babesia checklist
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The Babesia Checklist

Improving Detection of a Common Emerging Stealth Infection

Below are examples of signs, symptoms and indirect ways to help increase the diagnosis of Babesia. An examination of public genetic databases shows well over thirty-five species exist, many of which have variants. Please note that an unknown percentage of people infected have no symptoms, at least for many years.

This checklist is not meant to be used as a definitive tool to diagnose Babesia. I would suggest no definitive 100% or even 98% sensitive tool exists. My goal is merely to decrease illness resulting from false negative patients, i.e., people who are positive but do not show up as positive on a basic direct test.

Indeed, it is not uncommon for a patient with Babesia to present with a negative test result over ten times, regardless of the lab, and then to show up positive on DNA testing when exposed to two or three protozoa treatments for three days, or to have positive antibody testing six weeks after a similar provocation trial.

I do not oppose or endorse such approaches, but feel it necessary to mention that this has happened with “malaria” prevention treatment. Additionally, there have been instances in which the use of herbs, such as artesunate, for cancer prevention, has resulted in an unintended outcome: the conversion of a Babesia titer from negative to positive.

I have authored four books on the topic of Babesia so this scale is based on years of full time reading and a passion to advance detection.

If you also have a desire to try to master Babesia as much as possible, start by reading the entire World Pub literature on Babesia over several years, and then utilize that knowledge by focusing on treating this infection for over five years. I would appeal to you that one cannot be considered an expert in treating this fatal infection by merely reading a few articles or guidelines. Nor is expertise acquired by diagnosing and treating the highly obvious, immensely ill, sickest 1% of patients as the “norm” in Babesia diagnosis. The cure of Babesia does not fit a set formula, but no one should be hopeless about reaching a full recovery.

In summary, how can any certain medical or scientific Babesia position exist, when new species that infect humans are routinely emerging, and for which there is not even a direct test—regardless of sensitivity?

Please Circle All Symptoms That Apply

  1. Headaches with no clear cause
  2. Headaches that are hard to control and/or severe?
  3. Weight gain in clear excess of diet and exercise
  4. Weight loss with reasonable eating and average exercise
  5. Fatigue in excess of that experienced by most people in the same age range
  6. Fatigue that produces need for sleep in excess of 8 ½ hours daily
  7. Fatigue with ongoing insomnia [consider the possibility of both Bartonella and Babesia in this case]
  8. Daytime sleep urgency despite nighttime sleep
  9. Shortness of breath [no clear asthma, pneumonia, COPD or other common cause]
  10. Swelling in limbs and other parts of body
  11. Night sweats
  12. Excessive perspiration during normal daily activity
  13. Hot flashes in a normal temperature room
  14. A poor appetite
  15. Intermittent fever
  16. Chills
  17. A high fever
  18. A high fever in excess of three days
  19. Slowed thinking
  20. Listlessness
  21. Excess breast tissue in a man or boy
  22. Any decrease in appetite
  23. Severe chest wall pains
  24. Random stabbing pains
  25. Any enhanced sense: sensitivity to light, touch, smells or sound
  26. Family, friends or others report you look tired or foggy
  27. Nausea or vomiting
  28. A sense of imbalance
  29. Dark urine [this is rarer than some articles intimate]
  30. An enlarged liver (which sits under your right rib cage)
  31. An enlarged spleen (under your left rib cage). This is falsely believed to be a common human sign; actually it is very rare.
  32. A yellow hue on eyes, hands and skin (jaundice) with no other clear cause.
  33. Enlarged lymph nodes (but also in Lyme, Bartonella, other infections, high inflammation, tumors and other diseases)
  34. Brain troubles such as trouble keeping up with past routine life demands, lateness due to trouble with motivation and organization, and trouble with concentration [Any of these would be a positive]
  35. Memory troubles [this is not specific to one infection or one disease process. For example, exposure to indoor mold’s biological chemicals can decrease memory within an hour depending on the species mix.]
  36. Profound psychiatric illnesses [this is not limited to a single infection]
  37. Waves of generalized itching [this sign of infection and inflammation is not limited just to Babesia].
  38. Spike of a fever over 100.5 after a possible tick bite.
  39. Excess fat in lower belly area that is in excess of lifestyle and activity.
  40. Lumps or other types of tissue collection with no clear cause [Other tick and flea-borne infections can also cause these growths]
  41. One or more medical problems with unclear cause(s), with changing or contradictory diagnoses, or which are eventually called “idiopathic.”
  42. You have received blood from another person
  43. Psychiatric label(s) given for a child’s or, relatives for all their troubles when clear medical problems exist as shown by abnormal laboratory results (I am not talking about basic organ failure labs, but the use of wide testing which includes inflammation and anti-inflammation chemicals, hormones, nutrient levels, and other immune system chemicals
  44. You have two tick or flea infections with two positive tick or flea borne viruses, bacteria or protozoa. The presence of other infections such as tick borne viruses or bacteria raises suspicion of a Babesia infection.
  45. The presence of one or more mystery illnesses


  1. Absolute Eosinophils in the low or high range [this is not definitive in any manner, but is a useful tool]
  2. A percentage of Eosinophils in low range or high normal range
  3. Very high Eosinophils [rare with Babesia, but other findings suggest other possible causes]
  4. A normal or low VEGF lab result in the presence of Bartonella
  5. A TNF-a in excess of 1.0 in the presence of Bartonella
  6. A CD57 or CD57/8 level that drops right after the start of a Babesia treatment, or which falls steadily with ongoing treatment
  7. Hemolytic anemia with lab positive blood products in your urine [this is not a routine finding]
  8. Your clinician understands the use of indirect testing and feels your lab pattern is suggestive of the presence of Babesia. This involves more than an ECP spike.
  9. Since direct testing for Babesia by any lab misses many human species and is of variable reliability, and the common presence of Bartonella suppresses some antibody tests, a positive or “indeterminate” is likely a positive. Have you had an “indeterminate” or “borderline” Babesia result?
  10. After Babesia treatment with clear protozoa killing agents used also to kill malaria, IL-6 moves from very low to an increased level.
  11. After Babesia treatment with clear protozoa killing agents used also to kill malaria, IL-1B moves from very low to an increased level.

