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1. Pokhara University
School of Health and Allied Sciences
Babesiosis
“Red water fever”
Narayan Adhikari
Third Semester, B Pharm
School of Health and Allied Sciences
Pokhara University, Dhungepatan, Lekhnath, Kaski , Nepal

2. Pokhara University
School of Health and Allied Sciences
Overview
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3. Pokhara University
School of Health and Allied Sciences
INTRODUCTION
 Babesiosis is a rare infectious disease caused by
single-celled microorganisms (protozoa) belonging to
the Babesia family.
 It is believed that the Babesia protozoa are usually
carried and transmitted by ticks (vectors).
 Babesiosis occurs primarily in animals; however, in
rare cases, babesiosis infection may occur in humans.
Certain Babesia species are known to cause
babesiosis infection in humans (e.g., Babesia
microti), and the deer tick is a known vector
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4. Pokhara University
School of Health and Allied Sciences
Contd…
 Babesiosis is caused by microscopic parasites that
infect red blood cells.
 Most human cases of Babesiainfection in the United
States are caused by the parasite Babesia microti.
Occasional cases caused by other species (types)
of Babesia have been detected. Babesia microti is
spread in nature by Ixodes scapularis ticks (also
called blacklegged ticks or deer ticks).
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5. Pokhara University
School of Health and Allied Sciences
Contd…
 Babesia infection can range in severity from
asymptomatic to life threatening. The infection is
both treatable and preventable
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6. Pokhara University
School of Health and Allied Sciences
EPIDEMIOLOGY
• People can get infected with Babesia parasites in
several ways:
• The main way is through the bite of an infected tick
—during outdoor activities in areas where babesiosis
is found
• A less common way is by getting a transfusion from a
blood donor who has a Babesia infection but does
not have any symptoms. (No tests have been
licensed yet for screening blood donors for Babesia.)
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7. Pokhara University
School of Health and Allied Sciences
• Rare cases of congenital transmission—from an
infected mother to her baby (during pregnancy or
delivery)—have been reported.
• NOTE :Babesia parasites are not transmitted from
person-to-person like the flu or the common cold.
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8. Pokhara University
School of Health and Allied Sciences
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9. Pokhara University
School of Health and Allied Sciences
LIFECYCLE
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10. Pokhara University
School of Health and Allied Sciences
SYMPTOMS
 Many people who are infected with Babesia
microti feel fine and do not have any symptoms.
Some people develop nonspecific flu-like symptoms,
such as fever, chills, sweats, headache, body aches,
loss appetite,nausea or fatigue.
 Because Babesia parasites infect and destroy red
blood cells, babesiosis can cause a special type of
anemia called hemolytic anemia. This type of anemia
can lead to jaundice (yellowing of the skin) and dark
urine.
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11. Pokhara University
School of Health and Allied Sciences
Babesiosis can be a severe, life-threatening disease,
particularly in people who:
 do not have a spleen;
 have a weak immune system for other reasons (such
as cancer, lymphoma, or AIDS);
 have other serious health conditions (such as liver or
kidney disease); or
 are elderly.
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12. Pokhara University
School of Health and Allied Sciences
COMPLICATION
 a low and unstable blood pressure;
 severe hemolytic anemia (hemolysis);
 a very low platelet count (thrombocytopenia);
 disseminated intravascular coagulation (also known
as “DIC” or consumptive coagulopathy), which can
lead to blood clots and bleeding;
 malfunction of vital organs (such as the kidneys,
lungs, and liver); or
 death.
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13. Pokhara University
School of Health and Allied Sciences
DIAGONOSI
S
In symptomatic
people, babesiosis
usually is diagnosed
by examining blood
specimens under a
microscope and
seeing
Babesia parasites
inside red blood
cells.
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FIGURE: Babesia parasites in red
blood cells on a stained blood
smear. (CDC Photo: DPDx)

14. Pokhara University
School of Health and Allied Sciences
PREVENTION AND CONTROL
• No vaccine is available to protect people against
babesiosis. However, people who live, work, or travel
in tick-infested areas can take simple steps to help
protect themselves against tick bites and tickborne
infection.
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15. Pokhara University
School of Health and Allied Sciences
During outdoor activities in tick habitats, take
precautions to keep ticks off the skin.
 Walk on cleared trails and stay in the center of the
trail, to minimize contact with leaf litter, brush, and
overgrown grasses, where ticks are most likely to be
found.
 Minimize the amount of exposed skin.
 Apply repellents to skin and clothing.
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16. Pokhara University
School of Health and Allied Sciences
TREATMENT
Drug Adult dosage (usually treat for at least 7-10 days)
Atovaquone 750 mg orally twice a day
along with
Azithromycin On the first day, give a total dose in the range of 500-1000 mg orally;
on subsequent days, give a total daily dose in the range of 250-1000
mg
or
Clindamycin 600 mg orally 3 times a day
or
300-600 mg intravenously 4 times a day
along with
Quinine 650 mg orally 3 times a day
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17. Pokhara University
School of Health and Allied Sciences
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18. Pokhara University
School of Health and Allied Sciences
THANK YOU
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