Archive for the ‘Babesia’ Category

Seroprevalence of Babesia in Individuals with LD

http://online.liebertpub.com/doi/full/10.1089/vbz.2016.2020

Curcio Sabino R., Tria Laurel P., and Gucwa Azad L.. Vector-Borne and Zoonotic Diseases. October 2016, ahead of print. doi:10.1089/vbz.2016.2020.

Online Ahead of Print: October 24, 2016
Full Text HTML Full Text PDF (417.5 KB) Full Text PDF with Links (248.1 KB)
Author information
Sabino R. Curcio1, Laurel P. Tria,2 and Azad L. Gucwa1
1Department of Biomedical Sciences, Long Island University, Post Campus, Brookville, New York.
2Northwell Health Laboratories, Lake Success, New York.
Address correspondence to:
Azad L. Gucwa
Department of Biomedical Sciences
LIU Post
720 Northern Boulevard
Brookville, NY 11548
E-mail: azad.gucwa@liu.edu

ABSTRACT

Introduction: Babesiosis is an emerging tick-borne disease (TBD) caused by Babesia microti, an intracellular parasite of red blood cells. Currently, it is the highest ranked pathogen transmitted by blood transfusion. Most healthy individuals infected with B. microti are asymptomatic, but may be at risk for chronic infection. Similar to Lyme disease transmitted by Borrelia burgdorferi, B. microti is spread by Ixodes scapularis ticks. The rate of coinfection with these TBDs in humans is unclear as most studies have focused their prevalence in ticks or rodent reservoirs.

Materials and Methods: In this study, we aimed to determine the seroprevalence of B. microti infection in individuals who tested positive for Lyme disease. Serum samples obtained from 130 subjects in New York were tested by immunofluorescence assay (IFA) for the presence of IgM and IgG antibodies against B. microti.

Results: Overall, 26.9% of the serum samples tested were positive for IgM and IgG antibodies against B. microti, suggesting exposure to TBD (tick borne disease). Individuals who tested positive for Lyme disease as determined by two-tiered serological testing and the presence of both IgM and IgG antibodies directed against B. burgdorferi, were significantly increased for antibodies directed against B. microti (28.6%; p < 0.05), suggesting the possibility of coinfection with both TBDs. In contrast, the Lyme disease-negative control group had only 6.7% of samples seropositive for B. microti.

Conclusions: These findings suggest the need for more extensive studies investigating infection rates with multiple TBDs in areas where they are endemic and further support for the need to implement an FDA-approved screening test for blood products to help prevent transfusion-transmitted babesiosis.

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**My comment**

This study further shows evidence that when a person contracts LD, they are at risk for other co-infections as the LD lowers their immune function making them sitting ducks for other pathogens.  This is a real and present problem as most general practitioners haven’t a clue about co-infections.  The testing for all the TBI’s are poor and experience with symptomology is crucial in treating folks with TBI’s.  I truly believe that the addition of co-infections make TBI cases exponentially more difficult to treat.

If you type the various coinfections (Bartonella, Babesia, Mycoplasma, etc.) into the search bar on this website you can read about them and  various treatment options.  Feel free to copy these and take them to your health care provider for discussion.

Probable Transfusion-Transmission of Babesiosis

The Brief case: Probable transfusion-transmitted babesiosis in a transplant recipient

Kitt E, Keaton AA, Graf EH.
Journal of Clinical Microbiology 54:2632–2634.

http://dx.doi.org/10.1128/JCM.00981-16

Case

A 3-year-old immunocompromised male who had been hospitalized for 7 months in the cardiac intensive care unit developed fever and tachycardia in December. He was prenatally diagnosed with hypoplastic left heart syndrome and received right ventricle to pulmonary artery conduit surgery days after delivery. Due to worsening right ventricular function, after a hemi-Fontan procedure, he received an orthotopic heart transplant at the beginning of his 3rd year of life.

His posttransplant course was complicated by multiple episodes of rejection, cytomegalovirus (CMV) pneumonitis, and several central-line-associated bloodstream infections. As a result of the rejection, necessitating plasmapheresis as well as frequent blood draws for management, which led to anemia, he received 36 packed red blood cell transfusions over the course of 7 months posttransplantation. These transfusions were evenly spaced, and he remained hospitalized during the 7 months.

At the time of the febrile episode, he was on caspofungin, trimethoprim-sulfamethoxazole, and ganciclovir. The subsequent diagnostic workup included multiple sets of blood cultures, a urine culture, and a CMV viral load analysis. He was started on vancomycin and cefepime while awaiting microbiologic results. Other pertinent test results included a complete blood count (CBC) with differential showing pancytopenia and an aspartate transaminase (AST) level of 200 U/liter (reference range, 20 to 60 U/liter), an alanine aminotransferase (ALT) level of 84 U/liter (reference range, 5 to 45 U/liter), and a C-reactive protein level of 3.1 mg/dl (reference range, 0 to 0.9 mg/dl), which increased to 7.1 mg/dl over 4 days.

