Archive for the ‘Bartonella’ Category

One Tick Bite Could Put You at Risk For at Least 19 Different Diseases

http://www.businessinsider.com/deer-tick-can-carry-lyme-disease-powassan-virus-babesiosis-and-more-2017-6 by Kevin Loria, June 28,2017

The deer tick, also known as the blacklegged tick, is a fascinating but nasty little creature, and it’s spreading.

The tiny arthropods carry Lyme disease — the serious illness that we most associate them with — but that’s not the only pathogen they spread.

“One thing that people really need to be aware of is that Lyme disease is not the only pathogen that’s out there — there’s quite a few of them, [including] probably quite a few that we haven’t discovered yet,” says Rafal Tokarz, an associate research scientist at Columbia University’s Mailman School of Public Health.

And the deer tick, which as far as we know carries more illnesses than any other tick, “has been expanding its range enormously in the last 30 years,” says Durland Fish, professor emeritus of epidemiology at the Yale School of Public Health. Before the early 70s, it was largely unknown outside the Northeast, but now it has spread north, south, and west.

The diseases that we know deer ticks spread are all serious:

1. Lyme disease, which is transmitted by ticks infected with the bacterium Borrelia burgdorferi, infects roughly 300,000 Americans every year. It can be treated with antibiotics if caught early, but can cause severe inflammation, nerve, and joint pain,among other symptoms, if left untreated.

2. When people are infected with babesiosis, parasites infect and destroy red blood cells. Not everyone shows symptoms but it can be life-threatening for some at-risk patients. It’s “like tick-borne malaria,” says Fish, and is the most important contaminant of the blood bank right now, he says.

3. Anaplasmosis is spread by another bacteria carried by deer ticks. It usually shows up a week or two after a bite and can cause fever, headaches, nausea, and general malaise, among other symptoms. If untreated it can be severe, leading to hemorrhage, renal failure, and for a small fraction of even healthy patients, potentially can be fatal.

4. Deer ticks can also spread the Borrelia miyamotoi bacteria, which Fish says is similar to the one that causes Lyme. Symptoms include joint pain, fatigue, fever, chills, and headache.

5. A relatively recently discovered disease that’s spread by deer ticks as well as dog and Lone Star ticks is ehrlichiosis, caused by a bacteria in the same family as the one responsible for Rocky Mountain spotted fever. Symptoms often present like the flu.

6. Powassan virus has been around for a while but has received more attention recently, especially since the deer tick (which frequently bites humans) started spreading it — the ticks that transmitted the first reported cases in the 1950s rarely bite people. Unlike Lyme, which often takes many hours or even a couple days before it’s transmitted, Powassan infection can occur in as little as 15 minutes. Not everyone who gets bitten by an infected tick gets sick, but if they do, it’s a serious problem since there’s no treatment. In those (still rare) cases, Fish says that there’s about a 50% chance of permanent neurological damage and a 10% chance of death.

The broad range of potential conditions means that doctors don’t even necessarily know what to look for. Even worse, “ticks can frequently be co-infected with more than one pathogen,” says Tokarz. That’s especially true in certain locations, like on Long Island. One bite could transmit both Lyme disease and babesiosis, conditions that would normally be treated quite differently.

It’s also possible that having two or more illnesses could change the way the disease manifests. “We still don’t know whether co-infection exacerbates a disease or doesn’t make a difference,” says Tokarz.”Studies have shown both.”

Unfortunately, we don’t have any good way to control ticks and to stop the ongoing expansion, which will lead to more people getting sick.

In the places where people are at risk of picking up a tick “it is a very important, very severe problem, but the only thing that can be done is to educate people on the dangers of coming into contact with ticks,” says Tokarz.

If you get one on you, pull it off right away — don’t bother with urban legends about needing to burn it off. And protect yourself if you are going to be hiking or spending time in a place where ticks are common. Use permethrin-treated clothing for outdoors work and use insect repellent that contains DEET.

