Archive for the ‘Babesia’ Category

What’s in the TBDWG Report For Morgellons Patients?

https://www.morgellonssurvey.org/whats-in-the-tbdwg-report-for-morgellons-patients/What’s in the TBDWG Report for Morgellons Patients?

What’s in the TBDWG Report for Morgellons Patients?

 

In December of 2018, the Tick-Borne Disease Working Group released its first report to Congress regarding the epidemic of emerging disease. This article gives a basic rundown of relevant statements contained in the first of three TBDWG reports to Congress.

What is the Tick-Borne Disease Working Group?

The TBDWG is a fourteen-member panel of infectious disease professionals called together in light of the 21st Century Cures Act and organized by the Department of Health and Human Services. This group is tasked with reviewing the current science and treatment progress of the various tick-borne diseases and reporting their findings to Congress every two years in December. December 2018 saw the first report, there will be a second report in December 2020 followed by final recommendations at the end of 2022.

So what does this first report detail regarding Morgellons disease? Let’s dive in and find out!
Chronic Lyme Disease

At the start of the first TBDWG report it is stated,

“While most Lyme disease patients who are diagnosed and treated early can fully recover, 10 to 20% of patients suffer from persistent symptoms, which for some are chronic and disabling. Studies indicate that Lyme disease costs approximately $1.3 billion each year in direct medical costs alone in the United States.”

Sounds promising, but what about the insensitive testing methods? What does the report say about early diagnosis and why there are so many false negatives? Amazingly the report addresses these concerns directly, “Today, available diagnostic tests can be inaccurate and complex to interpret, especially during the earliest stage of infection when treatment is most effective. Unlike in other infectious disease settings, tests to directly measure the presence of the infecting organism, such as cultures or tissue biopsies, are not available for some tick-borne diseases such as Lyme disease. This leaves physicians without the tools needed to diagnose; and without an accurate diagnosis, it is challenging for physicians to provide early treatment.”

Wow! With that kind of admission about standard Lyme testing, you would expect similar honesty regarding other controversial aspects of Lyme disease. What about congenital transmission then, what does this report state about Lyme infecting unborn children?

Lyme Congenital Transmission

From the report, the sole instance of recognition appears on page 53 in the chapter titled “Treatment”. It states,

“Pregnancy: Transplacental infection of the human fetus has been recognized for relapsing fever borreliosis, as well as Lyme disease, babesiosis, and certain arthropodborne flaviviruses. Pregnancy poses particular challenges for treatment because few antimicrobials have been approved and are safe to use during pregnancy. Additional research into appropriate treatment options are needed.”

It’s right there in black and white and from the red, white and blue state of American Freedom and Democracy! Why then would the World Health Organization remove such an apparent consideration from its medical coding system?

But what about Morgellons specifically? What does this report elicit about those afflicted with this particular skin manifestation that’s been thoroughly associated with tick-borne disease?

What’s in the report for Morgellons?

Keyword analysis of the report reveals seventeen instances of the term “skin” speckled throughout. The first instance is regarding frequent skin lesions that occur early in the infectious process. It continues to state that with early treatment the better prognosis can be achieved. While that’s great and everything, what else does it say about skin lesions that may be particularly relevant?

Morgellons Disease

The next two instances of “skin” in the report occur regarding utilizing skin agents to deter ticks from attaching to the skin. The following six instances regard the characteristic erythema migrans bullseye rash and that relates to early diagnosis. This section is interesting in that it elaborates on the many kinds of erythema migrans that can occur and gives a visual presentation of each. Still, none of these erythema migrans look anything at all like Morgellons ulcerations.

The tenth and eleventh occurrence of the term “skin” in the first of three TBDWG reports to Congress are of interest as they describe Figure 10 in the report, “Skin Rashes of Tick-Borne Diseases”. Figure 10.a depicts Tularemia which is a Tick-Borne Infection (TBI) that produces lesions in the skin. The difference between Tularemia and Morgellons, however, is Tularemia does not produce collagenous fibers, which are the defining characteristic of Morgellons disease.

Tularemia Lesion

Occurrence twelve describes how skin rashes present early in dissemination and appears alongside a figure that demonstrates how the IgM response falls off over time, leaving a patient with primarily elevated IgG antibodies.

“Skin” appears for the thirteenth and fourteenth time in the report regarding the challenges of diagnosing skin rashes in individuals with darker skin tone. This section stresses the importance of TBI education in areas where Lyme is not considered endemic, as a lapse in diagnosis can result in severe patient complications.

The fifteenth and sixteenth use of the term “skin” appear alongside information regarding how the disease disseminates from the skin to other organs of the body in the sixth chapter which details treatment. This section is completely fascinating, eliciting how infected patients are more susceptible to re-infection and how mice vaccinated against influenza produced a suppressed immune response to the flu in light of their infection with Borrelia burgdorferi.

If Lyme disease can suppress the immune response for diseases other than itself, what else can it accomplish?

The final instance of the term “skin” in the TBDWG report to Congress is alongside recognition of NIAMS, the National Institute of Arthritis and Musculoskeletal and Skin Diseases. We went to the NIAMS website and was not at all surprised to produce a lack of search results for the termMorgellons“.

Is the TBDWG Report Good?
Canines Ticks Diseases https://www.maxpixel.net/Canines-Ticks-Diseases-185885

The first TBDWG Report is surprising. It’s not at all littered with propaganda and falsehoods that plague our esteemed medical establishments. Besides not directly addressing Morgellons the report does reveal several controversial facts about Lyme disease that many in official health agencies currently disagree about. This is a refreshing move in what could be considered a positive direction.