On the 5th day of fever, another CBC with differential was ordered and was noted by the hematopathologist to contain intraerythrocytic parasites. Immediately, a blood smear with Giemsa stain (Harleco Giemsa stain; EMD Millipore, Billerica, MA, USA) was performed by the microbiology laboratory, yielding the definitive diagnosis. Babesia species with a parasitemia level of 18% was reported to the clinical team. Real-time PCR testing, performed by a reference laboratory, provided the species-level identity of Babesia microti. All other infectious workups were negative. The patient was started on azithromycin plus atovaquone due to the contraindications against treatment with quinidine (QT interval prolongation in a heart transplant recipient with declining heart function).

Three days later, clindamycin was added when his parasitemia level did not decline. He was also given an exchange transfusion on day 4 after diagnosis in an attempt to reduce his parasitemia. After 14 days of therapy, his parasitemia became undetectable and he completed 6 full weeks of therapy, at which time he remained aparasitemic. Since transfusion was the child’s only known risk factor for Babesia infection, a complete investigation into the blood products used was conducted, but the infectious unit/donor could not be definitively identified. Banked products from the organ donor were also tested, and it was determined that the heart transplant was not the source of the Babesia infection.

Unlike Mosquitoes, Ticks Year Long Threat

http://www.omaha.com/living/move-over-mosquitoes-tick-fight-takes-attention/article_996c6495-f986-59cf-8649-6bfd46fc4209.html

According to the Companion Animal Parasite Council (CAPC) 2016 is going to be a banner year for ticks, with the CDC listing 15 different tick borne diseases (TBI’s) which range from debilitating to fatal.

The council sates that they thrive everywhere from wooded areas to gardens, landscape plants and even backyard grasses with most people coming into contact with them in their own backyards.

The article states a big help in lowering the tick population is by deterring deer from your living area by planting vegetation deer don’t like to building a tall fence, although they can jump over fences as high as 10 feet. They state a foliar spray such as Bobbex Deer Repellent is effective year-round and supposedly safe for use around children and pets and won’t wash off from rain or snow. It was found to be 93% effective in deterring deer when compared to other like repellents.

According to Sam Telford, a professor of infectious diseases at Tufts, “One or two years of severe weather may depress their numbers, but remember….the successful feeding of one female tick on a deer translates to 2,000 eggs.”

Many believe that ticks are not active in the winter. Unfortunately, this is a myth.

https://madisonarealymesupportgroup.com/2016/01/20/polar-vorticks/

LD Not in Australia: Here We Go Again

http://www.medicalnewstoday.com/releases/313821.php

A recent article in MNT reports emphatically that due to a study: https://www.mja.com.au/journal/2016/205/9/does-lyme-disease-exist-australia, “Classic” Lyme Disease does Not exist in Australia.  Period.  And, don’t even think about it.

Firstly let’s jut cut through the jargon. No such animal as “Classic Lyme Disease,” exists anywhere in the universe. Blanket statements about Lyme Disease are truly foolish as this is one of the most complex diseases known to man. We are talking about a pleomorphic bacteria that shape shifts into 3 possible forms to evade the immune system and drugs, and is a fungal shedder. The spirochetal form can penetrate any organ in the body including the brain where it can cause symptoms similar to what you find in an Alfred Hitchcock film. It recently has been found in microscopic worms and is associated with dementia and Alzheimer’s.
https://madisonarealymesupportgroup.com/2016/06/03/borrelia-hiding-in-worms-causing-chronic-brain-diseases/

This stuff can kill you but before it does, it makes you want to die.  The authors state that Borrelia burgdorferi and the tick that transmits LD, are not found in Australian animals or ticks, yet a quick cursory search shows:

http://www.lymedisease.org.au/about-lyme-disease/myths-surrounding-lyme-disease-in-australia/, that Willis identified the bacteria in Australian ticks in 1995.  Also, Carly and Pope found an Australian strain, Borrelia Queenslandica in 1962. A 1959 study by Mackerras found Borrelia in kangaroos, wallabies and bandicoots, not to mention there is a large number of positively diagnosed LD patients in Australia who have never traveled outside their country. This site also shows that LD is grossly under diagnosed and using estimates based on the US figures that extrapolates cases, approximately 18,000 new cases of LD occur each year, with potentially 378,000 patients in Australia.

http://www.lymedisease.org.au/stats/
Since Australian public health officials do NOT collect statistics on it, the Lyme Disease Association of Australia (LDAA) has collected bi-annual statistics since 2011. An interactive map shows 910 locations with confirmed LD by tick bite location, mainly on the coasts.

