Babseiosis - A Malaria-Like Disease Spread By Ticks - Spreading Rapidly Through Mid-Atlantic States
Ellen Stromdahl was at a garden party in coastal Virginia in June 2023 when her friend Albert Duncan stood up from where he was sitting and abruptly fainted. Duncan is an outdoorsman in his mid-80s — still active and healthy for his age. Stromdahl, an entomologist who works for the United States Army Public Health Center, the Army’s public health arm, rushed to his side. As Duncan came to, she noticed that his tanned skin was tinged with yellow. “This man looks jaundiced,” she thought to herself.
Duncan spent the next several days in and out of the emergency room. His doctors administered countless blood tests and ruled out the usual suspects for an octogenarian — heart disease, diabetes, pneumonia. Finally, on Stromdahl’s recommendation, Duncan’s wife, Nancy, asked his doctors to test him for babesiosis, a rare malaria-like disease caused by microscopic parasites carried by black-legged ticks. The test came back positive not just for babesiosis but also for Lyme disease, another far more common illness caused by the same type of tick.
If Duncan’s doctors had caught the infections sooner, they could have eradicated them with a combination of oral antibiotics and antiparasitic medications. But Duncan, weeks into his illness, needed a procedure called an exchange transfusion. Doctors pumped all of the infected blood out of his body and replaced it with donor blood. About two weeks after the garden party, he was well again.
Babesiosis is rare — the Centers for Disease Control and Prevention reports around 2,000 cases in the United States every year. But what made Duncan’s case even more unusual is that he contracted babesiosis in Virginia, a state that registered just 17 locally acquired cases of the disease between 2016 and 2023. It got Stromdahl wondering if babesiosis could be becoming more common in Virginia and neighboring states. She spent the following two years working with a team of 21 tick researchers from across the eastern U.S. and South Africa to assess the prevalence of Babesia microti, the parasite that causes babesiosis, in ticks and humans in those states from 2009 to 2024. The results of the study, published in April in the Journal of Medical Entomology, reveal that the Babesia parasite is rapidly expanding through the mid-Atlantic. This shift, which has coincided with changing weather patterns, could pose a serious threat to people in communities where the disease has long been considered rare.
EDIT
https://grist.org/health/babesiosis-mid-atlantic-delaware-maryland-virginia-tick-borne-disease-lyme-research/
= new reply since forum marked as read
/s? 
While the heart is not beating.
Sometimes exchange can involve removing and exchanging small amounts of blood at a time until the desired percentage has been achieved with two catheters in separate and usually oppositional (e.g., right and left leg) veins to allow removal and transfusion simultaneously to equalize over a long period of time or using a central venous line to administer the treatment more rapidly. But, if a full exchange is the goal, as in a major sickle cell crisis or where it is critical to remove all infected (or in the case of some toxins, "affected" ) blood to replace with tested blood/plasma, then cardiopulmonary bypass (CPB) may be needed.
With the parasite Babesia in overwhelming infection, it may still be possible to do a partial exchange transfusion (without CPB) that may be less than complete but sufficient to stabilize. The patient would then receive appropriate medications to clear the blood of any remaining parasites--usually atovaquone and azithromycin in humans, doxycycline + enrofloxacin + metronidazole in dogs (and being looked at in humans). Yeah, I've seen a few cases, albeit none diagnosed so late as to require blood exchange.
Probably TMI, but that's your answer. 
