babesiosis

Half of all children and a quarter of previously healthy adults with Babesia infection are asymptomatic. When people do develop symptoms, the most common are fever and hemolytic anemia, symptoms that are similar to those of malaria. People with symptoms usually become ill 1 to 4 weeks after the bite, or 1 to 9 weeks after transfusion of contaminated blood products. A person infected with babesiosis gradually develops malaise and fatigue, followed by a fever. Hemolytic anemia, in which red blood cells are destroyed and removed from the blood, also develops. Chills, sweats, and thrombocytopenia are also common symptoms. Symptoms may last from several days to several months.{{cite journal |vauthors=Marcos LA, Wormser GP |title=Relapsing Babesiosis With Molecular Evidence of Resistance to Certain Antimicrobials Commonly Used to Treat Babesia microti Infections |journal=Open Forum Infect Dis |volume=10 |issue=8 |pages=ofad391 |date=August 2023 |pmid=37539067 |pmc=10394720 |doi=10.1093/ofid/ofad391 }}

Less common symptoms and physical exam findings of mild-to-moderate babesiosis:

{{columns-list|colwidth=30em|

• Headache
• Muscle pain
• Anorexia
• Nonproductive cough (mucus is not coughed up)
• Arthralgias (noninflammatory joint pain, unlike arthritis, which is inflammatory)
• Nausea
• Vomiting
• Sore throat
• Abdominal pain
• Pink eye/Conjunctivitis
• Photophobia (abnormal intolerance to visual perception of light)
• Weight loss
• Emotional lability
• Depression
• Hyperesthesia (more sensitive to stimuli)
• Enlarged spleen
• Pharyngeal erythema
• Enlarged liver
• Jaundice (yellowing of the skin and of the sclera)
• Retinopathy with splinter hemorrhages
• Retinal infarcts
• Neutropenia{{cite journal|vauthors=Wormser GP, etal|title=Neutropenia in congenital and adult babesiosis|journal=Am J Clin Pathol|year=2015|volume=144|issue=1|pages=94–96|url=http://www.medscape.com/viewarticle/847995?nlid=86904_804&src=wnl_edit_medp_infd&uac=21973EZ&spon=3&impID=796573&faf=1|doi=10.1309/AJCP2PHH4HBVHZFS|pmid=26071466|doi-access=free|access-date=2015-08-19|archive-date=2019-12-18|archive-url=https://web.archive.org/web/20191218223616/http://www.medscape.com/viewarticle/847995?nlid=86904_804&src=wnl_edit_medp_infd&uac=21973EZ&spon=3&impID=796573&faf=1|url-status=live}}

}}

In more severe cases, symptoms similar to malaria occur, with fevers up to 40.5 °C (105 °F), shaking chills, and severe anemia (hemolytic anemia). Organ failure may follow, including adult respiratory distress syndrome. Sepsis in people who have had a splenectomy can occur rapidly, consistent with overwhelming post-splenectomy infection. Severe cases are also more likely to occur in the very young, very old, and persons with immunodeficiency, such as HIV/AIDS patients.{{cite journal |vauthors=Lobo CA, Singh M, Rodriguez M |title=Human babesiosis: recent advances and future challenges |journal=Curr Opin Hematol |volume=27 |issue=6 |pages=399–405 |date=November 2020 |pmid=32889826 |pmc=11042670 |doi=10.1097/MOH.0000000000000606 }}

A reported increase in human babesiosis diagnoses in the 2000s is thought to be caused by more widespread testing and higher numbers of people with immunodeficiencies coming in contact with ticks, the disease vector. Little is known about the occurrence of Babesia species in malaria-endemic areas, where Babesia can easily be misdiagnosed as Plasmodium. Human patients with repeat babesiosis infection may exhibit premunity.{{cite book|last1=Shaw|first1=Susan E.|last2=Day|first2=Michael J.|title=Arthropod-borne Infectious Diseases of the Dog and Cat|url=https://books.google.com/books?id=OwE4yoj3LukC&pg=PA71|date=11 April 2005|publisher=Manson Publishing|isbn=978-1-84076-578-6|page=71|access-date=14 October 2016|archive-date=26 June 2014|archive-url=https://web.archive.org/web/20140626180318/http://books.google.com/books?id=OwE4yoj3LukC&pg=PA71|url-status=live}}