If you want good information about LD it seems you have to find it yourself.

The authors also make their bias completely known when they describe the two camps of current thought on persistent LD. In their own words:

  1. The Infectious Diseases Society of America (IDSA), an association of physicians and medical scientists.
  2. The public advocacy group, The International Lyme and Associated Diseases Society (ILADS)  

They purposely describe ILADS as an advocacy group, not a group of medical doctors, researchers, and other qualified, credentialed and legitimate medical professionals.  I have met a fair share of LLMD’s (Lyme literate doctors) who are members of ILADS and they are some of the brightest doctors I have ever had the privilege of knowing.  They might as well have included a picture of wily haired fringe lunatics with raised fists.

Momentary Monologue

I am finding an alarming trend. When I was trained in journalism in the 80’s, we were taught to present facts and let the reader come to his or her own conclusion, unless it was an opinion piece. Everything I currently read has clear bias of the reporter. Just to be clear, in my case, and on this website, I am fighting for patients. The reason for this is clear – they need fighting for. I do not hide my bias but am proud to be on the side of those who are looking at the worldwide literature, research, and are listening to patients who have far better things to do than make up an illness. There must be a counter to the main-stream clap-trap that currently is being peddled about Lyme Disease or MSIDS (multi systemic infectious disease syndrome – or Lyme with friends as research shows few have just Lyme anymore).

This trend of biases is also in the research and medical fields, and is particularly glaring in groups like the CDC, IDSA, and NIHthe folks who are supposed to be protecting the public. They have been charged with protecting the innocent and they have flatly failed. Fueled by patents, conflicts of interest, collusion with research institutions and big pharmaceutical companies these people have completely forgotten their charge.

Back to the matter at hand

The authors then go on to warn of all the false positives in testing for Lyme. Get real. The ELISA test detects only 50-65% of infected patients, and as many state, is no better than a coin toss.  http://www.ilads.org/lyme/lyme-quickfacts.php.  And Dr. Sin Lee in an open Public Comment for the IDSA states, “It is questionable why the [IDSA] insist on using antibody tests to diagnose a bacterial infectious disease, an obvious deviation from the standard practice of clinical microbiology in dealing with Lyme disease which is really a systemic infection with periodic bacteremia.  http://www.lymestats.org/assets/25_antibody.pdf

Remember now, this isn’t bronchitis, this is a complex illness that can kill you. In fact, from 1999 to 2001, Dr. Martin Atkinson-Barr tested 150 ALS patients for LD and stated,

Not one patient was found to be negative across all tests. Many were PCR positive. Effective treatment of late stage ALS is possible with aggressive antibiotic therapy that must include Metronidazole. Other researchers have recently reported success in treating early stage ALS with antibiotic therapy.”
https://lymeandals.wordpress.com/item-1-possible-connection-between-als-and-lyme-disease/

According to the CDC you have to be positive on the ELISA before you can test with the Western Blot, a test that 20-30% of acute culture-proven LD patients remain negative on.  Please understand that these tests are made with one spirochete from one strain from one laboratory tick who never saw the outside world, when there are 300 strains and counting of borrelia worldwide and 100 strains and counting in the U.S, with new strains being discovered continually.

Then, the CDC vilifies small labs that specialize in virology and bacteriology and only stand by FDA approved lab monopolies that only report on a few of the bands, ignoring bands that are critical.

Translation: both of these tests suck.

The article then blathers on that to avoid those horrible, nasty false positive test results, Australian physicians should ONLY request tests if there is a well founded clinical suspicion of LD and not in situations of low-pre-test probability. Do you see the circular reasoning here? You are damned if you do and you are damned if you don’t, because after all, LD does not exist in Australia.

They state that a human volunteer was inoculated with B. queenslandica, but without causing disease, so therefore, they state emphatically it is very unlikely that it can induce “classic” LD.  What poor sucker volunteered for that?  And are you honestly going to state that due to the findings of one poor inoculated sucker that it can’t cause disease in others or even that it might not cause disease in this person later?  Wow.  Now, I’ve truly heard it all.

Moving on

They state that “after controvery in the US about chronic LD intensified, patients in Australia began presenting with non-specific symptoms that they related to the putative disorder, such as chronic fatigue, cognitive impairment, myalgias, and arthralgias. These patients were often clustered around a small number of general practitioners who, assessing their symptoms as being consistent with chronic LD, requested laboratory testing. Most tests undertaken in Australian laboratories returned negative results; specimens were then frequently sent to overseas laboratories, often to facilities describing themselves as being specialized for Lyme and associated diseases. Some of these laboratories reported positive results, interpreted by the treating medical practitioner as confirming their clinical diagnosis of chronic LD.”  The article then goes on to blame social media and patient advocacy groups for playing the Pied Piper’s flute and drawing people with Lyme out of the woodwork like Carpenter Ants.

