Archive for the ‘Ehrlichiosis’ Category

North Carolina: Ehrlichia Often Overlooked When Tick-borne Illness Suspected

http://outbreaknewstoday.com/north-carolina-ehrlichia-often-overlooked-tick-borne-illness-suspected-24872/

North Carolina: Ehrlichia often overlooked when tick-borne illness suspected

October 1, 2018

When a patient presents with signs and symptoms suspicious for a tick-borne illness, medical providers in central North Carolina regularly test for Lyme disease and Rocky Mountain Spotted Fever, but often don’t think about Ehrlichia, according to researchers at the University of North Carolina at Chapel Hill.

North Carolina map/ National Atlas of the United States
North Carolina map/ National Atlas of the United States

The failure to test for Ehrlichia, even as more and more evidence suggests that the infection may be just as common as other endemic tick-borne diseases, appears to impact patient care with antibiotics prescribed less frequently when testing is not ordered. This study’s results and recommendation for increased provider education were recently published in the Center for Disease Control and Prevention’s journal Emerging Infectious Diseases.

“Providers order Ehrlichia testing much less frequently than Rocky Mountain Spotted Fever or even Lyme disease, despite the low-incidence of Lyme disease in the state,” said Ross Boyce, M.D., M.Sc., the study’s lead author and a clinical instructor in the Division of Infectious Diseases at the UNC School of Medicine. “This disparity may be attributable to unfamiliarity with local vector epidemiology, as well as the greater attention given to Rocky Mountain Spotted Fever and Lyme disease in the popular media.”

Ehrlichia is an illness caused by the Lone Star Tick, which is found throughout the mid-Atlantic United States. Symptoms typically include fever, headache and muscle aches. Boyce and colleagues performed a retrospective chart review on 194 patients who underwent testing for tick-borne illness at UNC hospitals and associated clinics between June and September 2016.

They found that nearly 80 percent of patients were tested for Rocky Mountain Spotted Fever and two-thirds were tested for Lyme disease. Yet providers ordered testing for Ehrlichia in only one-third of patients. Among the initial results

37 patients tested positive for Rocky Mountain Spotted Fever, nine tested positive for Ehrlichia, one tested positive for Lyme disease and,

Using leftover serum, Boyce and colleagues tested the 124 patient samples that were not initially tested for Ehrlichia. Twenty-five of those samples ultimately tested positive for Ehrlichia,

putting the total number of positive results nearly equal with the number of Rocky Mountain Spotted Fever cases.

“Our results demonstrate that Ehrlichia accounted for a large proportion of reactive antibodies among a cohort of individuals with suspected tick-borne illness in Central North Carolina,” Boyce said. “These finding provide strong, albeit circumstantial evidence that Ehrlichia infection is as prevalent as Rocky Mountain Spotted Fever even as providers appear to consider this diagnosis much less frequently than other tick-borne diseases.”

While the CDC guidelines recommend empirical antibiotic treatment when there is suspicion for tick-borne illness, Boyce and colleagues work suggests that providers are less likely to provide antibiotics if testing is not ordered. While it is difficult to distinguish an acute infection from a past exposure with a single test, the study estimates that failure to test for Ehrlichia may have resulted in a missed diagnosis in more than 10 percent of individuals.

Boyce said educating front-line providers in primary care clinics and emergency departments about the prevalence of this tick-borne illness is urgently needed.

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**Comment**

Great example of the importance of medical practitioners understanding clearly that ticks are infected with many pathogens that can and do infect humans causing disease.  They need to ditch the one pathogen, one drug paradigm completely or patients are not going to improve.

Please see:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

More on Ehrlichiosis:

https://madisonarealymesupportgroup.com/2018/07/24/oklahoma-ehrlichiosis-central/

https://madisonarealymesupportgroup.com/2018/03/09/dogs-ehrlichiosis/

https://www.lymedisease.org/ehrlichiosis-tick-borne-disease-no-one-heard/

 

 

Tickology Video Series – Everything You Want to Know About Ticks & Prevention

Entomologist Larry Dapsis, Deer Tick Project Coordinator, of Cape Cod Cooperative Extension presents information about numerous types of ticks and the diseases they carry in the following Tickology video series.

Tickology

 Approx. 9 Min

Tick Identification & Ecology

Take aways:

  1. Female American Dog Tick is easy to spot as she has a creamy white wide spot up by the head.
  2. Female Lone Star tick has a bright white spot in the center of her back.
  3. Female Deer Tick has a bright red abdomen.
  4. A lot of this info is shared again in part 3 below where I have more notes.