Babesia species are in the phylum Apicomplexa, which also has the protozoan parasites that cause malaria, toxoplasmosis, and cryptosporidiosis. Four clades of Babesia species infect humans. The main species in each clade are:{{cn|date=August 2022}}

1. B. microti (< 3 μm)
2. B. duncani
3. B. divergens (cattle parasite seen mostly in Europe) and B. venatorum (roe deer parasite, formerly called EU1), most closely related to the large Babesia clade
4. Large Babesia (> 3 μm) mostly infects ungulates, but also includes K01 strain (an isolated case observed in South Korea, see isolated cases)

Image:Babesia life cycle human en.svg

Babesia parasites reproduce in red blood cells, where they can be seen as cross-shaped inclusions (four merozoites asexually budding, but attached forming a structure looking like a "Maltese cross"){{cite journal |vauthors=Noskoviak K, Broome E | title = Images in clinical medicine. Babesiosis | journal = N Engl J Med | volume = 358 | issue = 17 | pages = e19 | year = 2008 | pmid = 18434647 | doi =10.1056/NEJMicm070903 }} and cause hemolytic anemia, quite similar to malaria.

Unlike the Plasmodium parasites that cause malaria, Babesia species rarely exhibit an exoerythrocytic phase with trophozoite forms.{{cite journal |vauthors=Setty S, Khalil Z, Schori P, Azar M, Ferrieri P |title=Babesiosis. Two atypical cases from Minnesota and a review |journal=Am J Clin Pathol |volume=120 |issue=4 |pages=554–9 |date=October 2003 |pmid=14560566 |doi=10.1309/N3DP-9MFP-NUJD-4XJY }}

In nonhuman animals, Babesia canis rossi, Babesia bigemina, and Babesia bovis cause particularly severe forms of the disease, including severe haemolytic anaemia, with positive erythrocyte-in-saline-agglutination test indicating an immune-mediated component to the haemolysis. Common sequelae include haemoglobinuria "red-water", disseminated intravascular coagulation, and "cerebral babesiosis" caused by sludging of erythrocytes in cerebral capillaries.{{citation needed|date=June 2016}}

In bovine species, the organism causes hemolytic anemia, so an infected animal shows pale mucous membranes initially. As the levels of bilirubin (a byproduct of red blood cell lysis) continue to increase, the visible mucous membranes become yellow (icterus) due to the failure of the liver to metabolize the excess bilirubin. Hemoglobinuria is seen due to the excretion of red-blood-cell lysis byproducts via the kidneys. A fever of 40.5 °C (105 °F) develops due to the release of inflammatory byproducts.{{citation needed|date=June 2016}}

Only specialized laboratories can adequately diagnose Babesia infection in humans, so Babesia infections are considered highly under-reported. It develops in patients who live in or travel to an endemic area or receive a contaminated blood transfusion within the preceding 9 weeks, so this aspect of the medical history is vital. Babesiosis may be suspected when a person with such an exposure history develops persistent fevers and hemolytic anemia. The definitive diagnostic test is the identification of parasites on a Giemsa-stained thin-film blood smear.{{cite journal |vauthors=Wormser GP, Dattwyler RJ, Shapiro ED |title=The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America |journal=Clin. Infect. Dis. |volume=43 |issue=9 |pages=1089–134 |date=November 2006 |pmid=17029130 |doi=10.1086/508667 |url=http://www.empirestatelymediseaseassociation.org/Scientific%20Articles/IDSA%20RESTRICTIVE%20GUIDELINES%202006.pdf |display-authors=etal |doi-access=free |access-date=2019-09-20 |archive-date=2020-07-26 |archive-url=https://web.archive.org/web/20200726120418/http://www.empirestatelymediseaseassociation.org/Scientific%20Articles/IDSA%20RESTRICTIVE%20GUIDELINES%202006.pdf |url-status=live }}