Reaction or Changes in Body

  1. I react to any derivative of Artemisia (Sweet Wormwood).
    *Note: the reaction does not need to last more than a day and any immediate stomachaches or loose stool do not apply.
  2. I react to a malaria drug. (It requires profound wisdom for a clinician to distinguish between a side effect and a reaction caused by an effective Babesia treatment. For example, insomnia caused by the synthetic drug Larium is meaningless, since Larium has this as a side effect in uninfected patients. But fatigue and a severe headache resulting from a teaspoon of Mepron on day one are very suspicious symptoms for a known protozoan like Babesia or Malaria or other similar infections that are newly identified genetically).
  3. Mood changes with any herb or drug that kills protozoa like Babesia, with the exception of Larium
  4. Muscle aches or joint aches/pain, especially worse after use of a protozoa killing medicine such as proquanil, Alinia, ativoquone, clindamycin, or one of many new emerging progressive natural medicine or synthetic malaria drug treatments
  5. Insomnia after taking a malaria killing herb or drug
  6. Anxiety and/or depression after taking a malaria killing herb or drug
  7. Rage or temporary personality regression right after use of a malaria killing herb or medication


  1. Pets, farm animals or local relatives with ANY tick borne virus, bacteria or protozoa or clinical symptoms without a clear diagnosis or cause.
  2. Sexual contact is a debated form of communication of some tick and flea borne infections. I have no position. Isolation in a body fluid does not mean that is a route to spread the infection. If you and your healer feel this is a possible route of infection, has the patient had intimate contact with the sharing of body fluids with an infected person?
  3. The patient’s mother is suspected of having or has been diagnosed with Babesia, Ehrlichia, Rocky Mountain Spotted Fever, Anaplasma, Lyme or Bartonella based on newer direct and indirect testing or clinical signs and symptoms.
  4. A sibling, father, spouse or child with any tick borne infection who shared a residence or vacation with proximity to brush (wooded area).
  5. Exposure to outdoor environments with brush, wild grasses, wild streams, golf courses or woods in excess of ten minutes in any location lived in or visited since the age of eighteen months of age without the use of DEET or very high off-gassing essential oils on exposed skin areas.
  6. Your pet(s) or family animals of any type, e.g., horses, have had outdoor exposures to areas such as brush, wild grasses, wild streams or woods. If the pets were animals such as dogs, which can be given anti-tick and flea treatments, were these animals always on schedule with these treatments?
  7. Have you had clear exposure to ticks in your current or past homes? This includes exposures starting at the age of two years old.
  8. Have you had clear exposure to ticks during vacations or other travels?
  9. Do you assume that a flea or tick bite which is infectious must have some type of rash?


No blood smear will be positive for Babesia unless you have a profoundly massive number of infected red blood cells, which is rare. Therefore, no blood smear should be considered negative unless it has been examined for thirty minutes. While a 2-3 minute exam of large white blood cells may be fully sufficient to identify cancers and other diseases, a search for over eighty Babesia red blood cell presentations under 1000x, as found in my book, Hematology Forms of Babesia, requires at least thirty minutes, which requires private contracting with a microbiologist or pathologist or a favor from a lab director. Please appreciate that stains help define whether a substance is what it appears to be.

Babesia is an emerging infection. Any certainty claims or criticism about Babesia positions without extensive research and over 200 hours of reading is premature. Again, new Babesia species are emerging every one to four months. Indeed, even a new protozoan has been found that looks like Babesia under a high powered microscope, but when it is genetically sequenced it is not Babesia or immature malaria, which can look similar. It is a new infection.

Therefore, since this is a new emerging illness, this scale is meant merely to increase awareness of Babesia, an infection that can kill patients of any age. Writings in the past fifteen years have either seen Babesia as a mere “co-infection” or a footnote of a spirochete infection [e.g., Lyme]. Anything that can hide for a couple of decades, and then possibly kill you with a clot or by other means, is not a casual infection.

Babesia cure claims should be made with the use of indirect testing birthed from extracts of superior journals read over five years. Currently, these many well-established indirect lab test patterns are not used or understood by immensely busy and smart clinicians working full-time. While this is fully understandable, I hope it may change in the coming decade.

Dr. Schaller is the author of 29 books and 27 top journal articles. His publications address issues in at least twelve fields of medicine.

He has published the most recent four textbooks on Babesia.

He has published on Babesia as a cancer primer under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea borne infections, including Babesia [along with Bartonella and Lyme disease], were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.

Dr. Schaller has produced six texts on tick and flea-borne infections based on his markedly unique full-time reading and study practice, which is not limited to either finite traditional or integrative progressive medicine. With a physician’s medical license, he has been able to sort through many truth claims by ordering lab testing. He does not casually follow the dozens of yearly truth claims, without indirect testing laboratory proof. He has read full-time on these emerging problems for many years. He is rated a TOP and BEST physician. One of these award ratings is based on physician peer ratings.


© 2011 James Schaller, MD, MAR version 37.

This form may not be altered if it is printed or posted, in any manner, without written permission. Posting a critical or negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered, including these final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.

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