________________________________________________________________________________________

**My letter to the author**

Dear Mr. Loria,

Thank you for your piece on ticks and the pathogens they carry. I just wanted to add to your list; however, as there are many more pathogens carried by ticks. Also, they are discovering a variety of ticks carry pathogens, and if you think about it logically for a moment, ticks have similar habits and mouth parts, and require blood meals to survive, which technically makes every tick suspect. Unfortunately, geographical maps and entomology information (which ticks spread what) have been used to deny patients diagnosis and treatment. A doctor will look at the CDC map and claim, unequivocally, that since such and such isn’t supposed to be in that state, it isn’t TBI’s (tick borne infections). https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/ and then eventually they have to admit they are wrong: https://madisonarealymesupportgroup.com/2017/03/02/hold-the-press-arkansas-has-lyme/

How many went undiagnosed through the years?

https://www.lymediseaseassociation.org/about-lyme/other-tick-borne-diseases

  • 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

I run a physical support group here in Wisconsin, 4th in the nation for TBI’s, and nearly all of us are co-infected, and while Tokarz states he doesn’t know whether coinfection exacerbates a disease, we all do. http://danielcameronmd.com/babesia-and-lyme-its-worse-than-you-think/.  Each pathogen necessitates different medications so the CDC mono therapy of doxycycline won’t do a thing against many of the other pathogens.

Babesia can increase the severity of Lyme disease. Coinfected patients were more likely to have experienced fatigue, headache, sweats, chills, anorexia, emotional lability, nausea, conjunctivitis, and splenomegaly more frequently than those with Lyme disease alone. [7]
Babesia can also increase the duration of illness with Lyme disease. Babesia patients can remain symptomatic for years with constitutional, musculoskeletal, or neurological symptoms. One study found that 50% of coinfected patients were symptomatic for 3 months or longer, compared to only 4% of patients who had Lyme disease alone. [7] Meanwhile, one-third of patients with a history of both Babesia and Lyme disease remained symptomatic an average of 6 years. [2]

“The clinical pictures for 3 out of our 4 coinfected patients included a large number of symptoms, and 1 coinfected patient had persistent fatigue after treatment,” according to a study by Steere and colleagues. [8]”

https://madisonarealymesupportgroup.com/2016/03/20/why-we-cant-get-better/

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

https://madisonarealymesupportgroup.com/2014/11/14/studies-show-why-its-tough-to-treat-lyme-and-co/

https://madisonarealymesupportgroup.com/2015/05/08/interview-with-dr-horowitz/

For a fantastic book on all of this and more, read science journalist and past Executive Editor of Discover Magazine, Pam Weintraub’s work, Cure Unknown: Inside the Lyme Epidemic. http://www.astralgia.com/pamelaweintraubresume18.pdf

Sincerely,
Alicia Cashman
Madison Lyme Support Group
https://about.me/lymecoordinator56
lymecoordinator56@gmail.com
https://madisonarealymesupportgroup.com

Gene Transfer Keeps Bartonella Fit

https://m.phys.org/news/2017-06-gene-bacteria.html

Researchers at the University of Basel’s Biozentrum have discovered that Bartonella bacteria exchange genes efficiently using a domesticated virus encoded in their genome. As the findings published in Cell Systems demonstrate, the exchange of genetic material only takes place between bacteria with a high level of fitness. The gene transfer between pathogens prevents the accumulation of genetic defects, promotes the spread of beneficial gene mutations and thus keeps the bacteria fit. 

Bartonella are that can cause diverse infectious diseases in man, such as cat-scratch disease. In order to prevent the accumulation of mutations during the infection cycle, pathogens require efficient DNA repair mechanisms. Therefore, the sharing of intact within plays an important role, as errors in the gene pool can be eliminated and the genetic material kept fresh.

In collaboration with the ETH Zurich Prof. Christoph Dehio’s team at the Biozentrum, University of Basel, has discovered that for the efficient exchange of genes Bartonella use virus-like particles, so-called gene transfer agents. They also demonstrated that damaged bacteria are excluded from this gene transfer process and so it is much less likely that detrimental genetic material is spread in the .

