Archive for the ‘Babesia’ Category

Study Shows Babesia Odocoilei is Pathogenic to Humans

https://www.mdpi.com/2075-4418/11/6/947

Detection of Babesia odocoilei in Humans with Babesiosis Symptoms

by John D. Scott1,*,Muhammad S. Sajid1,2, Emily L. Pascoe1 and Janet E. Foley1
 
*Author to whom correspondence should be addressed.
Academic Editors: Raphael B. Stricker and Raul Colodner
Diagnostics 2021, 11(6), 947; https://doi.org/10.3390/diagnostics11060947
Received: 21 March 2021 / Revised: 13 May 2021 / Accepted: 24 May 2021 / Published: 25 May 2021
(This article belongs to the Special Issue Lyme Disease: Companion Diagnostics and Precision Medicine)

Abstract

Human babesiosis is a life-threatening infectious disease that causes societal and economic impact worldwide. Several species of Babesia cause babesiosis in terrestrial vertebrates, including humans. A one-day clinic was held in Ontario, Canada, to see if a red blood cell parasite, which is present in blacklegged ticks, Ixodes scapularis, is present in humans. Based on PCR testing and DNA sequencing of the 18S rRNA gene, we unveiled B. odocoilei in two of 19 participants. DNA amplicons from these two patients are almost identical matches with the type strains of B. odocoilei in GenBank. In addition, the same two human subjects had the hallmark symptoms of human babesiosis, including night sweats, chills, fevers, and profound fatigue. Based on symptoms and molecular identification, we provide substantive evidence that B. odocoilei is pathogenic to humans. Dataset reveals that B. odocoilei serologically cross-reacts with Babesia duncani.
Clinicians must realize that there are more than two Babesia spp. in North America that cause human babesiosis. This discovery signifies the first report of B. odocoilei causing human babesiosis.
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**Comment**
 
Perfect example of how Lyme/MSIDS doesn’t fit into any box but perhaps Pandora’s.  
 
Strain diversity is a large reason why people aren’t being diagnosed.  You can only find what you specifically test for.  This study shows there are undoubtedly people struggling with Babesia symptoms that remain undiagnosed and therefore untreated due to the fact B. odocoilei isn’t believed to be pathogenic to humans and isn’t being tested for.  
 
Now we know for sure.
 
Earlier this year Scott et al. found 71% of black legged ticks were infected with Babesia odocoilei.  In 2019, Scott et al. also provided the first report of black legged ticks co-infected with BBsl and B.odocoilei in Canada, as well as transstadial passage (remains with the tick throughout its life-cycle) of this species of Babesia in ticks found in birds. They also found 3 members of the Bbsl complex (Borrelia lanai-like spirochete, Bbss, and a distinct strain that may represent a separate Bbsl genospecies).
 
Their latest study now has proven Babesia odocoilei infects humans.  

For more on Babesia:

 
 
 
 

Category:

Babesia, Lyme, research, Ticks

The Impatient Patient

https://www.globallymealliance.org/blog/the-impatient-patient

The Impatient Patient

by Jennifer Crystal on April 12, 2021

<img style="box-sizing:inherit;max-width:100%;height:auto;" src="https://www.globallymealliance.org/hubfs/Imported_Blog_Media/MyLymeLife_2-87-3.png&quot; alt="The Impatient Patient“>

by Jennifer Crystal

When would I get better? Why was I not seeing improvement every day?

Recently a friend’s toddler son asked her for a snack. Holding his baby sister, my friend told her son he’d need to wait a minute. He looked at her squarely and asked, “Does anyone like to wait?” Kids have a way of telling it like it is. The truth is, no one is great at patience, especially when we’re hungry, tired, or anticipating a big event. Perhaps the hardest time to wait is when we’re sick. “Patients” are ironically named because when we’re stuck in bed waiting to feel better, waiting for medication to work, waiting to live, we become very impatient.

