Babesia Hudson Valley Cases Increase 16-Fold
Babesia cases in the Hudson Valley have increased dramatically, with researchers reporting a 16-fold rise in infections across several counties in New York.
In their article “Increasing incidence and changing epidemiology of babesiosis in the Hudson Valley region of New York State: 2009-2016,” Joseph and colleagues question how cases of Babesia infections are spreading given that the animal reservoirs—mice, shrews, and voles—typically do not travel large distances.
The Hudson Valley region of New York, including Westchester, Dutchess, and Albany counties, has become one of the most active areas for Babesia infections in the United States.
Cases of Babesia have been reported in two counties located east of the Hudson River: Dutchess County and Westchester County. Westchester County alone has a population approaching one million residents.
Babesia is commonly transmitted by the same tick that spreads Lyme disease, which is why many patients develop Babesia–Lyme coinfections.
Babesia Hudson Valley Cases Increased Nearly 17-Fold
Since 2009, there has been an explosion of Babesia infections in the Upper Hudson Valley region of New York. This area includes Albany County, Columbia County, Greene County, and Rensselaer County.
Over an eight-year period (2009-2016), researchers documented a 16.8-fold increase in the incidence of Babesia cases in the Upper Hudson Valley region.
The number of cases also increased in the Lower Hudson Valley region, which consists of Dutchess County, Putnam County, Westchester County, Orange County, Rockland County, Sullivan County, and Ulster County.
Why Babesia Hudson Valley Numbers Are Likely Underreported
The actual number of Babesia cases may be higher for several reasons:
- Babesia was not designated a reportable disease by the CDC until 2011.
- Between 2011 and 2016, New York State reported 2,750 Babesia cases—the highest number in any U.S. state.
- Babesia parasites in red blood cells may clear quickly, making diagnosis more difficult.
- Cases may not be reported to public health authorities.
“In conclusion, babesiosis is a rapidly emerging infection in the Hudson Valley region of New York State, the geographic region now accounting for more cases than any other single geographic area in the state,” the authors write.
Therefore, clinicians caring for patients with symptoms compatible with babesiosis who live in or have traveled to the Hudson Valley should consider the possibility of infection.
Editor’s Note: 33 Years Treating Babesia Hudson Valley Patients
I have practiced medicine in the Hudson Valley region of New York for more than 33 years and have treated patients with Babesia infections for the past three decades.
Many early Babesia cases were diagnosed when Babesia microti parasites were visible in red blood cells. Today, I typically diagnose Babesia using a positive antibody test or through clinical judgment when symptoms strongly suggest infection.
Although the authors focused on Babesia microti, I have also observed evidence suggesting that Babesia duncani may be present in this region. Originally identified on the West Coast, this species may be emerging in other areas.
Other Babesia species are also being identified in tick-borne infections, including newly recognized Babesia species.
Babesia infection has important treatment implications. Standard Lyme antibiotics such as doxycycline or amoxicillin do not treat Babesia. Patients with Lyme disease who are co-infected with Babesia typically require combination therapy that includes anti-parasitic medications such as azithromycin and atovaquone.
For patients who remain ill despite standard Lyme treatment, unrecognized Babesia infection may be the cause.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Hi Dr. Cameron. Just letting you know that when I was tested for Lyme (it took 4 mos to get a positive for BB) I was also tested more than once for Babesia but the tests were negative. I was told Babesia and Anaplasmosis were the most common co-infections in MN. When I went to the ER from the second nymph bites with a multiple lesion rash. I had red blotchy palms that prompted the ER doc to ask me “what’s that?” I said I didn’t know. Nothing said past that about it. I still have varying degree’s of blotchy palms since (7/17) I was wondering what the most prevalent clinical signs for Babesia look like in your studies. I know the sweats and chills for two years may be Babesia and would explain why Doxy didn’t work. Do Chronic Lyme patients need to be concerned about being exposed to COVID-19? Also I was recently rear ended and pushed into cars in front of me so there were two impacts that resulted in a diagnosis of whiplash and concussion. Is there anything I need to talk to my PT about concerning any other Lyme related conditions? I feel like I can’t say the word Lyme. It’s not being brought up as I am going through PT (Concussion therapy next). Is that because in MN there is still no protection for physicians to treat Lyme? I hear about people getting treated with a positive BB result but other than the original antibiotic treatment with Doxy, nothing has been brought up by any of my specialists or GP. (Only what I previously told you about Dr. Gary Bryant, Rheumatology at the U of M involved in the second attempt at a vaccine) That testing and treatments just aren’t there and he hopes to see it before he dies. I’m getting confusing messages but it would seem I may be in the wrong state to ask such questions. Most U of M physicians are IDSA members. Just wondering. Little nervous about going back to the hospital for PT today with the lack of discussion concerning Lyme, accident injuries and COVID-19. Lots in my questions and a bit of confusion but maybe you can take a crack at it. 🙂 Hope you are doing well. Stay safe.
I have patients in my practice who are equally confused and frustrated. I have to use clinical judgment as to whether to treat for a co-infection e.g., Babesia. I find that some of my Lyme disease patients do not realize they suffer from a tick-borne illness until they get a concussion. We do not know about COVID-19 and Lyme yet.
BTW I grew up in Minnesota. I practice in New York.
I live in northern California and back in the early 1990’s people came and tested our entire hillside community. The were a lot of positive results for lyme and babesia. My whole family was discovered to have babesia, but not lyme. All we were told at the time was to never donate blood. Is it possible that my siblings and I should be treated for babesia? Is it possible with treatment for me to be able to donate blood? Do you have recommendations for doctors in California?
I typically recommend an evaluation for Babesia and Lyme disease if I have a patient who is ill or never has been treated. I am not sure the blood back would clear you even if you are treated for Babesia. You could contact LymeDisease.org or ILADS.org.
Hi Doctor Cameron,
My ex husband knows you from Belizzi and Pizza Pizzazz and knows what a great doctor you are – he sent me here! I tested positive for Babesia microti last September (2021) and my titers were 1:20. They retested me in November (2021) and my titers were stable at 1:20. I still felt fatigue and unwell and just retested an my titers were 1:80. Do you think it’s time to begin treatment? If so, I look forward to seeing you soon.
We live in southern Ulster County. My daughter was first infected with Babesia in 2010 at age five. Her pediatrician recommended against treatment, citing CDC guidelines. When her initial symptoms were replaced with other ongoing concerns, we found a doctor willing to treat her four months after the infection began. She improved over the course of six months of medication, and we stopped treatment.
Over the years her IgG remained at 1:40 and she had several cycles of some symptoms and brief treatment. Last summer she had a new tick bite and confirmed Lyme, and her Babesia IgG went up to 1:320. She has had marked improvement with atovaquone and azithromycin, but is still struggling with symptoms. I wonder if it is something she will carry with her for the rest of her life to some degree.
I am happy to hear she had marked improvement with atovaquone and azithromycin. I have patients who have benefited from additional antibiotic treatment.