Babesiose (ticks)

Many people have become terrified for tick bites due to messages in the media. Unfortunately these messages are not always very clear and truthful. What exactly is known concerning the autochthonous Babesiose so far and what should we do?

FOREIGN TICKS
It was diagnosed that the sick dogs had been infected with Babesia Canis, a protozoiasis blood parasite which is passed by the so-called Dermacentor Tick (Foreign infection diseases). This is a tick type of which we have assumed so far that it didn’t “live” in the Netherlands. Dermacentor ticks have been found before on dogs of owners who returned from a holiday and they probably, connected with this, have been found incidentally on dogs which hadn’t been abroad. Next to the many import cases, so far only few autochthonous cases of Babesiose have been described in the Netherlands (only with 2 dogs in Koog aan de Zaan and with 3 dogs on the Veluwe in the eighties). At that time the ticks have probably been brought from abroad by other dogs; they fell off the dogs here and probably passed the infection after sloughing, without permanent establishment.

TICK RESEARCH
Further research will have to show if the Dermacentor ticks have established themselves in the Netherlands in the meantime. There are theories that this would be possible as a result of the warmer climate in our country during the last few years. Especially the soft winters would be more favorable for the ticks in order to be able to survive. In order to be able to chart the possible presence and the spread of this tick in the Netherlands as good as possible it is useful to turn in found or removed ticks with us for determination. Up till now this determination has been executed without costs by a parasitologist of the University Clinic for Domestic Animals in Utrecht. Turn the tick or ticks in, in a closed little pot within 2-3 days after you have found it. On the little pot you write (readable) your residence and the spot where you found the tick/ticks (in case it deviates from the residence).

BABESIOSE (TICK FEVER). Babesia Canis exclusively develops itself in the red blood cells of the dog. The incubation period varies from 1-2 weeks. In the acute stage you observe the following symptoms: listlessness, high fever, faster pulse and breath. Since a massive blood decomposition takes place, the dog will get anaemia (pale mucous membranes) and an urine with a red/brown color (also see Foreign Infection Diseases). Fortunately, there is a treatment for this disease. The treatment must take place with the means Imidocarb (Carbesia®). Your veterinarian must prescribe a prescription for the drugstore of the University Clinic for Domestic Animals in Utrecht. The treatment must start as early as possible and consists of 2 injections with an interval of 10 days. In case the treatment starts in time there is high pass rate. By the way, dogs which survive keep the infection (during months or possibly years) and afterwards they become (partially) resistant to this disease.

PREVENTION
It is very important to take preventive measures against ticks. There is a vaccine against Babesiose, but this vaccine only protects partially (the dog becomes sick but less serious) and the vaccine doesn’t protect against all variants of Babesiose. Besides, it is a very expensive vaccine and it is very painful for the dog when it is administered. So far, we don’t advise to vaccinate preventively! A preventive treatment with the means Carbesia® is probably useless. There are various means available for tick prevention. For the time being, the best means is the Frontline® spray (pipettes are less effective against ticks!) or a good tick leash. We advise the Scalibor® tick leash. Especially with long-haired dogs which often come in areas which contain many ticks (undeveloped grounds, rough grasslands and woods with a lot of low overgrowth) it might be useful to combine the means (spray and tick leash). If you use the spray you must especially spray the chest, neck and head area. You’d better don’t spray the head but dab it with a wad of cotton wool in order to avoid direct contact with eyes or mucous membranes of nose and beak. Keep the prescribed doses! Tick pesticides are and remain poison! We must realize that there is no tick pesticide which gives 100% guarantee against a tick infection. Check your dog every day so that you can remove the ticks as early as possible. The ticks need 2-3 days to pass the disease! Remove the ticks, without anaesthetizing them with alcohol or something else in advance. Preferably use a tick remover in order to remove the ticks completely easily.

FINALLY
Summarizing, it is important, especially in risk areas, to apply tick prevention and to check your dog every day. In case of doubt contact your veterinarian. For the time being it isn’t necessary yet to start vaccinating preventively or to be terrified, in contrast with the messages in the media. We keep you up to date concerning the ticks and the possible accompanying dangers!

VACCINATION AGAINST BABESIOSE; USEFULL OR NONSENSE?
MA. Amanda van Grondelle, veterinarian of the WHG Westerhuis Clinic for Domestic Animals, Dalwagen 29c, 6669 CA Dodewaard; T +31-488-410040; www.whgdierenartsen.nl
N.B. Our hand-outs aren’t only made based on scientific literature, but also based on our own insights and personal experiences. For this reason the information might deviate from the common literature.