I was impatient even before I got sick. A high-achieving lifestyle and the pressures that come with it always made me feel like I needed to hurry up and reach the next goal. If I didn’t, I might miss an important opportunity. I felt that if something didn’t happen right away, it might never happen at all. Then I got sick with chronic active Epstein-Barr virus, Lyme disease, babesiosis, ehrlichiosis, and possible Bartonella and all that forward motion and achievement came to a grinding halt. I was bedridden, hooked up to an IV, with nothing to do but wait. When would I get better? Why was I not seeing improvement every day?

Unfortunately, it often takes a long time for late-stage tick-borne illnesses to develop (for me, it took eight years to get an accurate diagnosis), which means it can take a long time to get better. Due to Herxheimer’s reactions, trial and error periods to figure out each person’s individual protocol, and setbacks from factors that are both in and out of our control, recovering from tick-borne illness is not a linear process. It can be especially hard to be patient when you feel like you’re taking two steps forward and one step back, or even one step forward and two steps back. Whether you’re three or ninety-three, no one likes to be slowed down.

When days, months, and even years of our lives are lost to illness, we feel increased urgency. We’re afraid that we’re losing precious time, as I discussed in my post “ A Lymie’s View from 39”. Illness-induced FOMO—fear of missing out—naturally manifests as impatience. A natural response to this impatience is to push our bodies to do more than they can so that we don’t miss out entirely. The minute I started to feel a little bit better, I’d go out and spend that energy. And while I enjoyed whatever I did, I paid for it with a flare of symptoms that sent me back to bed for days.

Not waiting caused damage, just as if my friend had not asked her son to wait, she might have dropped the baby or spilled the snack. She told him to wait because she had everyone’s well-being in mind. In just a few minutes, her son got his snack, and no one was hurt in the process. Patience paid off. Still, waiting—especially when it involves resting—goes against everything society has taught us about leading productive, meaningful lives. Though work-life balance has become more valued, busyness and achievement are still seen as badges of honor.

What bothered me most as an impatient patient was that I wasn’t doing anything. A friend who’d spent years recuperating from a traumatic brain injury helped reframe my thinking by telling me, “Your body is working really hard to heal right now. In order to let it do its job, you need to rest.” This realization helped me be more patient and loving with my sick body, more willing to give it what it needed—rather than fight against it—so that I could achieve my long-term goal of health.

Now that I have achieved and retained remission, I still can be impatient; it’s simply my nature. But I have learned to slow down; to pace myself; to trust my doctors, medications, and body; and most of all, to trust the process. I can’t get back the years I lost to illness. But I’m enjoying the ones I have now—which I wouldn’t have gotten if I’d pushed through the sicker years—and it truly does feel like the life I was meant to live is unfolding in its own time. I have to trust that it will continue to do so, as long as I am patient.

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Writer

Jennifer Crystal

Writer

Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her memoir about her medical journey is forthcoming. Contact her using her email.

Email: lymewarriorjennifercrystal@gmail.com

Category:

Babesia, Bartonella, Ehrlichiosis, Lyme, Psychological Aspects, Uncategorized, Viruses

Case Series Shows Wide Range of Babesia Symptoms & Presentations

https://danielcameronmd.com/case-series-shows-wide-range-babesia-symptoms-presentations/

CASE SERIES SHOWS WIDE RANGE OF BABESIA SYMPTOMS AND PRESENTATIONS

babesia-symptoms

Babesia can be a serious tick-borne illness in some patients. A case series published in the Nurse Practitioner Journal demonstrates the difficulty in diagnosing the disease, as it can cause a wide range of clinical presentations. The authors focus on five cases which occurred in southeastern New Jersey, an area endemic for Babesia. All of the patients were hospitalized.

By

This case series describes a broad range of Babesia symptoms in elderly patients, making the diagnosis particularly challenging.

Case 1: A 78-year-old white female was admitted with fever, chills, lethargy, fatigue, and marked changes in sensorium. “She had a maximum temperature of 100.6° F (38.1° C); sepsis was considered for this patient,” writes Paparone, a Nurse Practitioner (NP) from the Atlantic County Health Department in Northfield, New Jersey. A tick-borne illness was considered, in part due to multiple tick bites, abnormal liver function tests, anemia, and thrombocythemia. “Peripheral smear was positive for Babesia, and she had a Babesiaimmunoglobulin M (IgM) of 1:160 and Anaplasma (previously referred to as Ehrlichia) IgM of 1:320.” [1]

The woman’s mentation and lethargy dramatically improved when treated with a combination of doxycycline, atovaquone and zithromax.