So-called "Maltese cross formations" on the blood film are diagnostic (pathognomonic) of babesiosis since they are not seen in malaria, the primary differential diagnosis. Careful examination of multiple smears may be necessary, since Babesia may infect less than 1% of circulating red blood cells, thus be easily overlooked.{{cite journal |author=Krause PJ |title=Babesiosis diagnosis and treatment |journal=Vector Borne Zoonotic Dis. |volume=3 |issue=1 |pages=45–51 |year=2003 |pmid=12804380 |doi=10.1089/153036603765627451 }}

Serologic testing for antibodies against Babesia (both IgG and IgM) can detect low-level infection in cases with high clinical suspicion, but negative blood film examinations. Serology is also useful for differentiating babesiosis from malaria in cases where people are at risk for both infections. Since detectable antibody responses require about a week after infection to develop, serologic testing may be falsely negative early in the disease course.{{cite journal |vauthors=Krause PJ, Telford SR, Ryan R |title=Diagnosis of babesiosis: evaluation of a serologic test for the detection of Babesia microti antibody |journal=J. Infect. Dis. |volume=169 |issue=4 |pages=923–6 |date=April 1994 |pmid=8133112 |doi= 10.1093/infdis/169.4.923|display-authors=etal}}

A polymerase chain reaction (PCR) test has been developed for the detection of Babesia from the peripheral blood.{{cite journal |vauthors=Persing DH, Mathiesen D, Marshall WF |title=Detection of Babesia microti by polymerase chain reaction |journal=J. Clin. Microbiol. |volume=30 |issue=8 |pages=2097–103 |date=August 1992 |doi=10.1128/jcm.30.8.2097-2103.1992 |pmid=1500517 |pmc=265450 |url=|display-authors=etal}} PCR may be at least as sensitive and specific as blood-film examination in diagnosing babesiosis, though it is also significantly more expensive.{{cite journal |vauthors=Krause PJ, Telford S, Spielman A |title=Comparison of PCR with blood smear and inoculation of small animals for diagnosis of Babesia microti parasitemia |journal=J. Clin. Microbiol. |volume=34 |issue=11 |pages=2791–4 |date=November 1996 |doi=10.1128/jcm.34.11.2791-2794.1996 |pmid=8897184 |pmc=229405 |url=|display-authors=etal}} Most often, PCR testing is used in conjunction with blood film examination and possibly serologic testing.

Other laboratory findings include decreased numbers of red blood cells and platelets on complete blood count.{{cite journal |vauthors=Akel T, Mobarakai N |title=Hematologic manifestations of babesiosis |journal=Ann Clin Microbiol Antimicrob |volume=16 |issue=1 |pages=6 |date=February 2017 |pmid=28202022 |pmc=5310009 |doi=10.1186/s12941-017-0179-z |doi-access=free}}

In animals, babesiosis is suspected by observation of clinical signs (hemoglobinuria and anemia) in animals in endemic areas. Diagnosis is confirmed by observation of merozoites on a thin film blood smear examined at maximum magnification under oil using Romonovski stains (methylene blue and eosin). This is a routine part of the veterinary examination of dogs and ruminants in regions where babesiosis is endemic.{{cn|date=August 2022}}

Babesia canis and B. bigemina are "large Babesia species" that form paired merozoites in the erythrocytes, commonly described as resembling "two pears hanging together", rather than the "Maltese cross" of the "small Babesia species". Their merozoites are around twice the size of small ones.{{cn|date=August 2022}}

Cerebral babesiosis is suspected in vivo when neurological signs (often severe) are seen in cattle that are positive for B. bovis on blood smear, but this has yet to be proven scientifically. Outspoken red discoloration of the grey matter post-mortem further strengthens suspicion of cerebral babesiosis. Diagnosis is confirmed post-mortem by observation of Babesia-infected erythrocytes sludged in the cerebral cortical capillaries in a brain smear.{{cn|date=January 2023}}