Gene transfer using domesticated viruses

Gene transfer agents evolved as derivatives of bacteriophages, viruses that attack bacteria. However, other than bacteriophages packing their own genome they package random pieces of the bacterial genome and transfer these to other bacteria. Using these domesticated bacteriophages, bacterial populations can efficiently exchange DNA fragments. This type of gene transfer, however, comes at a high price: The fraction of the bacterial population that produces gene transfer agents dies while releasing the particles. But what are the advantages for the surviving bacterial population that takes up the gene fragments?

As the bacterial populations grow, bacteria divide regularly. For each cell division, the genome is duplicated and passed on to the two daughter cells. Errors creep in regularly during this recurrent process. Only efficient repair mechanisms, including the exchange of flawless genetic material, can prevent the accumulation of genetic aberrations. In short: The genetic material is kept fresh.

“A further evolutionary advantage of gene transfer agents is the spread of new genetic material throughout the bacterial population, endowing it with new properties. This may also include antibiotic resistance, explains Dehio. But this survival advantage for bacteria means, on the other hand, a threat to humans.

Only the fittest bacteria transfer genes

It has long remained unknown how the exchange of genetic material between bacteria using gene transfer agents works and how it is regulated. In their study, Dehio’s team has comprehensively identified the involved components. In particular, stress signals are key players in this process. Only bacteria in good condition exchange genetic material, whereas bacteria stressed as a result of unfavorable gene mutations do not transfer genes.

“In other words only the fittest and genetically most promising bacteria in a population divide and exchange genetic material. In genetically weakened and therefore stressed bacteria this mechanism is switched off,” says Maxime Québatte, the first author of the study.

The sharing of intact endows the fittest part of a bacterial population to persist in the host and to be passed onto new hosts successfully. This knowledge may, in turn, be used to develop new strategies to combat infections caused by the pathogen Bartonella.

More information: Maxime Québatte et al. Gene Transfer Agent Promotes Evolvability within the Fittest Subpopulation of a Bacterial Pathogen, Cell Systems (2017). DOI: 10.1016/j.cels.2017.05.011

 

Bartonella: Endocarditis, Opportunistic Infection in Cancer Patients, and Eye Inflammation

https://www.ncbi.nlm.nih.gov/m/pubmed/28490579/  Bartonella Species, an Emerging Cause of Blood-Culture-Negative Endocarditis.

Okaro U1, Addisu A2, Casanas B2, Anderson B3. Clin Microbiol Rev. 2017.

Abstract
Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria. Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed. The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana. We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella-mediated endocarditis and represents a potential reservoir for persistence by these bacteria.

https://www.ncbi.nlm.nih.gov/m/pubmed/28328183/  Seroprevalence of Bartonella species, Coxiella burnetii and Toxoplasma gondii among patients with hematological malignancies: A pilot study in Romania.

Messinger CJ1, Gurzau ES2,3, Breitschwerdt EB4,5, Tomuleasa CI6,7, Trufan SJ8, Flonta MM9, Maggi RG4,5, Berindan-Neagoe I6,10,11, Rabinowitz PM8. Zoonoses Public Health. 2017.

Abstract
Patients receiving immunosuppressive cancer treatments in settings where there is a high degree of human-animal interaction may be at increased risk for opportunistic zoonotic infections or reactivation of latent infections. We sought to determine the seroprevalence of selected zoonotic pathogens among patients diagnosed with haematologic malignancies and undergoing chemotherapeutic treatments in Romania, where much of the general population lives and/or works in contact with livestock. A convenience sample of 51 patients with haematologic cancer undergoing chemotherapy at a referral clinic in Cluj-Napoca, Romania, was surveyed regarding animal exposures. Blood samples were obtained and tested for evidence of infection with Bartonella species, Coxiella burnetii and Toxoplasma gondii, which are important opportunistic zoonotic agents in immunocompromised individuals. 58.8% of participants reported living or working on a farm, and living or working on a farm was associated with contact with livestock and other animals. 37.5% of participants were IgG seroreactive against one or more of five Bartonella antigens, and seroreactivity was statistically associated with living on farms. Farm dwellers were 3.6 times more likely to test IgG seroreactive to Bartonella antibodies than non-farm dwellers. 47.1% of the participants tested T. gondii IgG positive and 13.7% tested C. burnetii IgG positive, indicating past or latent infection. C. burnetii IgM antibodies were detected in four participants (7.8%), indicating possible recent infection. These results indicate that a large proportion of patients with haematologic cancer in Romania may be at risk for zoonotic infections or for reactivation of latent zoonotic infections, particularly with respect to Bartonella species. Special attention should be paid to cancer patients’ exposure to livestock and companion animals in areas where much of the population lives in rural settings.

https://www.ncbi.nlm.nih.gov/m/pubmed/28405890/  Seroprevalence of Bartonella Species in Patients with Ocular Inflammation.