This report did not try to appease the establishment, but at the same time, it doesn’t explore the full extent of the Lyme pandemic. The fact is the fourteen members of the TBDWG have two more reports to produce, and we know for certain many of them are aware of the significance Morgellons has relating to their efforts.

If a grade was to be applied to the first report it feels like this initial effort deserves a solid B+.

https://www.hhs.gov/ash/advisory-committees/tickbornedisease/index.html

 

2018 Review of Previous Pathogen Transmission Time Studies in Deer Ticks

https://www.ncbi.nlm.nih.gov/pubmed/29398603

2018 Mar;9(3):535-542. doi: 10.1016/j.ttbdis.2018.01.002. Epub 2018 Jan 31.

Pathogen transmission in relation to duration of attachment by Ixodes scapularis ticks.

Abstract

The blacklegged tick, Ixodes scapularis, is the primary vector to humans in the eastern United States of the deer tick virus lineage of Powassan virus (Powassan virus disease); the protozoan parasite Babesia microti (babesiosis); and multiple bacterial disease agents including Anaplasma phagocytophilum (anaplasmosis), Borrelia burgdorferi and Borrelia mayonii (Lyme disease), Borrelia miyamotoi (relapsing fever-like illness, named Borrelia miyamotoi disease), and Ehrlichia muris eauclairensis (a minor causative agent of ehrlichiosis).

With the notable exception of Powassan virus, which can be transmitted within minutes after attachment by an infected tick, there is no doubt that the risk of transmission of other I. scapularis-borne pathogens, including Lyme disease spirochetes, increases with the length of time (number of days) infected ticks are allowed to remain attached. This review summarizes data from experimental transmission studies to reinforce the important disease-prevention message that regular (at least daily) tick checks and prompt tick removal has strong potential to reduce the risk of transmission of I. scapularis-borne bacterial and parasitic pathogens from infected attached ticks.

The most likely scenario for human exposure to an I. scapularis-borne pathogen is the bite by a single infected tick. However, recent reviews have failed to make a clear distinction between data based on transmission studies where experimental hosts were fed upon by a single versus multiple infected ticks. A summary of data from experimental studies on transmission of Lyme disease spirochetes (Bo. burgdorferi and Bo. mayonii) by I. scapularis nymphs indicates that the probability of transmission resulting in host infection, at time points from 24 to 72 h after nymphal attachment, is higher when multiple infected ticks feed together as compared to feeding by a single infected tick.

In the specific context of risk for human infection, the most relevant experimental studies therefore are those where the probability of pathogen transmission at a given point in time after attachment was determined using a single infected tick. The minimum duration of attachment by single infected I. scapularis nymphs required for transmission to result in host infection is poorly defined for most pathogens, but experimental studies have shown that Powassan virus can be transmitted within 15 min of tick attachment and both A. phagocytophilum and Bo. miyamotoi within the first 24 h of attachment. There is no experimental evidence for transmission of Lyme disease spirochetes by single infected I. scapularis nymphs to result in host infection when ticks are attached for only 24 h (despite exposure of nearly 90 experimental rodent hosts across multiple studies) but the probability of transmission resulting in host infection appears to increase to approximately 10% by 48 h and reach 70% by 72 h for Bo. burgdorferi. Caveats to the results from experimental transmission studies, including specific circumstances (such as re-attachment of previously partially fed infected ticks) that may lead to more rapid transmission are discussed.

________________

**Comment**

There are a number of problematic issues with this study:

  1. This is a review of previous studies.  There is nothing NEW here.  
  2. It’s important to note that ticks typically carry more than just borrelia and transmission times have not taken this fact into account: https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/ and https://www.lymedisease.org/lyme-basics/co-infections/about-co-infections/  Infection with more than one pathogen is associated with more severe illness.https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.  This is a BIG DEAL.  Finally, a study showing what we face as patients in the real world.  They also never take into account nematodes (worms), mycoplasma, tularemia, and/or Bartonella.  These are infections many if not most patients have to contend with.  Some have been bioweaponized.
  3. They assume that the most likely scenario is for a person to be bitten by one tick.  Assuming makes an ass out of u and me.  When you take into account the latest information on the Asian tick, you quickly realize the probability of coming into contact with hundreds if not thousands of ticks at one time:  https://madisonarealymesupportgroup.com/2018/09/12/three-surprising-things-i-learned-about-asian-longhorned-ticks-the-tick-guy-tom-mather/  While human infection has yet to be found in the U.S., this tick is responsible for plenty of misery in Asia:  https://madisonarealymesupportgroup.com/2018/06/12/first-longhorned-tick-confirmed-in-arkansas/  It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, it has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.
  4. While they discuss the probability of multiple tick attachment, they never discuss the issue of partially fed ticks, where spirochetes would be in the salivary glands – leading to quicker transmission: http://iai.asm.org/content/61/6/2396.full.pdf  Ticks can spontaneously detach – and the authors of this study found that they did so 15% of the time in mice.  They also state that about a tenth of questing nymphs appear distended with partially fed sub-adult ticks being common.
  5. While the current review states, “There is no experimental evidence for transmission of Lyme disease spirochetes by single infected I. scapularis nymphs to result in host infection when ticks are attached for only 24 h (despite exposure of nearly 90 experimental rodent hosts across multiple studies), this study shows transmission can occur in under 16 hours:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278789/
  6. https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/  Within this video, microbiologist Holly Ahern discusses the numerous problems with animal Bb transmission studies.  Transmission Time:  Only one study done on Mice. At 24 hours every tick had transmitted borrelia to the mice; however, animal studies have proven that transmission can occur in under 16 hours and it occurs frequently in under 24 hours.  No human studies have been done and https://www.dovepress.com/lyme-borreliosis-a-review-of-data-on-transmission-time-after-tick-atta-peer-reviewed-article-IJGM  no studies have determined the minimum time it takes for transmission.  And, never forget the case of the little girl who couldn’t walk or talk after a tick bite attachment of 4-6 hours:  https://madisonarealymesupportgroup.com/2016/12/07/igenex-presentation/
  7. They continue to blame Lyme/MSIDS on the black legged tick as the sole perp when experience and studies show there’s more potential transmitters at play:  https://madisonarealymesupportgroup.com/2018/11/07/are-mosquitoes-transmitting-lyme-disease/https://madisonarealymesupportgroup.com/2016/07/23/german-study-finds-borrelia-in-mosquitos/https://madisonarealymesupportgroup.com/2019/01/17/remember-deer-keds-study-shows-bartonella-causing-deer-ked-dermatitis-in-humans/
Please, quit doing reviews of previous data and do something new using better laboratory techniques!  We don’t need MORE of the same thing.