 Approx. 12:30 Min.

Tick Borne Diseases

Take aways:

  1. He considers the American Dog Tick more of a nuisance than a threat.  I disagree.  Just ask anyone who’s ever had RMSF or Tularemia, both of which can kill you.
  2. The Deer Tick (Black legged tick) is endemic in 80 countries and has been here for thousands of years.
  3. Lyme is found in 49 out of 50 states in the U.S. (absent only in Hawaii)
  4. In 2016 the CDC adjusted Lyme prevalence to 300,000 new cases of Lyme a year.
  5. Martha’s Vineyard has more cases than anywhere in the universe.
  6. Risk of infection is year round.
  7. Largest risk is from the nymph as they are smaller and the bite is difficult to detect.   He is finding about 25% to be infected with Lyme.  50% of adults are infected.
  8. In Massachusetts, children ages 5-9 have the highest rates of infection.  Adults aged 50-70 has a surge of infection as well.
  9. Babesiosis, similar to Malaria, can be passed via blood transfusion with 50% of Massachusetts cases found in the south eastern part of the state and virtually found in some degree in every county in the state.
  10. Anaplasmosis (HGA) can look similar to Lyme and is more broadly distributed in Mass.
  11. All these diseases are steadily increasing.  95% of cases are aged 65 and older.
  12. Borrelia miyamotoi, related to Lyme, is a relapsing fever.  3% of Cape Cod ticks have it but is expected to increase.
  13. Powassan can put you in the hospital with brain swelling.  They did surveillance and found Powassan in 4 out of 6 site sites with infection rates as high as 10% in the tick population.  In reading the literature, he feels it has been on Cape Cod for thousands of years but it hasn’t been on medical radar.

  Approx. 8 Min.

Lone Star Tick – The New Tick in Town

Part 3 of the Tickology video project.

Take aways:

  1. The Lone Star Tick, normally considered a Southern tick, is in Cape Cod, and has moved North, and yes, is in Wisconsin.
  2. The adult female has a white dot on her back
  3. These ticks can run and are aggressive, fast & will actually chase you.  
  4. While he mentions a warming climate, independent Canadian tick researcher, John Scott, states emphatically temperature has nothing to do with tick expansion:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/
  5. He claims Lone Star ticks have been established in Sandy Neck Beach Park and Shining Sea Bike Trail for a long time – it’s just nobody was looking for them.  I suspect this to be true for many other areas as well.
  6. He claims these areas are “perfect flyways” for migratory birds for transporting ticks.
  7. Lone Star ticks prefer intermediate size hosts.  He put out video surveillance and picked up wild turkeys in areas where these ticks were established.  Rabbits & coyotes are good hosts as well
  8. The adult female lays a cluster of 4,000-5,000 eggs,  which leaves a high concentration of larvae in late summer.  He claims when you find one, it could be a matter of minutes and you could have 200-300 bites.
  9. He claims Lone Star tick larvae do not transmit pathogens.
  10. The adults; however, can transmit Erlichiosis, STARI, Tularemia and Alpha Gal or meat allergy (all animal products).
  11. He claims you will not find deer ticks in an open lawn.  I was told otherwise by Susan Paskewitz, chair of the Department of Entomology at UW–Madison, whose crew is finding them in fields where kids are playing sports, and it’s here as well: https://newyork.cbslocal.com/2018/05/07/ticks-lyme-disease-cdc-putnam-county/
  12. He is finding Lone Star ticks in open spaces.  They don’t mind the heat.  Deer ticks will seek out leaf litter and/or snow when conditions are harsh.

 Approx. 13:22 Min

Permethrin Treated Clothing & Footwear

Take aways:

