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Babesiosis

moderate

A malaria-like illness caused by a parasite (Babesia microti) that infects red blood cells. The same blacklegged tick that carries Lyme carries this. Rare in Canada but increasing in the same regions. Can be severe in older patients and people without a working spleen.

Pathogen
Babesia microti (protozoan parasite)
Vector
Blacklegged tick (Ixodes scapularis)
Onset
1–4 weeks after the bite, occasionally longer.

What it is

Babesiosis is closer to malaria than to the other tick-borne illnesses. The pathogen is a single-celled parasite that invades and breaks down red blood cells. Canadian cases are still rare, but the disease shows up wherever blacklegged ticks become established.

How long the tick has to be attached

Transmission typically takes 36–48 hours of attachment, a bit longer than Lyme. Same-day removal protects you well.

The first signs to watch for

Symptoms appear 1–4 weeks after a bite, sometimes longer. Many healthy adults have mild or no symptoms. When it does cause illness:

  • Fever, often with drenching sweats and shaking chills
  • Fatigue
  • Muscle and joint aches
  • Headache
  • Loss of appetite
  • In severe cases: dark urine, yellowing of the skin (hemolytic anemia), shortness of breath

Babesiosis shares its range and most of its symptoms with Lyme, so the two are often diagnosed together. If a presumed Lyme illness doesn’t respond to standard antibiotics, babesiosis is a common reason.

When to see a doctor

This week:drenching sweats and shaking chills in the weeks after a tick bite, especially if standard Lyme treatment doesn’t resolve the illness.

Emergency room: severe shortness of breath, very dark urine, jaundice, confusion, or any signs of organ failure, particularly in older patients or anyone without a spleen.

What your doctor will do

Mild babesiosis is treated with a combination of atovaquone and azithromycin. Severe cases (high parasite load, organ involvement, immunocompromised patients) may need clindamycin with quinine, and occasionally an exchange transfusion in hospital. Diagnosis is confirmed by blood smear or PCR.

Where it shows up in Canada

The same blacklegged-tick footprint as Lyme: southern Ontario, southern Quebec, Nova Scotia, and New Brunswick, with emerging cases elsewhere. Canadian babesiosis case counts are still low compared to Lyme, but the Public Health Agency of Canada tracks it as a notifiable disease.

Public Health Agency of Canada (babesiosis health-professional guidance).

Related

Last reviewed

General information only, not medical advice. In an emergency, call 911. Read the full disclaimer.

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