Over recent years, a multitude of pathogens have been reported to be tick-borne. Given this, it is unsurprising that these might co-exist within the same tick, however our understanding of the interactions of these agents both within the tick and vertebrate host remains poorly defined. Despite the rich diversity of ticks, relatively few regularly feed on humans, 12 belonging to argasid and 20 ixodid species, and literature on co-infection is only available for a few of these species. The interplay of various pathogen combinations upon the vertebrate host and tick vector represents a current knowledge gap. The impact of co-infection in humans further extends into diagnostic challenges arising when multiple pathogens are encountered and we have little current data upon which to make therapeutic recommendations for those with multiple infections. Despite these short-comings, there is now increasing recognition of co-infections and current research efforts are providing valuable insights into dynamics of pathogen interactions whether they facilitate or antagonise each other. Much of this existing data is focussed upon simultaneous infection, however the consequences of sequential infection also need to be addressed. To this end, it is timely to review current understanding and highlight those areas still to address.
Key Quote: “Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”
But there is another important point.
According to this review, 83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe. The review also states it takes 11 different visits to 11 different doctors, utilizing 11 different tests to be properly diagnosed. https://www.news-medical.net/news/20181101/Tick-borne-disease-is-multiple-microbial-in-nature.aspx?
It has also been discovered that many are infected with Borrelia miyamotoi which will also not be picked up with current CDC 2-tiered testing.
- Among positive ticks, 60% were for B. miyamotoi.
- Testing on over 2,000 humans (mainly late stage/chronic patients) showed 30% negative results and 70% positive, among which over 60% indicated the presence of specific Borrelia miyamotoi phages.