with what day it is, or if I had a conversation with someone earlier this morning, or last Wednesday. It's all a little disconcerting, but easier to handle since I know why it's happening, and that it's temporary. All of this is happening because the infection is in my brain, (which is why I've had balance issues for the last couple years) and as the antibiotics and my immune system kill the bugs, the whole process causes inflammation. The inflammation causes some messages to misfire, so once in awhile, information is not available when you need it.

When I was in Seattle this last time, I tried to use my ATM card, (it's for a checking account I've had for over 10 years, and I've never had a problem remembering my PIN) and for the life of me, I could not remember my PIN. I tried four different times to put it in, and couldn't get it right. The information was just not there. There was a long line of people behind me, and I was embarrassed by that and flustered about the whole situation. Luckily, I always bring an emergency credit card with me when I travel, so I just used that. That incident was really upsetting to me, but those kinds of moments are getting easier to deal with because I just tell myself that it's necessary to getting better.

In happier news, I think the Mepron and the Cortef are really helping me. I started on my second bottle of Mepron yesterday, and I have noticed substantial improvement in my energy over the last week. I have still been tired, and I still need to rest frequently, but I've been able to get so much more done compared to the last several months. So, I've taken the Mepron for about 22 or 23 days now. The doctor thought that the 2 strains of Babesia (a co-infection to Lyme that's similar to Malaria) that I have are probably contributing to the extreme fatigue that I've had, and that treating that infection and getting it out of the way would help. I think she was right, and I'm really excited about the improvement.

The rest of my antibiotics and supplements are going well, and I seem to be on the right track. I feel really blessed, because compared with others I have heard from and read about that are in my same situation, I think I'm tolerating everything really well, and that I'm actually pretty healthy given the circumstances. I had a fairly busy afternoon and evening yesterday, and I was expecting that I would probably be in bed all day today recovering. I woke up this morning feeling really good, so I'm going to try to get a few things done around the house. I have to take it easy though, so I have enough energy to get to church tomorrow. Sometimes when I feel good I have a tendency to overdo it.

A friend of mine came to visit last week and told me about another friend she has that was diagnosed with Lyme disease awhile ago. She describes it as knowing that you have a jar with a set number of marbles in it each day. The marbles represent your energy. If you want to use the marbles doing dishes and vacuuming the house, that's fine. If you want to save them so you can BBQ with friends, that's fine, too, but you probably aren't going to have enough to do both. The point is, everyday, you have to decide what you want to use your marbles for, since there is a limited supply. I thought that was a really great analogy. I am learning to pace myself for now, and eventually, when I get feeling better, I will have so much more appreciation for the gift of health and strength. You hear that phrase a lot, and it seems kind of trite most of the time when we use it. It has entirely new meaning to me because of all of this!

Oh, one more thing. I was watching Mystery Diagnosis this week on TLC. There was a guy on there that was having all these bizarre symptoms, and I was like...it sounds like he has Lyme. Well, I kept watching, and he totally did have it! It was pretty interesting. At the end they had a physician on talking about it a little bit, then they did a follow up with him. After antibiotic therapy for a year and a half, he was back to normal. Three years after his ordeal started, he said he was back to 100%. It was really encouraging to see that! I got my treadmill set up this week, and my goal for this next week is to walk everyday -- even if it's only 3 to 5 minutes. I think it will make me feel better knowing that I'm doing something. All-in-all, this has been a great week for me, and I'm very optimistic about the future.