Case 2: A 90-year-old white female was admitted for rectal bleeding with a hemoglobin of 7.6 g/dL and low platelet count of 103 × 109/L. The bleeding resolved with an octreotide infusion. The woman also had fever spikes to 100° F and a positive smear for Babesia. Her illness resolved with azithromycin and atovaquone.

Case 3: A 57-year-old white male was admitted with fever, malaise, and chills. His temperature had risen to 101° F during his 5-day hospital stay. Anaplasmosis was suspected due to his elevated liver enzymes, leukopenia, and thrombocytopenia. Intravenous doxycycline, oral clindamycin and quinine were prescribed. But he tested positive for Babesia. His hospital course was complicated by acute hearing deterioration. Quinine was stopped and his treatment was changed to oral azithromycin and oral atovaquone.

Case 4: An 81-year-old white male was admitted with increasing lethargy, weakness, chills, and blurred vision. Babesia was diagnosed on peripheral smear. Anaplasmosis was suspected based on anemia and thrombocytopenia.

Subsequently, serologic studies demonstrated an Anaplasmosis IgG of 1:256, Babesia IgM and IgG of 1:320. He was discharged after a 10-day combination of azithromycin and doxycycline. There was no evidence Babesia was treated during the hospitalization.

“At discharge on day 10, [he] was switched to clindamycin orally three times a day and quinine orally three times a day because of intolerance to azithromycin, and he completed a 14-day course of therapy,” writes Paparone.

Case 5: An 85-year-old white male was admitted with intermittent recurring fevers and chills. “He had a history of hairy cell leukemia, splenectomy, atrioventricular block (pacemaker), gouty arthritis, prostatic hypertrophy, and polymyalgia rheumatica,” writes Paparone. Babesia was diagnosed with 10.4% of his red blood cells infected. He was prescribed oral azithromycin and atovaquone. Doxycycline was added due to the possibility of a concurrent tick-borne infection.

He was discharged on day 8 only to be readmitted with an inability to ambulate and generalized weakness. His peripheral smear was positive for Babesia. “Due to the persistence of parasitemia despite adequate therapy, he was changed to clindamycin,” according to Paparone. His treatment was changed back to azithromycin and atovaquone due to gastric distress and a generalized erythematous coalescing rash. A peripheral smear for Babesia was negative at 5.5 weeks.

Each of the five cases presented differently: 

  1. Fever, chills, lethargy, fatigue, and marked changes in sensorium
  2. GI bleed
  3. Fever, malaise, and chills
  4. Increasing lethargy, weakness, chills, and blurred vision
  5. Intermittent recurring fevers and chills

Co-infections 

Three of the five cases with babesia symptoms were treated for co-infections without confirmatory serologic tests. Two of three cases were treated for Anaplasmosis without serologic confirmation.

Treatment tolerance

Zithromax and atovaquone were well tolerated in a population of patients with babesia symptoms that included 4 elderly patients ranging from 78 to 90 years old. Quinine was stopped due to hearing loss in one subject. Clindamycin and quinine were stopped in a second subject due to gastric distress and a generalized erythematous coalescing rash.

There was no evidence any of the 5 subjects babesia symptoms required blood transfusions despite their anemia and thrombocytopenia. This suggests that prompt recognition of Babesia in the hospital setting might avoid the transfusions described in the literature.

Babesia was successfully treated even in their immunocompromised patient, who was treated with exchange transfusion due to persistent parasitemia. “Red blood cell exchange transfusions are recommended for cases of severe babesiosis in patients with parasitemia of 10% or greater, severe anemia (hemoglobin less than 10 g/dL), or pulmonary, kidney or liver impairment,” writes Paparone. “Exchange transfusions are used to rapidly decrease parasitemia, correct anemia, and help remove toxic byproducts produced by the infection.”

