Babesiosis Launches "Surprise Attack" on Pennsylvanians
From the Lyme Disease Association of Southeastern Pennsylvania, (610-388-7333); www.lymepa.org
by Virginia T. Sherr, MD, DLFAPA Member of The Lyme Disease Association of Southeastern Pennsylvania
Dateline: Holland, PA, November 24, 2004
Babesiosis Launches "Surprise Attack" on Pennsylvanians - Just Raking Leaves Could Make You Sick
Doctors in the Commonwealth say the state's incidence of the malaria-like scourge, which is carried by the same ticks that spread Lyme disease, may exceed that of New Jersey, where the disease has reached epidemic proportions
Pennsylvanians have a new reason to beware of tick bites: babesiosis.
A disease of rodents that has crossed species to infect humans, this malaria-like disease was primarily considered a threat to people in coastal states and nearby islands. However, recent evidence indicates that the incidence of babesiosis in Pennsylvania may exceed its infection rate in New Jersey, where the CDC (Centers for Disease Control and Prevention) has said it is epidemic. This has taken Pennsylvania's physicians by surprise, says Psychiatrist Virginia T. Sherr, of Holland, Pa., who has seen a rising number of cases in her practice and in other parts of the state and recently published a report on her findings in the scientific journal, Medical Hypotheses.
"General George Washington crossed the Delaware River to launch a surprise attack on the British at Trenton, but babesiosis has followed a reverse direction, crossing the Delaware from New Jersey to launch a surprise attack on Pennsylvania," says Sherr. "Babesia-infected ticks enter the state on birds, as well as the deer and bear that swim across the river."
"We've been ambushed," she continues, "so we have to get up to speed fairly quickly to prevent losing the battle. There are medications that, given early enough, can help prevent chronic babesiosis."
Two forms of the disease have been seen in Pennsylvania: acute and chronic. Often mistaken for a severe case of the flu, acute babesiosis is characterized by fever, chills, sweats, headache, prostration, severe aches and pains, and occasionally blood loss with concomitant dark urine. If not properly treated, acute babesiosis, as malaria, can become chronic, causing physical as well as psychiatric symptoms.
Physical symptoms of chronic babesiosis include general fatigue, anemia, profuse night sweats, tension, profound chilliness, muscle pains, afternoon malaise, weakness and insomnia, but rarely total incapacitation. The journal article cites clinical observations by psychiatrists who treat patients with mental symptoms stemming from chronic babesiosis. They noted that, as with malaria of the brain, chronic babesiosis can cause psychiatric symptoms such as extreme irritability, anxiety, all-out road rage, and other tendencies to over-react emotionally. Dr. Sherr explained that these negative states are most frequently seen in babesiosis patients who also have Lyme disease. But the psychiatrists found that such disturbances were sometimes observed in patients who had been aggressively treated for Lyme, as well as in those whose testing suggested they had contracted babesiosis alone.
Babesia infection has been moving quickly across Pennsylvania. Sherr's colleagues in mid-state are seeing more cases - especially in their patients who also have Lyme disease. Dr. Harold Smith of Danville, Pa., says he is pleased to know that Sherr's work has been published. "I am finding most physicians don't yet know that the babesiosis epidemic has spread to Pennsylvania, but I am seeing it in my office patients with increasing frequency."
Babesiosis is caused by a single-celled parasite that lives in red blood cells and is carried by the same tiny deer ticks that spread Lyme disease. Doctors should look for it as a companion to cases of known Lyme disease, and in cases where there is no clear explanation for a patient's symptoms. In addition to Lyme and babesiosis, diseases borne by deer ticks include ehrlichiosis and bartonellosis. Tests for tick-borne diseases should be performed by laboratories that specialize in these infections.
Sherr urges doctors to report all positive cases to their county Health Department and to the CDC. They should also help to educate the public about the risks of babesiosis and other tick-borne diseases.
For prevention, Sherr advises parents to be careful during their autumn yard clean up and to keep children out of the woods, leaf piles, tall grass and other habitats that harbor the miniscule deer ticks. She advises using Repel (Permanone-permethrin) spray on clothing worn outdoors, protecting pets with long-lasting tick-repellant, and performing thorough tick checks on family members each night. Prevention is the best defense against the surprise attack of babesiosis in Pennsylvania.