In answer to this – the reason for the patient clustering is that some educated and credentialed M.D’s, general or not, started listening and using their God-given brains. When you are desperately ill, who are you going to see, someone who listens to you and treats you accordingly, or someone who marginalizes you, says it’s all in your head and proceeds to hand you some anti-depressants while your health spirals downward? Duh! Secondly, do you blame very ill patients for finding each other and consoling each other?  You give us no choice.

http://www.abc.net.au/local/stories/2014/05/13/4003802.htm  According to Dr. Hugh Derham, a Perth-based doctor in Australia, Lyme Disease/MSIDS is common but hasn’t been diagnosed because no one is looking for it.  The brightest thing in the article is when someone mentions that ticks could have hitched a ride into Australia with unknowing travelers.  I always chuckle when “authorities” put geographical constraints on ticks and LD.  Until the bird, fox, lizard, mouse, and 100 other reservoirs as well as numerous potential vectors quit crossing state and international boundaries, the potential for LD is everywhere.  Use your brain.  

The good news is the MNT article does state they have finally “discovered” previously unknown pathogens in Australia and when you read the full article in The Medical Journal of Australia, you learn that they mean specifically Babesia as well as a novel Borrelia species in Australian ticks (which they state has not been shown to be pathogenic). Further, they say patients and practitioners believe other pathogens play a role in “Lyme Disease,” such as Babesia, Anaplasma, Bartonella, and Ehrlichia. To which they counter that these microorganisms are not often diagnosed in Australia. More circular reasoning.  Since it isn’t commonly diagnosed, it isn’t there. This argument was used recently to keep children in Arkansas from getting treatment when a local yahoo stated that they had infected ticks but not infected peoplehttps://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/

Why don’t they teach logic and critical reasoning in school anymore?

They then repeat the often repeated mantra of antibiotic overuse. I want to ask them one question. Just one.

If they were sick with a deadly pathogen(s), would they want antibiotics?

Again, they make it sound as if Lyme literate physicians (LLMD’s) callously ignore all their medical training and randomly hand antibiotics out like candy. While I can not speak for all LLMD’s as they have their own approaches, my treatment and my husband’s treatment was a pulsed antibiotic regimen using multiple antibiotics in a combined effort for two weeks then taking a break from all antibiotics for two weeks until we were symptom-free for three to four months (we treated this way for 4.5 years).  In my understanding there is little chance for antibiotic resistance when pulsing multiple antibiotics with breaks, and constantly switching up the meds.

The article summarizes by saying that there is no convincing evidence that “classic” LD exists in Australia (to which I agree because there is no such beast as “classic LD”) and that prolonged IV or oral antibiotic therapy is unjustified and unethical and will do more harm than good, and that immediate treatment solutions for these patients are not available.

Well isn’t that lovely.

I say, wait until you or someone you love gets infected. Your tune will change – I promise.

For your reading enjoyment, here is an article about an IDSA Founder, right here in good old Wisconsin,  who used potent IV antibiotics:  https://madisonarealymesupportgroup.com/2017/07/09/idsa-founder-used-potent-iv-antibiotics-for-chronic-lyme/

http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Lyme-like_Illness/Submissions  Very recently, over 1,200 people submitted illness information to the Senate hearing in Australia.  I think we can safely say that Lyme/MSIDS is indeed in Australia.

Rock on Aussie Lyme/MSIDS patients.  We stand with you.

http://restormedicine.com/lyme-disease-in-australia/

http://www.lymedisease.org.au

https://www.facebook.com/LymeDiseaseAustralia

https://rarediseases.org/organizations/sarcoidosis-lyme-disease-support-australia/

MSIDS Patients: Make Cash Help Research

Talk to your doctor and get:

For the Babesia Microti study:

*evidence of a positive diagnosis within the past 10 years
*Preapproval of PLASMA MedResearch
*After pre approval, go to the Quest Diagnostic Lab closest to you for a blood draw of 2     tubes of blood
*Collect $40

For the Lyme study:

*new diagnosis of less than 4-5 weeks
*Preapproval of PLASMA Med Research
*After pre approval, go to the Quest Diagnostic Lab closest to you and give two units of plasma.
*Collect $1,200

For more information, contact:
Lloyd Sherman
Patient Recruitment Manager
P.   561.717.5210
M.  561.962.5065
lloyd@plasmamed.com
www.plasmamed.com