Authors’ recommendations  

“This case series illustrates the need for the NP to appreciate the variable clinical presentations of babesiosis to facilitate prompt diagnosis, provide proper therapeutic management, and avoid the poor outcomes associated with this disease.” [1]

• It is important for the NP to understand that infected patients may not recall a tick bite and that clinical presentations may not only be variable but also nonspecific, ranging from subclinical to severe.

• The possibility of co-infection with other tick-borne illnesses (Lyme disease and anaplasmosis) must be considered.

• Furthermore, the NP needs to assume an active role in patient education to affect babesiosis awareness and prevention.

Related Articles:

Case report: Delayed onset babesia

Geriatric babesia cases are rising and may require longer treatment

Babesia infection and tick-borne agents transmitted through blood supply

References:
  1. Paparone, P. and P.W. Paparone, Variable clinical presentations of babesiosis: A case series. Nurse Pract, 2017. 42(11): p. 1-7.

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For more:

Category:

Babesia, research, Treatment

Dr. Burrascano on Tick-borne Illness Testing

http://  Approx. 15 Min

IGeneX 2021 Presentation Wisconsin Naturopathic Doctors Association (WNDA)

May 10, 2021

See Dr. Joseph Burrascano presenting on behalf of IGeneX Laboratory at the annual WNDA conference. Topics cover testing for Lyme Disease, Tick-Borne Relapsing Fever, Bartonella, Babesia, Rickettsia, Anaplasma, and Ehrlichia.

Dr. Burrascano discusses the Lyme ImmunoBlot test for early Lyme, validated with CDC test samples, that will identify 93% of cases.

He discussed a 2018 study of over 10,000 patient samples from nearly every state which found patients testing positive for the following pathogens:

  • nearly 38% for Babesia
  • 32% for Lyme borrelia
  • nearly 28% for TBRF borrelia
  • 19% for Bartonella
  • nearly 17% for Anaplasma
  • nearly 13% for Rickettsia
  • nearly 7% for Ehrlichia

Further:

  • 40% tested positive for 2 pathogens
  • 15% for 3
  • 4.6% for 4
  • 0.7% for 5

Category:

Anaplasmosis, Babesia, Bartonella, Ehrlichiosis, Lyme, Rickettsia, Testing, Tickborne Relapsing Fever

How to Co-Exist With Wisconsin’s Ticks

https://mywisconsinwoods.org/2020/05/27/how-to-co-exist-with-wisconsins-ticks/

By Denise Thornton

If you plan to be out in the woods or live next to woods, don’t be too quick to trade long pants and long sleeves for shorts and a tee shirt as the weather warms. You need to protect yourself from the ticks that are starting to emerge. Tick bites are possible year-round, but ticks are most active April through September.

Many types of ticks never feed on people. In Wisconsin, the two most common ticks that do are the wood tick, which is not a health concern here, and the black-legged tick (Ixodes scapularis), commonly known as the deer tick, which can transmit several serious diseases including Lyme disease and, more recently, anaplasmosis, which can start with symptoms like fever and nausea and in some cases, progress to organ failure.

Deer tick (left) and Wood tick (right). Photo courtesy of prevention.com

Wisconsin is Tick Heaven

The Upper Midwest and the northeastern states are hardest hit by Lyme disease, and the numbers in Wisconsin are rising. According to the Wisconsin Department of Health Services, Wisconsin had 3,105 estimated cases in 2018.

Once considered to be a north woods hazard, deer ticks are now found in every county of the state. Deer are an important blood source for adult ticks, and in 2018 overwinter deer densities in the state varied from three to over 60 per square mile. The abundant woodlands interspersed with agriculture throughout much of central and southwestern Wisconsin creates high quality deer habitat.

“There’s been a change in the past 25 years,” says Dr. Susan Paskewitz, chair of the UW-Madison Department of Entomology. Ticks thrive in moist, shady forested environments, and love our increasingly mild winters. “We find them in pine forests, mixed forests and deciduous forests.”

Paskewitz has sampled along the woody edges and out into the yard in neighborhoods in Eau Claire and near Delton.