  1. Natural Pyrethrum is from the Aster Family, & is an extract from a type of chrysanthemum.  It has quick knockdown against insects but no residual control.  Breaks down in sunlight quickly.
  2. They manipulated it so now it has 4 weeks of residual control.
  3. You only use it on clothing and footwear.  He feels treating footwear to be crucial.  If a tick is on a treated surface with permethrin for 60 seconds it will die.  He feels strongly that using this product will reduce your exposure tick bites by upwards of 90%.  It is active thru 6 washings or 45 days which ever comes first.
  4. Pre-treated tick repellent clothing is also available.  EPA testing has shown it is active through 70 washings.  You can also send your clothing to “Insect Shield,” and they will treat your clothing and send it back with the 70 washing claim.  He says it’s about $10 per clothing item.
  5. It’s not the molecule that makes the poison, it’s the dosage.  As far as permethrin goes, there is low mammal toxicity except for cats.  It is 2,250 times more toxic to ticks than to humans.  According to the EPA, permethrin-treated clothing poses no harm to infants, children, pregnant women, or nursing mothers.
  6. Permethrin has low skin absorption and is metabolized quickly.
  7. National Research Council looked at long term exposure on the military wearing permethrin saturated clothing from head to foot for 18 hours a day for 10 years and found no reason for an adverse effect.
  8. The active ingredient is the same ingredient used for treating scabies and head lice and parents smear it on their kids from head to toe.
  9. He demonstrates how to apply it onto clothing and footwear.  Scroll to 10:00.  Make sure to wash these treated cloths away from other clothes.  Remember sunlight breaks it down so it lasts through 6 washings for 45 days, which ever comes first.
  10. He sprays the inside of the legs in case a tick gets underneath.  I tuck my pants into my white sprayed socks so ticks can not get inside.

 Approx. 6 Min

Skin Repellents

Take aways:

  1. The big distinction between repellents is the EPA registration.  Deet, Picaridan, IR 3535, and Oil of Lemon Eucalyptus have EPA registration with data on file for any claim being made.
  2. Go here for the EPA selection guide:  https://www.epa.gov/insect-repellents/find-repellent-right-you  (Fill in the questionnaire)
  3. Go to www.npic.orst.edu for pesticide information.
  4. Go to capecodextension.org for short factual answers on products.
  5. Naturals are not EPA registered so there is no data proving effectiveness.  Not all repel ticks.  Buyer beware.

__________________

For more on tick prevention:  https://madisonarealymesupportgroup.com/2017/05/11/tick-prevention-and-removal-2017/

https://madisonarealymesupportgroup.com/2018/06/06/mc-bugg-z/

https://madisonarealymesupportgroup.com/2018/05/27/study-conforms-permethrin-causes-ticks-to-drop-off-clothing/  “All tested tick species and life stages experienced the ‘hot-foot’ effect after coming into contact with permethrin-treated clothing,” Eisen said. 

https://madisonarealymesupportgroup.com/2018/04/03/fire-good-news-for-tick-reduction/  Study found a 78-98% reduction in ticks.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0112174 These data indicate that regular prescribed burning is an effective tool for reducing tick populations and ultimately may reduce risk of tick-borne disease.

 

 

Galaxy Awarded Grant to Develop Bartonella Testing in Endocarditis Patients

https://www.galaxydx.com/uncategorized/galaxy-diagnostics-awarded-phase-i-sbir-grant/#/

September 20th, 2018

Grant will support development of advanced molecular diagnostics for confirmation of Bartonella spp. infection in endocarditis patients

RTP, N.C.- Galaxy Diagnostics, an infectious disease diagnostics company specializing in flea and tick-borne disease testing, is pleased to announce the award of Phase I grant from the National Heart, Lung, and Blood Institute (NHLBI) under the Small Business Innovation Research Program. This grant funding will support development of advanced molecular diagnostics for confirmation of Bartonella spp. infection in patients with endocarditis (infection of the inner lining of the heart valves and chambers). This marks the second federal grant ever awarded for non-HIV research on Bartonella spp, including B henselae, the key agent causing cat scratch disease.

“We are thrilled to receive this funding from the NIH/NHLBI to support the development of better molecular diagnostics for Bartonella research and clinical use,” said Amanda Elam, President/CEO of Galaxy Diagnostics. “These bacteria were only recently discovered and have been recognized as one of the most important genuses of bacteria in emerging infectious disease today. Better diagnostic tests will allow clinicians and researchers to clarify the clinical importance of these pathogens for diseases affecting the joints, heart, eyes, and nervous system in people with healthy immune systems.” The current diagnostic challenge with this emerging pathogen is that recommended testing is not sensitive enough, often leading to false negatives. Jen Miller, Director of Research and Development at Galaxy Diagnostics, stated that, “Development of this rapid, highly sensitive and specific bartonellosis clinical diagnostic tool will result in an actionable, cost-effective assay for physicians.”  