INTRODUCTION
Babesiose is a disease which, just like other diseases passed by ticks, has received a lot of attention lately. It used to be a disease which we associated with journeys to Southern Europe or to (sub) tropical spots; nowadays, however, we notice the ticks infected with Babesia more often northerly. It has been proved in the meantime that you can get a Babesia infection in our own (cold) country. It is therefore logical that a good protection against this disease is required. In Holland you can buy a vaccine against Babesiose: Pirodog®. But is this a good vaccine? And are there negative aspects concerning a vaccination with Pirodog?

THE FACTS
Pirodog® contains the so-called ‘SPA’s’. These are Soluble Parasite Antigens. In other words: dissolvable molecules produced by the parasite (Babesia) with toxic characteristics which can stimulate the defense mechanism to produce antibodies. It isn’t therefore possible that an animal will get a real Babesia infection since there are no living parasites in the vaccine. In order to stimulate the defense mechanism additionally a material is added which is called ‘adjuvans’. This adjuvans can cause a local action: a (painful) lump on the injection spot. This phenomenon is also known with other vaccines to which an adjuvans is added (for example Pneumodog®).

The mentioned SPA’s are materials which are able to arouse an anti-body response with healthy animals, due to which the body can handle a real Babesia infection better. SPA’s also enter the blood in case of a natural infection. These SPA’s remain responsible for the most important acute symptoms with a Babesia infection. With vaccinated dogs antibodies against these SPA’s are already present, due to which the SPA content in the blood becomes less high. It appears that a vaccinated dog becomes less seriously ill in case of a Babesia infection: the general symptoms are less severe, the decrease of the red blood cells is less serious and the disease lasts shorter.

Research shows that the SPA’s, in the acute stage of an infection, cause a kind of shock state with a too low blood pressure. The body responds on it by withdrawing fluid from the tissue, in order to enlarge the circulating blood volume. This phenomenon can also take place in case of vaccination; after all we administer the SPA’s by means of injection!

Unfortunately a vaccination doesn’t protect against the infection. Therefore it isn’t true that a dog which has been vaccinated with Pirodog® cannot get a Babesia infection! We therefore observe as many parasites in the blood of both vaccinated dogs and dogs which haven’t been vaccinated. Vaccination therefore doesn’t contribute to reducing the spread of Babesia. With many other vaccinations (for example Parvo, distemper, and cat’s disease) this is the case.

The SPA’s which are in the vaccine appear to be rather specific. This means that a dog which has been vaccinated with Pirodog®, but gets infected by another variant of the Babesia parasite than the one which has been used to produce the vaccine, has zero protection. The chance on such a so-called heterologous infections is very realistic, by the way. There isn’t a vaccine which gives 100% protection. Certain animals are not able to produce a sufficient high content of antibodies. This might have various reasons, like age, bad general health, other contagious diseases, condition, hereditary qualities and certain medicines. It is therefore always important that we check an animal before a vaccination and weigh the pros and cons against each other. In case of a vaccination against a disease which already has immune suppressed characteristics, like with Babesiose, this assessment is even more important. After all, we administer materials which might cause this immune suppression. In case a dog has had Babesiose in the past, it might concern a chronic carrier. The vaccination will be less effective with these dogs.

CONCLUSIONS AND RECOMMENDATIONS
In the prevention of Babesiose a good tick fight is more important than the vaccination!!!! If you choose to vaccinate than only vaccinate healthy animals with a good functioning immune system. Don’t vaccinate dogs which get immune suppressing medicines like prednisone, cyclosporine, and cytostatica and so on. Medicines against Babesiose are also immune toxic. In case of a vaccination with Pirodog® don’t vaccinate against other diseases at the same time. Other vaccinations must be administered at least 3 weeks before or after a vaccination with Pirodog®. We advise to put the animals 12 hours before the vaccination on a fluid diet and to make sure that any stress is avoided during 48 hours upon vaccination. The first weeks upon vaccination you many not expose the dogs to heavy physical exercise

FINALLY
Above mentioned plea will probably indicate clearly that we (WHG veterinarians), for the time being, advise against a routine vaccination with Pirodog. Also in case of journeys to areas where Babesiose often is present. In our opinion, the advantages don’t outweigh the limitations and advantages of the vaccination. Number 1 in the fight against Babesiose remains good tick prevention, in our opinion. We advise the Scalibor® tick leash possibly in combination with the Frontline® spray and a daily check of your dog. Only in specific cases a Pirodog® vaccination might be worth considering.