Study Shows Diminished Pathogen-specific Antibody Production in Coinfected Mice Contributing to Persistent Infection

https://www.ncbi.nlm.nih.gov/pubmed/30619263

Age-Related Differential Stimulation of Immune Response by Babesia microti and Borrelia burgdorferi During Acute Phase of Infection Affects Disease Severity.

Abstract

Lyme disease is the most prominent tick-borne disease with 300,000 cases estimated by CDC every year while ~2,000 cases of babesiosis occur per year in the United States. Simultaneous infection with Babesia microti and Borrelia burgdorferi are now the most common tick-transmitted coinfections in the U.S.A., and they are a serious health problem because coinfected patients show more intense and persisting disease symptoms. B. burgdorferi is an extracellular spirochete responsible for systemic Lyme disease while B. microti is a protozoan that infects erythrocytes and causes babesiosis. Immune status and spleen health are important for resolution of babesiosis, which is more severe and even fatal in the elderly and splenectomized patients.

Therefore, we investigated the effect of each pathogen on host immune response and consequently on severity of disease manifestations in both young, and 30 weeks old C3H mice.

At the acute stage of infection, Th1 polarization in young mice spleen was associated with increased IFN-γ and TNF-α producing T cells and a high Tregs/Th17 ratio. Together, these changes could help in the resolution of both infections in young mice and also prevent fatality by B. microti infection as observed with WA-1 strain of Babesia. In older mature mice, Th2 polarization at acute phase of B. burgdorferi infection could play a more effective role in preventing Lyme disease symptoms. As a result, enhanced B. burgdorferi survival and increased tissue colonization results in severe Lyme arthritis only in young coinfected mice. At 3 weeks post-infection, diminished pathogen-specific antibody production in coinfected young, but not older mice, as compared to mice infected with each pathogen individually may also contribute to increased inflammation observed due to B. burgdorferi infection, thus causing persistent Lyme disease observed in coinfected mice and reported in patients.

Thus, higher combined proinflammatory response to B. burgdorferi due to Th1 and Th17 cells likely reduced B. microti parasitemia significantly only in young mice later in infection, while the presence of B. microti reduced humoral immunity later in infection and enhanced tissue colonization by Lyme spirochetes in these mice even at the acute stage, thereby increasing inflammatory arthritis.

___________________
**Comment**
Glad to see more work done on the polymicrobial nature of Lyme/MSIDS as most of us out here in Lyme-land struggle with numerous pathogens, not just Lyme (borrelia).

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.”

Another problem:  

83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe.

https://madisonarealymesupportgroup.com/2018/11/17/investigating-disease-severity-in-an-animal-model-of-concurrent-babesiosis-lyme-disease/  These findings suggest that B. Burgdorferi coinfection attenuates parasite growth while B. Microti presence exacerbates Lyme Disease-like symptoms in mice.

https://madisonarealymesupportgroup.com/2018/10/02/1st-documented-case-of-girl-with-blood-stream-infection-with-bartonella-with-coinfection-of-another-bartonella-strain/

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/  Our study reveals high pathogen co-infection rates in ticks, raising questions about possible co-transmission of these agents to humans or animals, and their consequences to human and animal health. We also demonstrated high prevalence rates of symbionts co-existing with pathogens, opening new avenues of enquiry regarding their effects on pathogen transmission and vector competence.

https://madisonarealymesupportgroup.com/2018/10/11/babesia-found-in-patient-with-persistent-symptoms-following-lyme-treatment/  Because the Ixodes scapularis tick can harbour and transmit multiple parasites simultaneously, the possibility of coinfection should be considered in any patient not responding to appropriate initial medical therapy.

To date, ticks can transmit 18 and counting pathogens – ALL as devastating as Lyme: https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

https://madisonarealymesupportgroup.com/2017/10/28/lyme-wars-part-5-coinfections/  (Click on NBC link for new story.  Approx 5 Min.)  All tests came back negative.  Don’t be fooled.  This stuff ISN’T RARE!  Dr. Phillips discusses how Bartonella isn’t even on the radar and is often confused with Lyme as symptoms overlap greatly.