Launched in 2009 to commercialize advanced test methods to support diagnosis of Bartonellosis in animals and people, Galaxy Diagnostics is a spin out from North Carolina State University. The company is currently focused on developing more sensitive diagnostics for a range of flea and tick borne diseases, including Bartonellosis, Lyme Borreliosis (LB), Babesiosis, Rickettsiosis, Ehrlichiosis, and Anaplasmosis. Better diagnostic tests for flea- and tick-borne diseases will support more accurate diagnosis and better stewardship of antibiotics in the treatment of animals and people.

About Galaxy Diagnostics Inc.

As a social venture and a One Health company, Galaxy Diagnostics is passionate about protecting the animal-human bond through the surveillance, prevention and clinical management of flea- and tick-borne diseases shared by humans and animals. Not only do we offer the best molecular and serology test options available, but we work with researchers and clinicians to generate new knowledge about emerging infectious diseases such as bartonellosis, borreliosis and other vector-borne diseases. Based on our scientific expertise, we are able to provide counsel to clinicians and researchers dedicated to achieving the most accurate diagnosis possible for their patients. This central goal is reflected in our corporate values and everyday interaction with patients, clinicians and researchers.

Media Contact: James Rebenski

contact@galaxydx.com

 

Tick Infestations of Wildlife & Companion Animals in Ontario, Canada, With Detection of Human Pathogens in Ixodes Scapularis Ticks

https://www.ncbi.nlm.nih.gov/m/pubmed/30206012/

Tick infestations of wildlife and companion animals in Ontario, Canada, with detection of human pathogens in Ixodes scapularis ticks.

Smith KA, et al. Ticks Tick Borne Dis. 2018.

Abstract

The growing risk of transmission of tick-borne zoonotic pathogens to humans in Ontario, Canada, warrants investigations into regional tick distribution, tick burdens of local peridomestic animals, and prevalence of tick-borne pathogens. The objectives of this study were to investigate the geographic distribution and magnitude of tick infestations in opportunistically sampled mammalian wildlife and companion animals (i.e., dogs) in southern Ontario and to test these ticks for evidence of zoonotic tick-borne pathogens. Ticks collected from wildlife carcasses, live-trapped wildlife and companion animals (2015-2016), as well as wildlife diagnostic cases (2011-2013), were identified to species and life stage.

Ixodes scapularis ticks were tested by real-time PCR for Anaplasma phagocytophilum, Babesia microti, Borrelia miyamotoi and Borrelia burgdorferi sensu stricto (s.s.). Amblyomma americanum ticks were tested for Ehrlichia chaffeensis. A total of 1687 ticks of six species were collected from 334 animals, including 224 raccoons (n = 1381 ticks) and 50 dogs (n = 67 ticks).

The most common tick species collected from parasitized raccoons were Ixodes texanus (n = 666 ticks) and Dermacentor variabilis (n = 600 ticks), which were removed from 58.5% (median: 2 ticks; range: 1-36) and 49.1% (median: 2 ticks; range: 1-64) of raccoons, respectively. Of I. scapularis tested, 9.3% (4/43) were positive for Bo. burgdorferi s.s. and 2.3% (1/43) for A. phagocytophilum. These results reveal that numerous tick species parasitize common, peridomestic wildlife and that at least two zoonotic, tick-borne pathogens circulate in southern Ontario. Host-tick vector-pathogen dynamics should continue to be monitored in the face of global climate change, landscape alterations and expanding human populations.

________________

**Comment**

This researcher obviously hasn’t read his own countryman’s work:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/   Another problem with the climate change models is they overlook the fact that deer ticks were established in northwestern Ontario, southern Manitoba and were already in central Canada prior to 1970. What they predict to happen in the future has already happened in Canada. Their oversight caused a skewed rate of tick expansion and a miscalculation of northward projected movement.

“For blacklegged ticks, climate change is an apocryphal issue.” -John Scott

apocryphal:
adj. Of questionable authorship or authenticity
adj. Erroneous; fictitious

Monster Ticks Found in Germany Threaten Europe With Deadly Disease – Crimean-Congo Fever

https://www.express.co.uk/news/science/1004232/disease-Crimean-Congo-fever-germany-monster-tick

MONSTER ticks found in Germany threaten Europe with DEADLY disease Crimean-Congo fever

A MONSTER tick species has found its way to Germany and threatens to spread DEADLY tropical disease Crimean-Congo fever across the whole of Europe.
tick
MONSTER ticks found in Germany threaten Europe with DEADLY disease Crimean-Congo fever (Image: Universitat Hohenheim)

 

Scientists in Germany have discovered a tropical tick which can grow up to an INCH LONG – 10 times bigger than a common tick.

