Tick-Borne Babesiosis On The Rise: What To Know In Maryland

MARYLAND — Babesiosis, a dangerous and in rare cases deadly tick-borne disease, that mostly circulates in the Northeast and Midwest is increasing in prevalence and may be a risk in Maryland, the Centers for Disease Control and Prevention said in a report Thursday.

While the disease is not yet considered endemic, meaning cases regularly occur in the state, Maryland incidents have increased enough that health officials now want blood donations in Maryland screened for babesiosis.

Cases of babesiosis, which is largely transmitted through blacklegged tick bites, increased in eight of the 10 northeastern states that reported illnesses from 2011 to 2019. It declined in only two states where the disease is now considered endemic, Minnesota and Wisconsin.

Also, the CDC said, three new states — Maine, New Hampshire and Vermont — joined the list of states where babesiosis is now considered endemic. The disease is already considered endemic in Connecticut, Massachusetts, New Jersey, New York and Rhode Island.

The first U.S. case of babesiosis was reported on Nantucket Island, Massachusetts, in 1969, but the CDC didn’t ask state health departments to report it until 2011. Overall, tick-borne diseases increased 25 percent from 40,795 reported illnesses in 2011 to 50,856 in 2019, according to the report.

Between 2011-2019, 16,456 cases of babesiosis were reported to the CDC.

Babesiosis isn’t considered endemic in Maryland, but it poses a threat. During the period studied by the CDC, the Maryland Department of Health reported 10 or fewer cases and noted one to five cases of babesiosis cases per 100,000 residents.

In 2019, the Food and Drug Administration recommended screening blood donations for babesiosis in 15 states — the 10 where it is now endemic, but also in Delaware, Maryland, Pennsylvania, Virginia and the District of Columbia.

Symptoms of babesiosis can include fever, chills, sweats, headaches, body aches, nausea, fatigue, and muscle and joint pain.

Illnesses may be asymptomatic, mild or severe. In rare cases, the disease can be fatal, especially for people who are immunocompromised or lack a spleen. Federal health data shows up to 20 percent of adult cases and 50 percent of pediatric cases are asymptomatic, but illnesses can also range from mild to severe, with complications including plummeting blood platelets, kidney failure or acute respiratory distress syndrome, which causes a buildup of fluid in the lungs.

The illness can be treated with a combination of antimicrobial medications, such as azithromycin and atovaquone, according to the CDC.

Keep Ticks Off

• Ticks are most active from late spring through early fall.
• Insect repellent containing 20-30% DEET is recommended to prevent tick bites.
• Treat clothes with permethrin (don't use permethrin directly on skin).
• Long pants and long sleeves help keep ticks off of skin, and tucking pant legs into socks and shirts into pants keeps ticks on outside of clothing.
• Talk to your veterinarian about tick control products for your pets.
• Wooded or brushy areas with tall grass and leaf litter are prime tick habitat. Walk in the center of the trail.
• Check youself, your kids and your pets daily for ticks when spending time in tick habitat.
• Bathe or shower as soon as possible after coming indoors (within 2 hours) to wash off ticks.

To Remove Ticks

• Use fine-tipped tweezers.
• Grab the tick close to the skin; do not twist or jerk the tick.
• Gently pull straight up until all parts of the tick are removed.
• Wash your hands with soap and water or an alcohol-based rub.
• Clean the site of the tick bite with soap and water or an antiseptic.
• Do not use petroleum jelly, a hot match, nail polish, or other products to remove ticks.

The researchers said babesiosis is likely more common than indicated by the data, which is incomplete because not all states report cases to the CDC and asymptomatic cases aren’t flagged by physicians.

Babesiosis can also be spread through blood transfusions and organ donations from an infected person, or from mother to child during pregnancy, according to the CDC.

The aching and fever associated with babesiosis can sometimes be confused with Lyme disease, but it is distinguished by a rash at the site of the tick bite. About 30,000 cases of Lyme disease are reported annually, according to the CDC.

A forecast wet spring in the eastern half of the country could create ideal conditions for ticks, which are usually active from late May until early September. Scientists think longer summers contribute to an increase in tick-borne illnesses. Also, exploding deer populations have given the blacklegged tick — often commonly known as a deer tick — more hosts for feeding and reproduction.