 

Multistate Infestation with the Exotic Disease Vector Tick Haemaphysalis Longhornis – U.S., Aug. 2017- Sept. 2018

https://www.cdc.gov/mmwr/volumes/67/wr/mm6747a3.htm

Multistate Infestation with the Exotic Disease–Vector Tick Haemaphysalis longicornis — United States, August 2017–September 2018

C. Ben Beard, PhD1; James Occi, MA, MS2; Denise L. Bonilla, MS3; Andrea M. Egizi, PhD4; Dina M. Fonseca, PhD2; James W. Mertins, PhD3; Bryon P. Backenson, MS5; Waheed I. Bajwa, PhD6; Alexis M. Barbarin, PhD7; Matthew A. Bertone, PhD8; Justin Brown, DVM, PhD9; Neeta P. Connally, PhD10; Nancy D. Connell, PhD11; Rebecca J. Eisen, PhD1; Richard C. Falco, PhD5; Angela M. James, PhD3; Rayda K. Krell, PhD10; Kevin Lahmers, DVM, PhD12; Nicole Lewis, DVM13; Susan E. Little, DVM, PhD14; Michael Neault, DVM15; Adalberto A. Pérez de León, DVM, PhD16; Adam R. Randall, PhD17; Mark G. Ruder, DVM, PhD18; Meriam N. Saleh, PhD14; Brittany L. Schappach10; Betsy A. Schroeder, DVM19; Leslie L. Seraphin, DVM3; Morgan Wehtje, PhD3; Gary P. Wormser, MD20; Michael J. Yabsley, PhD21; William Halperin, MD, DrPH22 (View author affiliations)

Summary

What is already known about this topic?

Haemaphysalis longicornis is a tick indigenous to Asia, where it is an important vector of human and animal disease agents, which can result in human hemorrhagic fever and substantive reduction in dairy production.

What is added by this report?

During 2017–2018, H. longicornis has been detected in Arkansas, Connecticut, Maryland, New Jersey, New York, North Carolina, Pennsylvania, Virginia, and West Virginia on various species of domestic animals and wildlife, and from two humans.

What are the implications for public health practice?

The presence of H. longicornis in the United States represents a new and emerging disease threat. Characterization of the tick’s biology and ecology are needed, and surveillance efforts should include testing for potential indigenous and exotic pathogens.

Haemaphysalis longicornis is a tick indigenous to eastern Asia and an important vector of human and animal disease agents, resulting in such outcomes as human hemorrhagic fever and reduction of production in dairy cattle by 25%. H. longicornis was discovered on a sheep in New Jersey in August 2017 (1). This was the first detection in the United States outside of quarantine. In the spring of 2018, the tick was again detected at the index site, and later, in other counties in New Jersey, in seven other states in the eastern United States, and in Arkansas. The hosts included six species of domestic animals, six species of wildlife, and humans. To forestall adverse consequences in humans, pets, livestock, and wildlife, several critical actions are indicated, including expanded surveillance to determine the evolving distribution of H. longicornis, detection of pathogens that H. longicornis currently harbors, determination of the capacity of H. longicornis to serve as a vector for a range of potential pathogens, and evaluation of effective agents and methods for the control of H. longicornis.

H. longicornis is native to eastern China, Japan, the Russian Far East, and Korea. It is an introduced, and now established, exotic species in Australia, New Zealand, and several island nations in the western Pacific Region. Where this tick exists, it is an important vector of human and animal disease agents. In China and Japan, it transmits the severe fever with thrombocytopenia syndrome virus (SFTSV), which causes a human hemorrhagic fever (2), and Rickettsia japonica, which causes Japanese spotted fever (3). Studies in Asia identified ticks infected with various species of Anaplasma, Babesia, Borrelia, Ehrlichia, and Rickettsia, and all of these pathogen groups circulate zoonotically in the United States (4,5). In addition, parthenogenetic reproduction, a biologic characteristic of this species, allows a single introduced female tick to generate progeny without mating, thus resulting in massive host infestations. In some regions of New Zealand and Australia, this tick can reduce production in dairy cattle by 25% (6). Before 2017, H. longicornis ticks were intercepted at U.S. ports of entry at least 15 times on imported animals and materials (James W. Mertins, U.S. Department of Agriculture [USDA], personal communication).

The USDA Animal and Plant Inspection Service coordinated cooperative efforts through telephone conference calls with various local, state, and federal agricultural and public health agencies. Through these efforts, enhanced vector and animal surveillance were implemented to detect additional tick infestations. Suspect archival specimens that were available among previously collected ticks were also examined. Ticks were identified definitively by morphology at the USDA National Veterinary Services Laboratories or by DNA sequence analysis (molecular barcoding) at Rutgers University Center for Vector Biology, Monmouth County (New Jersey) Mosquito Control Division; College of Veterinary Medicine, University of Georgia; and Center for Veterinary Health Sciences, Oklahoma State University. By definition, a “report” is any new morphologic or molecular identification of H. longicornis ticks with a new county or host species from that county, identified from August 2017 through September 2018. Subsequent repeat collections are not reported here.

From August 2017 through September 2018, vector and animal surveillance efforts resulted in 53 reports of H. longicornis in the United States, including 38 (72%) from animal species (23 [61%] from domestic animals, 13 [34%] from wildlife, and two [5%] from humans), and 15 (28%) from environmental sampling of grass or other vegetation using cloth drags or flags* or carbon dioxide–baited tick traps. With the exception of one report from Arkansas, the remaining reports of positively identified ticks are from eight eastern states: New Jersey (16; 30%), Virginia (15; 28%), West Virginia (11; 21%), New York (three; 6%), North Carolina (three; 6%), Pennsylvania (two; 4%), Connecticut (one; 2%), and Maryland (one; 2%) (Figure). Among the 546 counties or county equivalents in the nine states, ticks were reported from 45 (8%) counties (1.4% of all 3,109 U.S. counties and county equivalents) (Table 1). Excluding 15 reports of positive environmental sampling using flagging, dragging, or carbon dioxide traps, the remaining 38 reports reflect collection of ticks from infested host species (Table 2). Surveillance efforts did not include testing the ticks or hosts for pathogens. No cases of illness in humans or other species were reported. Concurrent reexamination of archived historical samples showed that invasion occurred years earlier. Most importantly, ticks collected from a deer in West Virginia in 2010 and a dog in New Jersey in 2013 were retrospectively identified as H. longicornis.