Treatment of asymptomatic carriers should be considered if parasites are still detected after 3 months. In mild-to-moderate babesiosis, the treatment of choice is a combination of atovaquone and azithromycin. This regimen is preferred to clindamycin and quinine because it has fewer side effects. The standard course is 7 to 10 days, but this is extended to at least 6 weeks in people with relapsing disease. Even mild cases are recommended to be treated to decrease the chance of inadvertently transmitting the infection by donating blood. In severe babesiosis, the combination of clindamycin and quinine is preferred. In life-threatening cases, exchange transfusion is performed.{{cite journal|last1=Tanyel |first1=Esra |last2=Guler |first2=Nil |last3=Hokelek |first3=Murat |last4=Ulger |first4=Fatma |last5=Sunbul |first5=Mustafa |title=A case of severe babesiosis treated successfully with exchange transfusion|journal=Int J Infect Dis|year=2015|pmid=26232090|doi=10.1016/j.ijid.2015.07.019 |volume=38 |pages=83–5|doi-access=free }} In this procedure, the infected red blood cells are removed and replaced with uninfected ones; toxins produced by the parasites may also be removed.{{cite journal |vauthors=Saifee NH, Krause PJ, Wu Y |title=Apheresis for babesiosis: Therapeutic parasite reduction or removal of harmful toxins or both? |journal=J Clin Apher |volume=31 |issue=5 |pages=454–8 |date=October 2016 |pmid=26481763 |doi=10.1002/jca.21429 }}

Imidocarb is a drug used for the treatment of babesiosis in dogs.{{cite web |url=http://www.merck-animal-health-usa.com/products/130_163327/productdetails_130_163631.aspx |title=Imizol {{!}} Overview |author= |publisher=Merck Animal Health |access-date=15 August 2015 |archive-url=https://web.archive.org/web/20150807190718/http://www.merck-animal-health-usa.com/products/130_163327/productdetails_130_163631.aspx |archive-date=7 August 2015 |url-status=dead }}

Extracts of the poisonous, bulbous plant Boophone disticha are used in the folk medicine of South Africa to treat equine babesiosis. B. disticha is a member of the daffodil family Amaryllidaceae and has also been used in preparations employed as arrow poisons, hallucinogens, and in embalming. The plant is rich in alkaloids, some of which display an action similar to that of scopolamine.{{cite web|first=James A.|last=Duke|author-link=James A. Duke|title="Boophone disticha" (Liliaceae)|publisher=Dr. Duke's Phytochemical and Ethnobotanical Databases|url=https://phytochem.nal.usda.gov/phytochem/ethnoPlants/show/8865|access-date=November 10, 2011|archive-date=January 15, 2018|archive-url=https://web.archive.org/web/20180115001244/https://phytochem.nal.usda.gov/phytochem/ethnoPlants/show/8865|url-status=live}}

Babesiosis is a vector-borne illness usually transmitted by Ixodes scapularis ticks. B. microti uses the same tick vector as Lyme disease, and may occur in conjunction with Lyme. The organism can also be transmitted by blood transfusion.{{cite journal|vauthors=Herwaldt BL, Linden JV, Bosserman E, Young C, Olkowska D, Wilson M | title = Transfusion-associated babesiosis in the United States: a description of cases| journal = Ann Intern Med| year = 2011| volume = 155| issue = 8| pages = 509–19| pmid = 21893613| doi=10.7326/0003-4819-155-8-201110180-00362| doi-access = | s2cid = 74852997}}{{cite journal| journal = Ann Intern Med| year = 2011| volume = 155| issue = 8| pages = 556–7| title = Transfusion-associated babesiosis: shouldn't we be ticked off?| author = Leiby DA| pmid = 21893616| doi=10.7326/0003-4819-155-8-201110180-00363| doi-access = | s2cid = 807441}} Ticks of domestic animals, especially Rhipicephalus (Boophilus) microplus and R. (B.) decoloratus transmit several species of Babesia to livestock, causing considerable economic losses to farmers in tropical and subtropical regions.{{cn|date=August 2022}}

