Babesia

Diagnostic Tests for Babesia

The diagnosis of Babesia should be considered in patients who live or travel to areas that are endemic for Babesiosis and experience a viral-like illness or have been bitten by Ixodes ticks or recently had a blood transfusion. As the symptoms and signs are relatively nonspecific, laboratory testing is required for diagnosis. IGeneX offers the following tests to help physicians in the accurate detection of Babesia.

  • Babesia IFA

    Babesia IFA

    The Babesia Immunofluorescence Assay (IFA) is designed to detect human IgM and IgG antibodies to Babesia antigens in human serum. For diagnostic purposes, Babesia IFA test results should be used in conjunction with other information available to the diagnosing physician. Currently, IGeneX offers both B. microti and B. duncani IFA tests.

     

     

    Principal

    The Babesia IFA is a two-stage sandwich assay, which is based on an antigen-antibody-complex formation involving the following steps:

    • Binding of anti-Babesia specific antibodies in human serum to fixed Babesia on a slide.
    • Binding of fluorescent-labeled anti-humanIgG/IgM antibodies specific to the human anti–Babesia antibodies bound to fixed Babesia on the slide.
    • Identifying green fluorescing Babesia parasites with a fluorescent microscope.


    Reference Range

    • Babesia antibody titers IgM <20
    • Babesia antibody titers IgG  <40

    Clinical Significance

    The Babesia IFA antibody test is used to detect antibodies to Babesia in human serum. Titers rise during the first two-to-four weeks of illness and then decline over the next six-to-12 months. In patients with previously high titers, an IgG titer of less than  160 may indicate a resolving infection. If the IFA is negative but clinical symptoms are present, polymerase chain reaction (PCR) and/or fluorescent in situ hybridization (FISH) testing are suggested. Babesia is carried by the same species of ticks that cause Ehrlichiosis, Bartonellosis, and Lyme disease. Therefore, patients with positive titers should also be tested for other tick-borne diseases.

    Limitations

    1. A single negative IFA test result does not exclude the possibility of Babesia 
    2. Other Babesia antibodies may cross-react and yield a false positive Babesia IFA test.
    3. Results should be interpreted in conjunction with other laboratory and clinical findings.


    Results Interpretation >

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  • Babesia FISH

    Babesia FISH

    The Babesia Fluorescent In-Situ Hybridization (FISH) assay is designed for qualitative detection of ribosomal RNA of Babesia parasites directly in a blood smear. The test’s highest degree of specificity is provided by nucleic acid probes, which bind to RNA sequences of the Babesia. This test detects all species of Babesia.

    Principal

    The FISH assay is based on two fundamental principles:

    • Hybridization directly on a thin blood smear with a fluorescein-labeled Babesia –specific probe
    • Identification of Babesia parasites on a blood smear by viewing with a fluorescent microscope


    Reference Range

    • Babesia– Negative, Babesia specific rRNA not detected.

    Clinical Significance

    The FISH assay provides a significant increase in sensitivity and specificity over standard Giemsa-stained smears for the presence of intraerythrocytic parasites (piroplasts) in RBCs. The parasites exist as a ring and/or merozoite forms. A positive sample must show fluorescing rings in at least two RBCs. A negative sample must show no fluorescence within the RBCs.

    Limitations

    1. A single negative FISH test result does not exclude the possibility of Babesia 
    2. Results should be interpreted in conjunction with other laboratory and clinical findings.


    Special Instructions

    1. In special circumstances, blood smears may be accepted by IGeneX for testing in place of EDTA whole blood. Please contact our Lab Director for more information and authorization. Smears made improperly will not be accepted
    2. For Medicare patients, download ABN forms here.


    Results Interpretation >

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  • Babesia PCR Screen (B. Microti and/or B. Duncani)

    Babesia PCR Screen (B. Microti and/or B. Duncani)

    The Babesia microti/duncani Polymerase Chain Reaction (PCR) screen is an assay that detects Babesia DNA in whole blood and speciates to B. microti and B. duncani. The combination of the following three steps imparts a very high specificity and sensitivity to the test:

    • Hybridization/Selection
    • Amplification of Babesia-specific DNA
    • Detection of Babesia-specific amplified DNA fragments


    Reference Range

    • microti: Negative, B. microtispecific DNA not detected
    • duncani:Negative, B. duncani specific DNA not detected

    Clinical Significance 

    The Babesia microti/duncani PCR screen is an assay that detects Babesia specific DNA (B. microti and/or B. duncani). Babesia ribosomal DNA (rDNA) fragments are hybrid-selected by probes, followed by PCR amplification of selected Babesia rDNA. PCR products are confirmed with Babesia-specific probes in a southern blot assay. The primers and probes used for the selection of Babesia rDNA fragments are designed from published, small ribosomal RNA sequences.

    Limitations

    1. Results should be interpreted in conjunction with other laboratory and clinical findings.
    2. Test results can only help the physician in confirming a clinical diagnosis.

    Results Interpretation >
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Which Kit to Order

Panels Blood Urine Misc
*TBD1 | Tick Borne Disease Panel 1
*CP1 | Co-infection Panel 1
*CP2 | Co-infection Panel 2
*CP3 | Co-infection Panel 3
CP4 | Co-infection Panel 4
CP5 | Co-infection Panel 5
BAB1 | Babesia Panel 1
*BAB2 | Babesia Panel 2
(*) Not yet available for New York residents.

Collection Kits

Compatible with Samples Other than Blood or Urine

Misc. Collection Kit

The Miscellaneous Collection Kit is compatible with tick-borne disease tests that require samples other than blood or urine, such as cerebral spinal fluid (CSF), tissue, placenta or breast milk.

Compatible with All Tests that Require Blood

Blood Collection Kit

The Blood Collection Kit is compatible with most of the tick-borne disease tests and panels. The panels are usually the most comprehensive available for testing for Borreliosis/Lyme disease as well as co-infection(s) with other tick-borne illnesses.

Compatible with All Tests that Require Urine

Urine Collection Kit

The Urine Collection Kit is compatible with all tick-borne disease tests that require urine samples. These tests are particularly useful during the acute phase of a tick-borne disease infection before antibodies are present as well as for seronegative patients, patients with vague symptoms of long duration, and previously-treated patients with recurring symptoms.

Receipt of payment for the testing and a signed Requisition Form is required upon submission of patient's test specimen to IGeneX, with the exception of Medicare patients.