Archive for the ‘Rickettsia’ Category

Bartonella Found in Dogs After Infection With Rickettsia

2019 Dec 31. doi: 10.1111/jvim.15675. [Epub ahead of print]

Detection of Bartonella spp. in dogs after infection with Rickettsia rickettsii.



Dynamics of infection by Bartonella and Rickettsia species, which are epidemiologically associated in dogs, have not been explored in a controlled setting.


Describe an outbreak investigation of occult Bartonella spp. infection among a group of dogs, discovered after experimentally induced Rickettsia rickettsii (Rr) infection.


Six apparently healthy purpose-bred Beagles obtained from a commercial vendor.


Retrospective and prospective study. Dogs were serially tested for Bartonella spp. and Rr using serology, culture, and PCR, over 3 study phases: 3 months before inoculation with Rr (retrospective), 6 weeks after inoculation with Rr (retrospective), and 8 months of follow-up (prospective).


Before Rr infection, 1 dog was Bartonella henselae (Bh) immunofluorescent antibody assay (IFA) seroreactive and 1 was Rickettsia spp. IFA seroreactive. After inoculation with Rr, all dogs developed mild Rocky Mountain spotted fever compatible with low-dose Rr infection, seroconverted to Rickettsia spp. within 4-11 days, and recovered within 1 week. When 1 dog developed ear tip vasculitis with intra-lesional Bh, an investigation of Bartonella spp. infection was undertaken. All dogs had seroconverted to 1-3 Bartonella spp. between 7 and 18 days after Rr inoculation. Between 4 and 8 months after Rr inoculation, Bh DNA was amplified from multiple tissues from 2 dogs, and Bartonella vinsonii subsp. berkhoffii (Bvb) DNA was amplified from 4 of 5 dogs’ oral swabs.


Vector-borne disease exposure was demonstrated in research dogs from a commercial vendor. Despite limitations, our results support the possibilities of recrudescence (reappearance) of chronic subclinical Bartonella spp. infection after Rr infection and horizontal direct-contact transmission between dogs.



Bartonella isn’t even on most GP’s radar, yet patients with tick-borne illness often have it.  This dog study shows how Bartonella can be chronic, subclinical, and reactivated by other pathogens.  Subclinical can mean a few things – either the patient appears asymptomatic (without symptoms) or it isn’t picked up on testing or both.

This issue highlights an important field of study that’s begging to be done.

Does a tick bite lower the immune system so that what was a subclinical issue now triggers an active infection?  It makes sense that a tick bite would do this, as vaccines have been shown to do this. Vaccines are designed to lower the immune system so the body mounts an immune response and creates antibodies to whatever is in the vaccine.

Dr. Burrascano, a highly experienced Lyme literate doctor, found that multiple tick bites caused greater disease severity:

Others have found that vaccines have reactivated dormant infections:


There is further damning evidence that Gardasil can produce life-threatening reactions in those who have been close to a cat, fleas, or ticks, since many of these animals are infected with Bartonella, Babesia, or Lyme (borrelia). Also, since many MSIDS patients (multi systemic infectious disease syndrome) also struggle with viruses such as Mono or active EBV, a cytokine storm can resultwith mucus being over manufactured in lungs and airways and well as wide-spread inflammation.

Asymptomatic girls after receiving Gardasil activated dormant Bartonella which was confirmed by testing.


He has started treating Lyme Borreliosis patients 20 years ago in the USA and during the last 5 years in Ireland. He has also successfully treated a number of young women who fell ill after their HPV vaccination, which seems to have stimulated a latent Lyme infection to reactivate.

Here, we clearly see that vaccines caused active infection in previously asymptomatic patients.  It makes complete logical sense that a tick bite would do the same, yet mainstream medicine hasn’t a clue and continues to treat this as a simple disease requiring 21 days of doxycycline.

There are pressing answers needed by doctors and patients yet current research seems hell-bent on focusing on climate change.

More climate data will not help patients or doctors one iota.

Disease-Causing Tick Common Along Gulf Coast Is Now In Indiana, IU Experts Say

Disease-causing tick common along Gulf Coast is now in Indiana, IU experts say

Indiana University researchers have found a Gulf Coast tick in southern Indiana.

As the name suggests, this species of arachnid is primarily found in states that border the Gulf of Mexico. Its presence in Indiana could signify an expanded range, and for Hoosiers that would mean an increased risk of contracting a nasty disease.

Tidewater fever, or rickettsia parkeri, is a form of Rocky Mountain spotted fever. Both illnesses can result in fever, headache, rash and muscle aches.