In the United States, the majority of babesiosis cases are caused by B. microti, and occur in the Northeast and northern Midwest from May through October. Areas with especially high rates include eastern Long Island, Fire Island, Nantucket Island, and Martha's Vineyard.{{cite book |first1=A. James |last1=Giannini |first2=Henry R. |last2=Black |first3=Roger L. |last3=Goettsche |title=Psychiatric, psychogenic, and somatopsychic disorders handbook: a laboratory and clinical guide to the medical management of emotional and intellectual pathology |url=https://books.google.com/books?id=LCBsAAAAMAAJ |year=1978 |publisher=Medical Examination |isbn=978-0-87488-596-5 |page=86 |access-date=2016-10-14 |archive-date=2020-07-26 |archive-url=https://web.archive.org/web/20200726152514/https://books.google.com/books?id=LCBsAAAAMAAJ |url-status=live }}{{cite news | last = Belluck | first = Pam | title = Tick-Borne Illnesses Have Nantucket Considering Some Deer-Based Solutions | work = The New York Times | url = https://www.nytimes.com/2009/09/06/us/06nantucket.html | access-date = September 6, 2009 | date = September 6, 2009 | archive-date = November 15, 2011 | archive-url = https://web.archive.org/web/20111115071438/http://www.nytimes.com/2009/09/06/us/06nantucket.html | url-status = live }}{{cite journal|vauthors=Herwaldt BL, Persing DH, Précigout EA |title=A fatal case of babesiosis in Missouri: Identification of another piroplasm that infect humans |journal=Annals of Internal Medicine |volume=124 |issue=7 |pages=643–50 |year=1996 |pmid=8607592 |doi=10.7326/0003-4819-124-7-199604010-00004 |s2cid=46733758 |display-authors=etal }}{{cite journal |author=Mylonakis E |title=When to suspect and how to monitor babesiosis |journal=Am Fam Physician |volume=63 |issue=10 |pages=1969–74 |date=May 2001 |pmid=11388711 |url=http://www.aafp.org/link_out?pmid=11388711 |access-date=2012-05-26 |archive-date=2022-07-21 |archive-url=https://web.archive.org/web/20220721141444/https://www.aafp.org/pubs/afp/issues/2001/0515/p1969.html |url-status=live }}{{cite web | url = https://www.cdc.gov/parasites/babesiosis/gen_info/faqs.html | publisher = Centers for Disease Control and Prevention (CDC | date = May 5, 2009 | access-date = September 6, 2009 | title = Babesiosis FAQs | archive-date = November 28, 2010 | archive-url = https://web.archive.org/web/20101128002053/http://www.cdc.gov/parasites/babesiosis/gen_info/faqs.html | url-status = live }}

The Centers for Disease Control and Prevention now requires state health departments to report infections using [https://www.cdc.gov/parasites/babesiosis/resources/50.153.pdf Form OMB No. 0920-0728].{{cite web |title=Parasites - Babesiosis: National Surveillance |url=https://www.cdc.gov/parasites/babesiosis/surveillance.html |website=Centers for Disease Control and Prevention |access-date=19 June 2018 |archive-url=https://web.archive.org/web/20171216225718/https://www.cdc.gov/parasites/babesiosis/surveillance.html |archive-date=December 16, 2017}} In 2014, Rhode Island had an incidence of 16.3 reported infections per 100,000 people.{{cite web |last1=Centers for Disease Control and Prevention |title=Data & Statistics |url=https://www.cdc.gov/parasites/babesiosis/data-statistics/index.html |website=Center |access-date=19 June 2018 |archive-date=19 June 2018 |archive-url=https://web.archive.org/web/20180619040122/https://www.cdc.gov/parasites/babesiosis/data-statistics/index.html |url-status=live }}

In Europe, B. divergens is the primary cause of infectious babesiosis and is transmitted by I. ricinus.

Babesiosis has emerged in the Lower Hudson Valley, New York, since 2001.{{cite journal| title = Babesiosis in Lower Hudson Valley, New York, USA| volume = 17| issue = 5|date=May 2011|vauthors=Joseph JT, Roy SS, Shams N, Visintainer P, Nadelman RB, Hosur S | journal = Emerg Infect Dis| doi = 10.3201/eid1705.101334 |pmid=21529393 |pmc=3321771| pages = 843–7|display-authors=etal}}

Related news articles:

{{cite news| url = https://www.nytimes.com/2011/06/21/health/21ticks.html| title = Once Rare, Infection by Tick Bites Spreads| author = Laurie Tarkan| work = The New York Times| date = June 20, 2011| access-date = February 24, 2017| archive-date = November 25, 2016| archive-url = https://web.archive.org/web/20161125100535/http://www.nytimes.com/2011/06/21/health/21ticks.html| url-status = live}}