Discussion

Cooperative efforts among federal, state, and local experts from agricultural, public health, and academic institutions during the last year have documented that a tick indigenous to Asia is currently resident in several U.S. states. The public health and agricultural impacts of the multistate introduction and subsequent domestic establishment of H. longicornis are not known. At present, there is no evidence that H. longicornis has transmitted pathogens to humans, domestic animals, or wildlife in the United States. This species, however, is a potential vector of a number of important agents of human and animal diseases in the United States, including Rickettsia, Borrelia, Ehrlichia, Anaplasma, Theileria, and several important viral agents such as Heartland and Powassan viruses. Consequently, increased tick surveillance is warranted, using standardized animal and environmental sampling methods.

The findings in this report are subject to at least two limitations. First, the findings are limited by the variable surveillance methods used to identify the geographic and host distribution of H. longicornis. These methods included both passive and active surveillance. Conclusions about the geographic and host distribution might reflect the biases in the collection and submission of samples to states and USDA and the paucity of available information. Second, the data in this report reflect the collection of specimens that were positively identified by morphology or molecular barcoding. These represent sentinels that H. longicornis is present in different U.S. states and regions, and not a comprehensive assessment of the distribution of H. longicornis in the United States. The absence of positive samples from many states and counties might reflect the absence of infestation, absence of sampling, or failure to recover the tick. Even in states where H. longicornis has been found, the available data do not describe the actual extent or intensity of infestation.

The biology and ecology of H. longicornis as an exotic species in the United States should be characterized in terms of its vector competence (ability to transmit a pathogen) and vectorial capacity (feeding habits, host preference, climatic sensitivity, population density, and other factors that can affect the risk for pathogen transmission to humans) for tickborne pathogens known to be present in the United States (5). Surveillance for H. longicornis should include adequate sampling of companion animals, commercial animals, wildlife, and the environment. Where H. longicornis is detected, there should be testing for a range of indigenous and exotic viral, bacterial, and protozoan tickborne pathogens potentially transmitted by H. longicornis. Given the similarity between SFTSV and Heartland virus, a tickborne phlebovirus (https://www.cdc.gov/heartland-virus/index.html), further evaluation of the potential role of H. longicornis in transmission of this disease agent among animal reservoirs and possibly to humans is warranted. A broad range of interventions should be evaluated, including insecticide and acaricide sensitivity testing. Many state and federal agencies are developing and disseminating information for stakeholders, including development of hotlines, and some states are identifying ticks submitted by the public. The recently documented occurrence of H. longicornis in the United States presents an opportunity for collaboration among governmental, agricultural, public health agencies and partners in academic public health, veterinary sciences, and agricultural sciences to prevent diseases of potential national importance before onset in humans and other animal species.

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Acknowledgments

Wes Watson, Andrew D. Haddow, Naomi Drexler, Gleeson Murphy, Harry Savage, Howard Ginsberg, Kim Cervantes, field and laboratory personnel.

Corresponding author: C. Ben Beard, cbeard@cdc.gov, 970-221-6418.


* Drags consist of white cloth (usually 1 m2) that have a wooden leading frame and are dragged by a cord through grass or a leafy forest floor. Flags are similar but are used to brush uneven surfaces such as small bushes in wooded areas. Drags and flags are used to sample the environment for ticks trying to locate a host.

Carbon dioxide traps consist of dry ice–filled small boxes with holes that allow the CO2 to escape which are placed on a white cloth or mat in a grassy area or forest floor. Ticks, attracted by the CO2, crawl on to the cloth or mat surface, which is inspected for ticks after a period of time.

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References

  1. Rainey T, Occi JL, Robbins RG, Egizi A. Discovery of Haemaphysalis longicornis (Ixodida: Ixodidae) parasitizing a sheep in New Jersey, United States. J Med Entomol 2018;55:757–9. CrossRef PubMed
  2. Luo L-M, Zhao L, Wen H-L, et al. Haemaphysalis longicornis ticks as reservoir and vector of severe fever with thrombocytopenia syndrome virus in China. Emerg Infect Dis 2015;21:1770–6. CrossRef PubMed
  3. Mahara F. Japanese spotted fever: report of 31 cases and review of the literature. Emerg Infect Dis 1997;3:105–11. CrossRef PubMed
  4. Kang J-G, Ko S, Smith WB, Kim H-C, Lee I-Y, Chae J-S. Prevalence of Anaplasma, Bartonella and Borrelia species in Haemaphysalis longicornis collected from goats in North Korea. J Vet Sci 2016;17:207–16. CrossRef PubMed
  5. Rosenberg R, Lindsey NP, Fischer M, et al. Vital signs: trends in reported vectorborne disease cases—United States and territories, 2004–2016. MMWR Morb Mortal Wkly Rep 2018;67:496–501. CrossRef PubMed
  6. Heath A. Biology, ecology and distribution of the tick, Haemaphysalis longicornis Neumann (Acari: Ixodidae) in New Zealand. N Z Vet J 2016;64:10–20. CrossRef PubMed
Return to your place in the textFIGURE. Counties and county equivalents* where Haemaphysalis longicornis has been reported (N = 45) — United States, August 2017–September 2018