Brydak-Godowska J1, Kopacz D1, Borkowski PK2, Fiecek B3, Hevelke A4, Rabczenko D5, Tylewska-Wierzbanowska S3, Kęcik D1, Chmielewski T3. Adv Exp Med Biol. 2017.

Abstract
Bartonella species, vector-borne etiologic agents of many systemic or self-limited infections, are responsible for a widening spectrum of diseases in humans, including inflammatory conditions of the eye. The aim of this study was to determine whether there is any relationship between uveitis and the evidence of Bartonella spp. infection in the serum, ocular fluid, and cataract mass in patients with intraocular inflammation. Polymerase chain reaction (PCR)-based tests and DNA sequencing were performed on surgery-extracted specimens of intraocular fluid and lens mass of 33 patients. Sera from 51 patients and 101 control subjects were tested for the presence of specific antibodies against Bartonella spp. Neither IgM-class antibodies against Bartonella spp. nor Bartonella spp. DNA were detected. A specific IgG-class antibody was found in 33.3% of the patients with uveitis. The rate of positive Bartonella serology was higher among the uveitis patients than that in control subjects. This high rate may in part result from unrecognized indirect mechanisms rather than the immediate presence and multiplication of Bartonella spp. in the eyeball. Nonetheless we believe that screening for Bartonella spp. should become part of the diagnostic workup in uveitis.

Another ocular study:  https://madisonarealymesupportgroup.com/2017/04/06/ocular-bartonellosis/

Bartonella Henselae in Children with Congenital Heart Disease

http://insights.ovid.com/crossref?an=00006454-201705000-00022

The Pediatric Infectious Disease Journal. 36(5):516-520, MAY 2017

Christopher P Ouellette; Sarita Joshi; Karen Texter; Preeti Jaggi

Abstract

Two children with congenital heart disease status post surgical correction presented with prolonged constitutional symptoms, hepatosplenomegaly (simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly) and pancytopenia (decrease in red blood cells, white blood cells and platelets).

Concern for malignancy prompted bone marrow biopsies that were without evidence thereof. In case 1, echocardiography identified a multilobulated vegetation on the conduit valve. In case 2, transthoracic, transesophageal and intracardiac echocardiography were performed and were without evidence of cardiac vegetations; however, pulmonic emboli raised concern for infective endocarditis. Both patients underwent surgical resection of the infected material and had histopathologic evidence of infective endocarditis. Further diagnostics identified elevated cytoplasmic antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies in addition to acute kidney injury with crescentic glomerulonephritis on renal biopsy. Serologic evidence of infection with Bartonella henselae was observed in both patients. These 2 cases highlight the potential multiorgan involvement that may confound the diagnosis of culture-negative infective endocarditis caused by B. henselae.

Co-infection of Ticks: The Rule Rather Than the Exception

http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004539

Sara Moutailler, Claire Valiente Moro, Elise Vaumourin, Lorraine Michelet, Florence Hélène Tran, Elodie Devillers, Jean-François Cosson, Patrick Gasqui, Van Tran Van, Patrick Mavingui, Gwenaël Vourc’h, Muriel Vayssier-Taussat
Published: March 17, 2016  https://doi.org/10.1371/journal.pntd.0004539

Abstract

Introduction

Ticks are the most common arthropod vectors of both human and animal diseases in Europe, and the Ixodes ricinus tick species is able to transmit a large number of bacteria, viruses and parasites. Ticks may also be co-infected with several pathogens, with a subsequent high likelihood of co-transmission to humans or animals. However few data exist regarding co-infection prevalences, and these studies only focus on certain well-known pathogens. In addition to pathogens, ticks also carry symbionts that may play important roles in tick biology, and could interfere with pathogen maintenance and transmission. In this study we evaluated the prevalence of 38 pathogens and four symbionts and their co-infection levels as well as possible interactions between pathogens, or between pathogens and symbionts.

