New research suggests that red blood cell exchange transfusions could significantly improve outcomes for patients hospitalized with severe babesiosis, a rare tick-borne illness that can become life-threatening.
The study, led by Harvard Medical School researcher David Leaf, offered what researchers say is the strongest evidence yet that the procedure can help the sickest patients survive a disease that remains relatively uncommon but appears to be increasing in the United States, Nantucket Current reported. For people at high risk, that could be an important development.
Babesiosis, also known as Nantucket fever, is caused by a parasite transmitted by ticks and can lead to fever, fatigue, anemia, and, in severe cases, death. Nantucket, Massachusetts, has long been considered an epicenter of the disease, though the total number of cases on the island remains low.
According to Current, the paper analyzed 3,000 hospitalized patients treated at 82 medical centers over 15 years, making it one of the largest clinical examinations of severe babesiosis to date.
The treatment itself is intensive and generally reserved for the most critical cases. In a red blood cell exchange transfusion, a patient's blood is passed through a machine that filters out infected red blood cells and replaces them with healthy donor cells.
Of the severely ill patients who received the treatment, 3.6% died or were readmitted within 30 days, compared with 9.8% of patients who did not receive it. Because babesiosis is rare and associated research is underfunded, Leaf's team used a "target trial emulation," a statistical method designed to mimic some of the rigor of a clinical trial. The project utilized more than 100 collaborators.
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This matters because severe babesiosis can worsen quickly, especially for people who are immunosuppressed or have other health conditions. The findings suggest that reaching a hospital capable of performing exchange transfusions could make a meaningful difference in a medical emergency.
While the procedure is invasive and unlikely to become standard for mild infections, the research may help hospitals and clinicians better identify when aggressive treatment is worth pursuing.
It is also a reminder that public health threats do not need to be widespread to be serious. There are only a little over 2,000 documented cases of babesiosis in the U.S. each year, but researchers say the true total is likely higher, and cases have risen over time.
As the warming planet helps tick populations survive and spread into new areas, it may become more important for families, doctors, and health systems to monitor illnesses such as babesiosis, alpha-gal syndrome, and Lyme disease. Data from the Centers for Disease Control and Prevention shows that tick bites are contributing to the highest number of weekly emergency room visits since tracking began in 2017.
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"It may be life-saving," senior study author Peter Krause told Current of the treatment. "If I were to explain the importance of this study to someone, especially at high risk, I would say you can derive a little bit of comfort from this."
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