The figure is a map showing the counties and county equivalents where Haemaphysalis longicornis has been reported (N = 45), in the United States, during August 2017–September 2018.* Benton County, Arkansas; Fairfield County, Connecticut; Washington County, Maryland; Bergen, Hunterdon, Mercer, Middlesex, Monmouth, Somerset, and Union Counties, New Jersey; Davidson, Polk, and Rutherford Counties, North Carolina; Richmond, Rockland, and Westchester Counties, New York; Bucks and Centre Counties, Pennsylvania; Albemarle, Augusta, Carroll, Fairfax, Giles, Grayson, Louisa, Page, Pulaski, Rockbridge, Russell, Scott, Smyth, Staunton City, Warren, and Wythe Counties, Virginia; Cabell, Hardy, Lincoln, Mason, Marion, Monroe, Putnam, Ritchie, Taylor, Tyler, Upshur Counties, West Virginia.

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TABLE 1. Percentage of Haemaphysalis longicornis–infested counties or county equivalents in infested states — nine states, August 2017–September 2018Return to your place in the text
State No. of counties* per state No. (%) of counties* with H. longicornis on host or in environment
Arkansas 75 1 (1)
Connecticut 8 1 (13)
Maryland 24 1 (4)
New Jersey 21 7 (33)
New York 62 3 (5)
North Carolina 100 3 (3)
Pennsylvania 67 2 (3)
Virginia 134 16 (12)
West Virginia 55 11 (20)
Total 546 45 (8)

* Counties or county equivalents

TABLE 2. Distribution of Haemaphysalis longicornis, by host and species — nine states, August 2017–September 2018Return to your place in the text
Host category, no. (% of total)/Species No. (% of host category)
Domestic animal, 23 (61)
Cat 1 (4)
Cow 4 (17)
Dog 12 (52)
Goat 2 (9)
Horse 2 (9)
Sheep 2 (9)
Total 23 (100)
Wildlife, 13 (34)
Coyote 1 (8)
White-tailed deer 7 (54)
Gray fox 1 (8)
Groundhog 1 (8)
Virginia opossum 2 (15)
Raccoon 1 (8)
Total 13 (100)
Human, 2 (5) 2 (100)
Total 38 (100)

Beard CB, Occi J, Bonilla DL, et al. Multistate Infestation with the Exotic Disease–Vector Tick Haemaphysalis longicornis — United States, August 2017–September 2018. MMWR Morb Mortal Wkly Rep 2018;67:1310–1313. DOI: http://dx.doi.org/10.15585/mmwr.mm6747a3.

____________________

**Comment**

In the section discussing the species and the other pathogens it’s been known to transmit, Theileria was mentioned. Theileria is a malarial-like pathogen similar to Babesia:

https://en.wikipedia.org/wiki/Theileria_microti

Babesia IS also spread by ticks and is a frequent coinfection with Lyme.

An important difference from malaria is that T. microti does not infect liver cells. Additionally, the piroplasm is spread by tick bites (Ixodes scapularis, the same tick that spreads Lyme disease), while the malaria protozoans are spread via mosquito. Finally, under the microscope, the merozoite form of the T. microti life cycle in red blood cells forms a cross-shaped structure, often referred to as a “Maltese cross“, whereas malaria forms more of a diamond ring structure in red blood cells.[3]

Much is yet to be discovered about the Asian tick that clones itself and can drain cattle of its blood.  For more:  https://madisonarealymesupportgroup.com/2018/09/12/three-surprising-things-i-learned-about-asian-longhorned-ticks-the-tick-guy-tom-mather/

One of the biggest discoveries by Mather was how the ticks line up on stalks of grass resembling grains of wheat.  When anything touches this, it’s like a tick cluster bomb and ticks go everywhere.  Not just one or two, mind you, but hundreds at one time.  See link for pictures.

https://madisonarealymesupportgroup.com/2018/03/01/asian-ticks-mysteriously-turn-up-in-new-jersey/

https://madisonarealymesupportgroup.com/2018/10/03/1st-person-bitten-by-east-asian-longhorned-tick/

https://madisonarealymesupportgroup.com/2018/11/05/hawk-found-carrying-asian-long-horned-tick-the-one-that-drains-cattle-of-all-their-blood/

 

 

 

22 With Babesia, 8 Develop Acute Respiratory Distress Syndrome – 3 Die

https://www.ncbi.nlm.nih.gov/pubmed/30585748

2018 Dec 26:1-6. doi: 10.1080/00325481.2019.1558910. [Epub ahead of print]

Babesiosis as a cause of acute respiratory distress syndrome: a series of eight cases.

Abstract

OBJECTIVES:

The characteristics of patients with Acute Respiratory Distress Syndrome (ARDS) as a complication of Babesia microti infection have not been systematically described.

METHODS:

Adult patients admitted to the medical intensive care unit (MICU) of a tertiary care hospital in the Lower Hudson Valley of New York from 1/1/2008 to 8/1/2016 were evaluated for ARDS complicating babesiosis.