“Of 90 houses tested, by the end of June, 80 percent of them had at least one deer tick in the area we were sampling. Most were within three to six feet of the woods,” Paskewitz continued, “but a few were found in bright, open, mowed lawn. I don’t think they live long there, but they were making their way out there, so if you are walking out to get your mail without your shoes on, you might pick up that particular tick.”  (See link for article)

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**Comment**

They say a picture‘s worth a thousand words.  The picture of this tick in the gum line in the mouth of a dog shows how durable and tenacious ticks are.

A few points for consideration:

  • Migrating birds, rodents, deer, lizards, and human movement are transporting ticks everywhere.  For far too long doctors have been looking at maps to diagnose people.  Trust me, ticks are virtually everywhere and adapt to weather conditions quite easily.
  • If I’ve written this once, I’ve written it 1,000 times – many people never see the tick or the rash and research shows the rash is highly variable – certainly not a sure thing.  
  • For more on tick prevention:  https://madisonarealymesupportgroup.com/2019/04/12/tick-prevention-2019/  I’m happy to report I saw some controlled burning in ditches as I was driving North today.  This has proven to reduce tick populations significantly.  I wish more of this was happening.
  • Regarding the section on if you find a tick bite: while it’s true that removing the tick as soon as possible is step #1, step #2 is getting prompt treatment as the “wait and see” approach has doomed patients to decades of suffering.  Demand immediate prophylactic treatment for each and every tick bite.  Trust me – whatever mild side effects and inconvenience a month or two’s worth of doxycycline can cause is nothing compared to the pain and suffering of a chronic, relapsing infection.
  • Testing for all tick-borne illnesses is abysmal.  Lyme is just the tip of the spear.  Ticks are literal garbage cans full of numerous pathogens they can transmit in just one bite.  The only infections listed in this article were Lyme disease, Anaplasmosis, and Babesia, when there are 19 and counting infections ticks can transmit.  Research has shown being infected with more than one pathogen causes more severe illness for a longer duration.  It is imperative that treatment includes medications that focus on each pathogen.  For the mounting list of tick-borne pathogens:
    • Babesiosis
    • Bartonellosis
    • Borrelia miyamotoi
    • Bourbon Virus
    • Colorado Tick Fever
    • Crimean-Congo hemorrhagic Fever
    • Ehrlichiosis/Anaplasmosis
    • Heartland Virus
    • Meat Allergy/Alpha Gal
    • Pacific Coast Tick Fever: Richettsia philipii
    • Powassan Encephalitis
    • Q Fever
    • Rickettsia parkeri Richettsiosis
    • Rocky Mountain Spotted Fever (RMSF)
    • SFTS: Severe Fever with Thrombocytopenia Syndrome
    • STARI: Southern Tick-Associated Rash Illness
    • Tickborne meningoencephalitis
    • Tick Paralysis
    • Tularemia
  • While the wood tick and deer tick are the most common ticks in Wisconsin, they are hardly the only ticks we must be concerned about.  Go here for more on the various types of ticks and the diseases they carry. The Lone Star tick has been found in Wisconsin and one allergist in MN states he diagnoses approximately 1 patient per month with Alpha-gal allergy – some patients hailing from WI.  Wisconsin is a hot-spot for Powassan virus, and we recently had our first death due to Rocky Mountain Spotted Fever. It would be a huge mistake to believe you only have to worry about Lyme, Anaplasmosis, and Babesia in Wisconsin.  Nearly every patient I work with also has Bartonella – a tenacious pathogen that isn’t even on most doctors’ radars, and Mycoplasma is very common.
  • Most articles such as these don’t tell you what to do once you’ve become infected. Optimally, you would be prepared before this ever happened by finding the Lyme literate doctors (LLMD) in your state.  The best way to do this is to contact your local Lyme support group. There is also a tab on the right side of this website called, “Find a Lyme Support Group.”  There is also another tab slightly down from that in which you can contact ILADS directly for doctors in your area.  Read this if you don’t know what a LLMD is.  LLMDs are specially trained in tick-borne illness and know how to diagnose patients clinically.  This is crucial because current 2-tiered CDC testing misses anywhere from 70-85% of cases or more.  You truly can not trust testing.  They also know how to treat this complex illness that typically is far more than just Lyme.

Category:

Babesia, Lyme, Prevention, Testing, Ticks, Transmission, Treatment, Viruses