Methodology/principal findings

A total of 267 Ixodes ricinus female specimens were collected in the French Ardennes and analyzed by high-throughput real-time PCR for the presence of 37 pathogens (bacteria and parasites), by rRT-PCR to detect the presence of Tick-Borne encephalitis virus (TBEV) and by nested PCR to detect four symbionts. Possible multipartite interactions between pathogens, or between pathogens and symbionts were statistically evaluated. Among the infected ticks, 45% were co-infected, and carried up to five different pathogens. When adding symbiont prevalences, all ticks were infected by at least one microorganism, and up to eight microorganisms were identified in the same tick. When considering possible interactions between pathogens, the results suggested a strong association between Borrelia garinii and B. afzelii, whereas there were no significant interactions between symbionts and pathogens.

Conclusion/significance

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.

Author Summary

Ticks transmit more pathogens than any other arthropod, and one single species can transmit a large variety of bacteria and parasites. Because co-infection might be much more common than previously thought, we evaluated the prevalence of 38 known or neglected tick-borne pathogens in Ixodes ricinus ticks. Our results demonstrated that co-infection occurred in almost half of the infected ticks, and that ticks could be infected with up to five pathogens. Moreover, as it is well established that symbionts can affect pathogen transmission in arthropods, we also evaluated the prevalence of four symbiont species and demonstrated that all ticks were infected by at least one microorganism. This work highlights the co-infection phenomenon in ticks, which may have important implications for human and animal health, emphasizing the need for new diagnostic tests better adapted to tick-borne diseases. Finally, the high co-occurrence of symbionts and pathogens in ticks, reveals the necessity to also account for these interactions in the development of new alternative strategies to control ticks and tick-borne disease.

To which we all said AMEN!

A few notes on the study:  To see a chart showing exactly what coinfections and symbionts they looked at, go to the link for the study.  They looked at 6 strains of borrelia (Lyme), Anaplasma, Ricketssia helvetica, Bartonella, Babesia, and Neoehrlichia mikurensis (Order: Rickettsiales, Family: Anaplasmataceae).  The symbiots looked at were:  Wolbachia, Spiroplasma, Acinetobacter, and Midichloria mitochondri.

While I am unfamiliar with most of the symbionts, Wolbachia concerns me as scientists are actively inserting Wolbachia into mosquitoes and releasing them into the wild in efforts of eradicating Dengue Fever, Chikungunya, yellow fever, and possibly even Malaria.  While scientists claim Wolbachia, a gram-negative bacterium in the family of Rickettsiales, can not infect humans, they can and do infect worms which cause human disease.  Since nematodes have been found in ticks and many Lyme/MSIDS patients have to treat for worms, the question begs to be asked, “Does Wolbachia play a role in Lyme/MSIDS?”  This is a question I plan on writing about, but the answer could very well be, “Yes.”  I certainly pray that more research on Wolbachia in relation to Lyme/MSIDS is done as this could definitely be a fly in the proverbial ointment.

Lastly, I believe recorded coinfection numbers to be abysmally low.  My own LLMD doesn’t even test for them, he feels the tests are that poor.  Also, probably the numbers reflect the most severe cases – leaving many out.  As you are aware, coinfections are notorious for presenting differently than the textbook presentations that most doctors are familiar with. Dr. Horowitz writes and speaks about this often.

Published on Nov 3, 2014
At the “Symposium on Tick-borne Diseases” held May 17, 2014

37:30 You will only find a positive test for Babesia if the level of parasitima in the blood is greater than 5%.  38:05 Medical textbooks also state you should have hemolytic anemia, thrombocytopenia, and renal failure if you have Babesia.  Dr. Horowitz states he has not had one Lyme/MSIDS patient present this way.  

How many doctors are going to think outside their medical textbooks?