RESULTS:

Of 22 patients with babesiosis in the MICU, eight (36.4%; 95% CI: 19.7-57.0%) had ARDS. Six patients (75%) developed ARDS following initiation of anti-babesia drug therapy; however, the mean duration of symptoms in these patients exceeded that of patients who developed ARDS prior to initiation of treatment (7.50 ± 3.83d vs. 4.50 ± 0.71d, p = 0.34). Three patients (37.5%; 95% CI: 13.7-69.4%) expired without recovery from ARDS. In comparison, the mortality rate for the 14 MICU babesiosis patients without ARDS was 14.3% (p = 0.31). There was a trend toward younger age in survivors relative to non-survivors (mean age 54.6 ± 13.8y vs. 74.0 ± 6.24y, p = 0.07). Three of the five survivors did not require mechanical ventilation. The mean sequential organ failure assessment score of non-survivors was significantly higher than that of survivors (12.3 ± 1.15 vs. 6.0 ± 1.4, p = 0.0006).

CONCLUSION:

Among 22 critically ill adult patients with B. microti infection, ARDS developed in eight (35.4%), and three (37.5%) expired without resolution of the ARDS. ARDS often followed the initiation of anti-babesia drug therapy, raising the question of whether the death of the parasite per se contributed to its development. However, this observation was confounded by the longer duration of symptoms preceding initiation of drug therapy.

________________

More on Babesia:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/ According to Dr. Horowitz ARDS is often worsened in hospitalized patients who were given steroids (which suppress the immune system) which can cause death.

The number of symptoms and duration of illness in patients with concurrent Lyme disease and babesiosis are greater than in patients with either infection alone:  http://www.lymepa.org/c07%20Lyme%20disease%20and%20Babesiosis%20coinfection.pdf

This finding implies the presence of living spirochetes, because spirochete DNA in blood is amplifiable only when these pathogens remain viable.  It also suggests a synergistic inflammatory response to both a parasitemia and an increased spirochetemia. In addition, babesial infection enhances Lyme disease myocarditis in mice, which suggests that coinfection might also synergize spirochete-induced lesions in human joints, heart, and nerves.

The same was found in animals:  https://www.sciencedirect.com/science/article/abs/pii/S0020751918302406

Similar to humans, B. microti coinfection appears to enhance the severity of Lyme disease-like symptoms in mice. Coinfected mice have lower peak B. microti parasitaemia compared to mice infected with B. microti alone, which may reflect attenuation of babesiosis symptoms reported in some human coinfections. These findings suggest that B. burgdorferi coinfection attenuates parasite growth while B. microti presence exacerbates Lyme disease-like symptoms in mice.

https://www.sciencedirect.com/science/article/pii/S1877959X18302978  Our findings suggest that Babesia infections may indeed be quite common among individuals who have been exposed to tick bites.

Authorities and mainstream doctors to this day are not considering Lyme/MSIDS a polymicrobial illness, but it usually is:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

https://madisonarealymesupportgroup.com/2018/12/11/babesia-widespread-in-canada-its-high-tolerance-to-therapy/

https://madisonarealymesupportgroup.com/2018/10/06/case-of-recurrent-fever-multiple-splenic-infarcts-why-short-treatment-duration-often-doesnt-work-for-babesia/

https://madisonarealymesupportgroup.com/2018/03/22/what-is-air-hunger-anyway/

https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

https://madisonarealymesupportgroup.com/2018/10/11/babesia-found-in-patient-with-persistent-symptoms-following-lyme-treatment/

https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

Babesia Widespread in Canada & it’s High Tolerance to Therapy

https://www.ncbi.nlm.nih.gov/m/pubmed/29772759/?i=3&from=/30463941/related

Human Babesiosis Caused by Babesia duncani Has Widespread Distribution across Canada.

Scott JD, et al. Healthcare (Basel). 2018.

Abstract

Human babesiosis caused by Babesia duncani is an emerging infectious disease in Canada. This malaria-like illness is brought about by a protozoan parasite infecting red blood cells. Currently, controversy surrounds which tick species are vectors of B. duncani. Since the availability of a serological or molecular test in Canada for B. duncani has been limited, we conducted a seven-year surveillance study (2011⁻2017) to ascertain the occurrence and geographic distribution of B. duncani infection country-wide. Surveillance case data for human B. duncani infections were collected by contacting physicians and naturopathic physicians in the United States and Canada who specialize in tick-borne diseases. During the seven-year period, 1119 cases were identified. The presence of B. duncani infections was widespread across Canada, with the highest occurrence in the Pacific coast region. Patients with human babesiosis may be asymptomatic, but as this parasitemia progresses, symptoms range from mild to fatal. Donors of blood, plasma, living tissues, and organs may unknowingly be infected with this piroplasm and are contributing to the spread of this zoonosis. Our data show that greater awareness of human babesiosis is needed in Canada, and the imminent threat to the security of the Canadian blood supply warrants further investigation. Based on our epidemiological findings, human babesiosis should be a nationally notifiable disease in Canada. Whenever a patient has a tick bite, health practitioners must watch for B. duncani infections, and include human babesiosis in their differential diagnosis.

https://www.ncbi.nlm.nih.gov/m/pubmed/30463941/

Establishment of a continuous in vitro culture of Babesia duncani in human erythrocytes reveals unusually high tolerance to recommended therapies.

Abraham A, et al. J Biol Chem. 2018.

Abstract

Human babesiosis is an emerging tick-borne disease caused by apicomplexan parasites of the genus Babesia. Clinical cases caused by Babesia duncani have been associated with high parasite burden, severe pathology and death. In both mice and hamsters, the parasite causes uncontrolled fulminant infections, which ultimately lead to death. Resolving these infections requires knowledge of B. duncani biology, virulence, and susceptibility to anti-infectives, but little is known and further research is hindered by a lack of relevant model systems. Here, we report the first continuous in vitro culture of B. duncani in human red blood cells. We show that during its asexual cycle within human erythrocytes, B. duncani develops and divides to form four daughter parasites with parasitemia doubling every ~22 h. Using this in vitro culture assay, we found that B. duncani has low susceptibility to the four drugs recommended for treatment of human babesiosis, atovaquone, azithromycin, clindamycin and quinine, with IC50 values ranging between 500 nM and 20 μM. These data suggest that current practices are of limited effect in treating the disease. We anticipate this new disease model will set the stage for a better understanding of the biology of this parasite and will help guide better therapeutic strategies to treat B. duncani-associated babesiosis.