In Australia, one locally-acquired case of B. microti has been reported, which was fatal.{{cite journal |last1=Senanayake |first1=Sanjaya N |last2=Paparini |first2=Andrea |last3=Latimer |first3=Maya |last4=Andriolo |first4=Kerrie |last5=Dasilva |first5=Alexandre J |last6=Wilson |first6=Heather |last7=Xayavong |first7=Maniphet V |last8=Collignon |first8=Peter J |last9=Jeans |first9=Phillip |last10=Irwin |first10=Peter J |title=First report of human babesiosis in Australia |journal=Medical Journal of Australia |date=March 2012 |volume=196 |issue=5 |pages=350–2 |doi=10.5694/mja11.11378|pmid=22432676 |s2cid=33068508 }} A subsequent investigation found no additional evidence of human Babesiosis in over 7000 patient samples, leading the authors to conclude that Babesiosis was rare in Australia.{{cite journal |last1=Faddy |first1=Helen M. |last2=Rooks |first2=Kelly M. |last3=Irwin |first3=Peter J. |last4=Viennet |first4=Elvina |last5=Paparini |first5=Andrea |last6=Seed |first6=Clive R. |last7=Stramer |first7=Susan L. |last8=Harley |first8=Robert J. |last9=Chan |first9=Hiu-Tat |last10=Dennington |first10=Peta M. |last11=Flower |first11=Robert L.P. |title=No evidence for widespread Babesia microti transmission in Australia |journal=Transfusion |date=July 2019 |volume=59 |issue=7 |pages=2368–74 |doi=10.1111/trf.15336|pmid=31070793 |s2cid=148570372 }} A similar disease in cattle, commonly known as tick fever, is spread by Babesia bovis and B. bigemina in the introduced cattle tick Rhipicephalus microplus. This disease is found in eastern and northern Australia.{{cite web|title=Tick fever (bovine babesiosis) |author=Queensland Government, Department of Primary Industries and Fisheries |url=http://www.dpi.qld.gov.au/4790_5838.htm |access-date=21 February 2012 |url-status=dead |archive-url=https://web.archive.org/web/20110405112007/http://www.dpi.qld.gov.au/4790_5838.htm |archive-date=5 April 2011 }}

A table of isolated cases of babesiosis, which may be underestimated given how widely distributed the tick vectors are in temperate latitudes.

The disease is named for the genus of the causative organism,[https://www.merriam-webster.com/dictionary/babesia "babesia"] {{Webarchive|url=https://web.archive.org/web/20220424212822/https://www.merriam-webster.com/dictionary/babesia |date=2022-04-24 }} at Merriam-Webster online. which was named after the Romanian bacteriologist Victor Babeș.{{WhoNamedIt|doctor|367|Victor Babeș}} In 1888, Victor Babeș identified the microorganisms in red blood cells as the cause of febrile hemoglobinuria in cattle.{{cite journal|last1=Vannier|first1=Edouard|last2=Krause|first2=Peter J.|title=Human Babesiosis|journal=New England Journal of Medicine|date=21 June 2012|volume=366|issue=25|pages=2397–2407|doi=10.1056/NEJMra1202018|pmid=22716978|s2cid=205116383 |url=https://dermatologycentral.typepad.com/files/nejmra1202018.pdf|url-status=live|archive-url=https://web.archive.org/web/20211112081212/https://dermatologycentral.typepad.com/files/nejmra1202018.pdf|archive-date=2021-11-12}} In 1893, Theobald Smith and Frederick Kilborne discovered that a tick was the vector for transmission in Texas cattle. The agent was B. bigemina. This was the first demonstration that an arthropod could act as a disease vector to transmit an infectious agent to a vertebrate host.{{cn|date=August 2022}}