The ticks, known as Hyalomma marginatum have the potential to spread the viral disease Crimean-Congo fever (CCHF).

Symptoms of CCHF include fever, muscle pains, headache, vomiting, diarrhoea, and bleeding into the skin. A QUARTER of those contracting Crimean-Congo fever will die.

Researchers have blamed the unusually hot weather over Europe for the cause of the ticks movement northwards as more birds have migrated to Europe following the scorching temperature. (Please see comment at end of article)

Seven of the species were discovered this year – previously there have only been two examples of tropical ticks in Germany, one in 2015 and another in 2017.

Scientists are now concerned that as the warm temperatures continue to become more common in Germany, France and the UK the ticks could settle there and migrate across Europe permanently.

Parasitologist Ute Mackenstedt from the University of Hohenheim in Stuttgart said: “We assume that we have to reckon with more and more tropical species of ticks in Germany that can settle here due to good weather conditions.”

crimean congo fever

Symptoms of CCHF include fever, muscle pains, headache, vomiting, diarrhoea, and bleeding (Image: GETTY)

Dr Lidia Chitimia-Dobler, tick expert at the University of Hohenheim and the Institute for Microbiology (IMB) of the German Federal Armed Forces in Munich, said: “Five of the seven ticks we can determine beyond doubt, four are the species Hyalomma marginatum and one of the kind Hyalomma rufipes.

“We did not expect ticks here in Germany at this time.”

Dr Gerhard Dobler, physician and microbiologist at the IMB, added: “In one of the specimens found, we were able to prove the pathogen of a tropical form of tick typhus.

_______________

**Comment**

For another read on this monster tick in Germany:  https://www.dw.com/en/scientists-find-dangerous-tropical-ticks-in-germany/a-45086012  There is a video in the article that cites Lyme is easily cured with a couple weeks of antibiotics, yet treatment failures have been noted since the beginning of time.

They admit that they don’t even know what pathogens are transmitted in Germany, and that new ticks are cropping up there.

Please know that independent tick researcher John Scott has shown climate change has nothing to do with tick expansion or the spread of Lyme/MSIDS:   https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/

Scott shows that migratory birds are serving as transits carrying infected ticks all over the world, even in places where there aren’t any white-footed mice. He also shows numerous fallacies with the climate models – particularly the fact they don’t include important data.  In the end ticks are marvelous ecoadaptors and research has they can survive the harshest of conditions.  What does affect them is lack of light (photo period).  

https://www.cdc.gov/vhf/crimean-congo/index.html Crimean-Congo Hemorrhagic Fever (CCHF) can be transmitted to humans through infected ticks, animal blood, and infected human blood and/or bodily fluids (so human to human). CCHF has also been spread in hospitals due to improper sterilization.  Fatality rate in hospitalized patients has ranged from 9-50%.  Being a virus, care is supportive; however, it is sensitive in vitro to ribavirin, an anti-viral drug.  Recovery is slow.

Signs and symptoms:

  • Sudden onset of symptoms
  • headache
  • high fever
  • back pain
  • joint pain
  • stomach pain
  • vomiting
  • red eyes
  • flushed face
  • red throat & petechiae (red spots on palate are common)
  • jaundice
  • mood changes
  • sensory perception
  • severe bruising
  • sever nosebleeds
  • uncontrolled bleeding at injection sites

Please note the last quote of the story – that they proved a tropical form of tick typhus in one of tropical ticks found in Germany. Typhus, a bacteria, is making a comeback, particularly in the South. Common in the U.S. in the 40’s, and normally attributed to lice, now it’s been proven to be in a tick. In other words, another disease and a tick found where they supposedly shouldn’t be.

Typus is a rickettsial infection with ticks carring numerous species including rickettsia, ehrlichia, and anaplasma. Rocky Mountain Spotted Fever is also considered a tick-borne typhus fever.  https://www.health.ny.gov/diseases/communicable/rocky_mountain_spotted_fever/fact_sheet.htm

Divided into the typhus group and the spotted fever group, disease is transmitted through ectoparasites (fleas, lice, mites, and ticks). Inhalation and inoculating conjunctiva with infectious material can also cause disease.  The good news for most is that doxycycline is a front-line drug for it.  Broad-spectrum antibiotics aren’t helpful.