_________________

For more on Babesia:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

My husband and I both had Babesia.  Thankfully, that is one we are symptom-free from, but we treated for an entire year.  Dr. Horowitz states it’s one of the most tenacious coinfections he treats.

We used:

  • Mepron (750mg/5ml two times a day)
  • Allergy Research Brand Artemisinin (500mg 2X/day)
  • An intracellular such as one of the following:

*azithromycin (Zithromax) 500mg twice a day
*clarithromycin (Biaxin) 500mg  twice a day
*doxycline 100mg 2 pills twice a day
*minocycline 100mg  twice a day

Wise treatment overlaps.  It works synergistically and it helps prevent tolerance.

Babesia treatment is typically 3 weeks on, 1 week off.  I believe we pulsed the Artemisinin MWF.  This is a particular potent form and will give you a metallic taste in your mouth.  To read about it:  https://www.allergyresearchgroup.com/quality-artemisinin  (I am not affiliated with any products or services).  I was thankful for the pulsing as I had heart-attack type herxes and the breaks from those were welcome!

See Babesia Treatment link above for a symptom check-list you can print and fill out.

 

 

 

 

 

 

Five Genera of Pathogens Found in Ticks On Russian Dogs

https://www.ncbi.nlm.nih.gov/m/pubmed/30428925/

Dog survey in Russian veterinary hospitals: tick identification and molecular detection of tick-borne pathogens.

Livanova NN, et al. Parasit Vectors. 2018.

Abstract

BACKGROUND: Species of Canidae in Russia can be infested with up to 24 different tick species; however, the frequency of different tick species infesting domestic dogs across Russia is not known. In addition, tick-borne disease risks for domestic dogs in Russia are not well quantified. The goal of this study was to conduct a nationwide survey of ticks collected from infested dogs admitted to veterinary clinics in Russian cities and to identify pathogens found in these ticks.

METHODS: Ticks feeding on dogs admitted to 32 veterinary clinics in 27 major cities across Russia were preserved in ethanol and submitted to a central facility for examination. After identification, each tick was evaluated for infection with known tick-borne pathogens using PCR.

RESULTS: There were 990 individual ticks collected from 636 dogs. All collected ticks belonged to the Ixodidae (hard ticks) and represented 11 species of four genera, Dermacentor, Ixodes, Rhipicephalus and Haemaphysalis. Four most common tick species were D. reticulatus, followed by I. persulcatus, I. ricinus and R. sanguineus. Ixodes persulcatus ticks were found to be infected with 10 different pathogens, and ticks of this species were more frequently infected than either D. reticulatus or I. ricinus. Ixodes persulcatus females were also more frequently co-infected with two or more pathogens than any other tick.

Pathogenic species of five genera were detected in ticks:

  • Anaplasma centrale, A. phagocytophilum & A. marginale (Anaplasma)
  • Babesia canis, B. microti, B. venatorum, B. divergens, B. crassa & B. vogeli (Babesia)
  • Borrelia miyamotoi, B. afzelii and B. garinii (Borrelia)
  • Ehrlichia muris, E. canis and E. ruminantu (Ehrlichia)
  • Theileria cervi (Theileria – a parasitic protozoan)
Anaplasma marginale, E. canis, B. crassa, B. vogeli and T. cervi were detected in I. persulcatus, and Babesia canis in D. marginatum, for the first time in Russia.

CONCLUSIONS: Multiple ticks from four genera and 11 species of the family Ixodidae were collected from domestic dogs across Russia. These ticks commonly carry pathogens and act as disease vectors. Ixodes persulcatus ticks present the greatest risk for transmission of multiple arthropod-borne pathogens.

_________________

**Comment**

It’s getting harder and harder for The Cabal to hide the polymicrobial nature of Lyme/MSIDS.  The data just keeps pouring in:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

I’m thankful they included Bartonella as that one is often omitted but definitely a player. I’m also thankful for the mention of viruses as they too are in the mix. The mention of the persister form must be recognized as well as many out there deny its existence.

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.

And those tests miss half of all cases:  

https://madisonarealymesupportgroup.com/2018/09/12/lyme-testing-problems-solutions/  ...with the C6 Elisa its around 50% sensitive (in the context of the two tiered testing system on its own it has a sensitivity of 75%) because it misses about half of true positive cases….The Western Blot also has many problems with sensitivity at all stages but especially within the first month and again later on the more chronic it becomes.If you take the terrible sensitivity of both tests in the two tiered system you will start to see how testing positive consecutively on both is very unlikely, mathematically improbable and biologically almost impossible unless you are in the HLA autoimmune group which is comparatively rare.

https://madisonarealymesupportgroup.com/2018/01/16/2-tier-lyme-testing-missed-85-7-of-patients-milford-hospital/  Dr. Sin Lee identifying faulty serology tests for Lyme disease in 85.7% of the walk-in patients in the Emergency Room of Milford Hospital.

Please note that all the studies showing the polymicrobial nature of tick borne illness  are foreign.

The Cabal has everyone in the U.S. in a head-lock.

Will the real researchers please stand up and be counted?