posted
My daughter has Babesia symptoms, a positive Babesia FISH assay, but never tested positive for either Babesia microti or Babesia duncani. Does anyone have information on how do you get tested for other Babesia species such as B. divergens in the USA?
Different Babesia species are spreading worldwide. In this recent study published in Clinical Microbiology and Infection, 3 different species of Babesia (microti, divergens, and EU-1) were discovered in patients in Belgium, where B. microti infections had not previously been suspected. We have also been finding different Babesia species apart from B. microti, such as Babesia WA-1 (duncani) in our patients from the East Coast. In 2011, I reported at the ILADS international conference in Toronto, a study we performed on 137 patients using LabCorp testing for Babesia WA-1, where we found that 26/137 patients (19%) tested positive for Babesia WA-1 from Winter Park, Florida up to Hamlin, Maine. This species is usually reported only from patients on the West Coast. Tick-borne co-infections are spreading, and this article highlights the need for physicians to regularly test patients for multiple species of Babesia if they present with malarial-like symptoms without a clear etiology.
A retrospective serological survey on human babesiosis in Belgium.
Lempereur L, Shiels B, Heyman P, Moreau E, Saegerman C, Losson B, Malandrin L.
Abstract In Europe, most clinical babesiosis cases in humans have been attributed to Babesia divergens and Babesia sp. EU1. Babesia microti infection of humans occurs mainly in the United States; although a case of autochthonous B. microti infection and serological evidence of infection have been reported in Europe. The Indirect Fluorescent Antibody Test was used to screen sera from 199 anonymous Belgian patients with history of tick bite and clinical symptoms compatible with a tick-borne disease. The serological screen detected positive reactivity in 9% (n = 18), 33.2% (n = 66), and 39.7% (n = 79) of the samples against B. microti, B. divergens, and Babesia sp. EU1, respectively. Thus, evidence of contact among three potentially zoonotic species of Babesia and humans has been confirmed in Belgium. Preventive action and development of better diagnostic tools should help in prevention of clinical cases and to clarify the true burden of such infection for individuals and public health.
-------------------- KarlaL Posts: 694 | From New Lebanon, NY | Registered: Dec 2010
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I suggest you call Igenex and ask them. It is my understanding that tests for the other species are not widely available in the U.S.
Perhaps Igenex can also tell you when they expect to be able to test for more species or if their current tests are known to cross-react with the European species.
Posts: 9931 | From Maryland | Registered: Dec 2007
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Both Fry Lab and Clongen Lab have tests for Babesia species by PCR.
However, my suggestion is a blood smear from either Fry or Clongen. For Clongen Lab the test is NOT listed on the test requisition form on their website. You have to call the lab and they will tell you what to write on the test requisition form.
The blood smear is cheaper than a PCR test and it will detect all species.
However - even a negative PCR or negative bloodsmear will not rule out Babesia. For duncani or microti an antibody test should also be done. People who test positive on any of the 3 methods - antibody, PCR or blood smear should be treated for Babesia if they are symptomatic.
The CDC actually says that 4 blood smears (2 thick and 2 thin smears) should be done to rule out Babesia on the basis of that testing method. In a hospital setting the ideal testing is to do both a thick and a thin blood smear every 6 or 8 hours for a total of 3 sets of tests. There are several journal articles in which patients had very severe Babesia complications with less than one percent of their red blood cells infected by the Babesia parasite.
If the patient is running fevers, supposedly testing at the time the fever is the highest gives a better chance of producing a positive test result for a blood smear. Also blood from a finger prick or your ear might be positive when venous blood is not.
Another indirect testing method that some LLMD's use is the ECP (Eosinophil Cationic Protein) test. That test can be done by LabCorp or Quest I think - some docs use a medication challenge when doing that test.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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I found one lab that also supposedly tests for Babesia divergens in the U.S. by PCR. As far as I know this test has only been available for a couple of years. Was NOT available when hubby died from ARDS due to Babesia on 10/9/12.
Have no idea how accurate the test is or the cost. But the test might be a more cost effective option since they test one blood sample for Babesia microti, Babesia duncani and Babesia divergens all.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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When hubby first had a Babesia duncani (WA-1) test after being sick for 10 years his antibody level was 1:2048. And it was at the end of December so obviously not a new tickbite. So I don't have a lot of confidence in using the antibody levels to predict how recent the infection is.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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Please note that researchers agree that there is NO CROSS REACTION between antibodies for Babesia microti and Babesia duncani. So both tests should be done for anyone who thinks they have Babesia.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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posted
Thank you for the references and I will bring them up at my daughters next LLMD office visit! My daughter has had several strongly positive Fry Lab Modified May-Grünwald and Fluorescent DNA Stain biofilm stains. Confusingly both her Fry labs protomyxzoa and babesia species PCRs were negative. Dr Fry is finding babesia-like organisms in his biofilm patients with negative protomyxzoa PCRs. I wish that he would publish soon. There clearly needs to be more research in this area.
-------------------- KarlaL Posts: 694 | From New Lebanon, NY | Registered: Dec 2010
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There is one more test Fry can do. Hubby had the same findings on blood drawn after death.
Clongen saw Babesia like organisms on a blood smear - report was issued on the day of his death.
Fry lab did not find FL1953. Initially they thought there was Babesia based on the species PCR test - test was indeterminate I think. Anyway, a pan PCR test found 3 different Babesia like organisms - all I have are numbers. The organisms are supposedly in the GenBank but I do not have names or know what animals the Babesia like blood borne parasites are normally found in.
I am still working with pathologists at Columbia Presbyterian in New York (sent the brain and other tissues there) and also A.M. to try to find out more.
The additional testing from Fry was only $100 at the time I did it. Call and talk to Jeremy at the lab - they can retest the blood samples they already have.
P.S. Also check with Fry Lab - the species PCR test may not include Babesia duncani - I know that Clongen does not include that species in their Babesia species test.
One other lab to consider - testing is expensive and hubby got negative test results but it might work for someone else. Also again Babesia duncani testing is separate.
Note - spirostat has changed their name to KS3 Lab. Also it looks like they may no longer offer the additional Babesia testing they used to do. But they do test for some things very few other labs look for.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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Thanks again Bea, for sharing your husband's pan PCR Fry lab results showing multiple babesia-like species. Very interesting! The pan PCR test may be the best one to order for my daughter, though I am wondering how long Fry labs keeps blood samples. So sorry for your loss of your husband, but grateful that you are sharing what you have learned to help others.
-------------------- KarlaL Posts: 694 | From New Lebanon, NY | Registered: Dec 2010
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