In 1957, the first human case was documented in a splenectomized Croatian herdsman. The agent was B. divergens. In 1969, the first case was reported in an immunocompetent individual on Nantucket Island. The agent was B. microti, and the vector was the tick I. scapularis.{{citation needed|date=June 2016}} Equine babesiosis (caused by the protozoan Theileria equi) is also known as piroplasmosis (from the Latin {{Lang|la|piro}}, meaning pear + Greek plasma, a thing formed).{{cite web|url=https://www.lexic.us/definition-of/piroplasma|title=Definition of Piroplasma|publisher=lexic.us|access-date=November 9, 2011|archive-date=November 11, 2011|archive-url=https://web.archive.org/web/20111111142406/http://www.lexic.us/definition-of/Piroplasma|url-status=live}}

Veterinary treatment of babesiosis does not normally use antibiotics. In livestock and animals, diminazen (Berenil), imidocarb, or trypan blue would be the drugs of choice for treatment of B. canis rossi (dogs in Africa), B. bovis, and B. bigemina (cattle in Southern Africa). In acute cases in cattle, a blood transfusion may be carried out. A vaccine is effective against B. canis canis (dogs in the Mediterranean region), but is ineffective against B. c. rossi. B. imitans causes a mild form of the disease that frequently resolves without treatment (dogs in Southeast Asia).{{cn|date=January 2023}}

{{Reflist}}

{{Wikispecies|Babesia}}

• {{cite web |author=Center for Global Health |title=Babesiosis |date=2019-06-25 |work=Parasites and Health, DPDx—Laboratory Identification of Parasites of Public Health Concern |publisher=Centers for Disease Control & Prevention |url=http://www.dpd.cdc.gov/dpdx/HTML/Babesiosis.htm |access-date=2003-10-07 |archive-url=https://web.archive.org/web/20130307053855/http://www.dpd.cdc.gov/dpdx/HTML/Babesiosis.htm |archive-date=2013-03-07 |url-status=dead }} Public domain source from which the first version of this article was derived.
• {{cite journal |last1=Krause |first1=Peter J |last2=Auwaerter |first2=Paul G |last3=Bannuru |first3=Raveendhara R |last4=Branda |first4=John A |last5=Falck-Ytter |first5=Yngve T |last6=Lantos |first6=Paul M |last7=Lavergne |first7=Valéry |last8=Meissner |first8=H Cody |last9=Osani |first9=Mikala C |last10=Rips |first10=Jane Glazer |last11=Sood |first11=Sunil K |last12=Vannier |first12=Edouard |last13=Vaysbrot |first13=Elizaveta E |last14=Wormser |first14=Gary P |title=Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA): 2020 Guideline on Diagnosis and Management of Babesiosis |journal=Clinical Infectious Diseases |date=27 January 2021 |volume=72 |issue=2 |pages=e49–e64 |doi=10.1093/cid/ciaa1216 |pmid=33252652 |url=https://academic.oup.com/cid/article/72/2/e49/6012666|doi-access=free }}
• {{cite journal |vauthors=Homer MJ, Aguilar-Delfin I, Telford SR, Krause PJ, Persing DH |title=Babesiosis |journal=Clin. Microbiol. Rev. |volume=13 |issue=3 |pages=451–69 |date=July 2000 |pmid=10885987 |pmc=88943 |doi= 10.1128/CMR.13.3.451-469.2000}}
• [https://web.archive.org/web/20021115013840if_/http://www.merckvetmanual.com:80/mvm/index.jsp?cfile=htm/bc/10402.htm "Babesiosis: Overview"]—The Merck Veterinary Manual
• [https://web.archive.org/web/20120913002322/http://www.oie.int/wahis_2/public/wahid.php/Diseaseinformation/Diseasehome Current status of Equine piroplasmosis worldwide] at OIE. WAHID Interface—OIE World Animal Health Information Database
• [https://www.woah.org/en/what-we-do/animal-health-and-welfare/animal-diseases/ Disease card]—OIE

{{Medical resources

| ICD10 = {{ICD10|B|60|0|b|50}}

| ICD9 = {{ICD9|088.82}}

| ICDO =

| OMIM =

| DiseasesDB = 1200

| MedlinePlus =

| eMedicineSubj =

| eMedicineTopic =

| MeshID = D001404

| Orphanet=108

}}

{{Chromalveolate diseases}}

{{Tick-borne diseases}}

{{Flea-borne diseases}}

Category:Babesia

Category:Protozoal diseases

Category:Tick-borne diseases

Category:Zoonoses