“It’s not as bad as Rocky Mountain spotted fever, but it’s something you don’t want to get, for sure,” said Keith Clay, IU distinguished professor emeritus of biology.

Clay recently left IU after more than three decades to become chair of the Department of Ecology and Evolutionary Biology at Tulane University. He still leads IU’s Project Vector Shield, an initiative started in 2018 that collects ticks and mosquitoes from sites throughout Indiana.

The goal is to provide early warning for disease vectors that pose a threat to people and livestock. The project is part of IU’s Prepared for Environmental Change Grand Challenge initiative.

IU study: We have more ticks here that carry Lyme disease than thought

Tick season: What you need to know to keep yourself, and your dog, safe

Ticks and mosquitoes are collected during the growing season — roughly April through October — at 10 sites scattered across southern Indiana. Researchers regularly perform what’s known in the tick world as dragging or flagging at each site during the growing season, Clay said.

This technique consists of slowly dragging a heavy, white corduroy cloth across an area of vegetation. If ticks are present, they will instinctively grab onto the cloth, thinking it’s a deer, a dog or some other creature that could provide a blood meal.

“Maybe you get none, maybe one or two, and sometimes you hit a hot spot and get 500 on a cloth,” Clay said. “It’s kind of like fishing.”

When ticks are found on a cloth, they’re collected with tweezers and placed in sample tubes with 70% ethanol. This kills the ticks instantly while preserving them until they can be analyzed at an IU lab. There, the ticks are sorted by species, sex and life stage.

When Clay started looking at ticks in the late 1990s, the dog tick was the only species found in this area. Since then, the lone star tick population has exploded. It’s by far the most common species found in Indiana today, Clay said.

Recently, the blacklegged deer tick, which transmits Lyme disease, has become more common, particularly in the southern part of the state.

A student who was sorting ticks in the IU lab recently noticed one that looked different. Clay thought it was a Gulf Coast tick, but he wanted to be sure. High-resolution photos of the bug were taken and sent to the U.S. National Tick Collection at Georgia Southern University.

“It took an expert about 10 seconds to identify it,” Clay said.

At first, Vector Shield researchers thought this was the first Gulf Coast tick found in Indiana. This was based on the Centers for Disease Control and Prevention maps of tick distribution, Clay said.

It turned out the Indiana State Department of Health had previously found a Gulf Coast tick in Gibson County. That’s just north of Posey County, the source of the tick IU researchers discovered.

“Two ticks don’t make for an invasion, but it’s at least plausible that there’s a lot more of them out there,” Clay said.

It’s not exactly clear what’s causing the increase of tick diversity in Indiana. Climate change is one likely factor. Winters aren’t as severe and don’t last as long, Clay said. This extends the growing season and the time that ticks — along with other animals they may latch on to — are active.

Changing landscapes could also play a role. Southern Indiana was once all forest, Clay said. Development and farming has transformed the region into more of a patchwork. Grasslands and scrubby areas are where ticks tend to thrive, he said.

Like other animals, ticks tend to follow their food. The deer population, as well as livestock, has increased dramatically over the past 300 years, Clay said.

Of course, both of the Gulf Coast ticks found in Indiana could be random occurrences in which the bugs latched on to someone or something that traveled north from the southern U.S.

“Maybe they don’t persist and form a viable population,” Clay said, “but it certainly warrants a closer look.”

Antinuclear Antibodies in Infectious Diseases

2019 Nov 12:1-9. doi: 10.1080/23744235.2019.1690676. [Epub ahead of print]

Antinuclear antibodies in infectious diseases.


Introduction: Antinuclear antibody (ANA) tests are widely used for the diagnosis of autoimmune diseases, but ANAs are also commonly found in patients with various infections. This retrospective study aimed to investigate the relationship between infections and ANA status.

Methods: Patients that visited the Department of Infectious Diseases at Inha University Hospital between January 2007 and July 2018 were investigated. We analysed their ANA test results and reviewed rheumatic and infectious diagnoses of patients with positive ANA findings.

Results: Of the 9,320 patients during the study period, 1,111 underwent ANA testing and 110 tested positive. Seven of the 110 patients were previously diagnosed with ANA-positive disease, and 21 were diagnosed with autoimmune disease during the present study. Of the remaining 82 patients, 43 were confirmed with infectious disease. The most common pathogen was Mycobacterium tuberculosis (n = 10), followed by Treponema pallidum (n = 5), Orientia tsutsugamushi (n = 5), Escherichia coli (n = 5), Bartonella henselae(n = 3), and human immunodeficiency virus (n = 3). Of the 39 patients without a confirmed pathogen, 7 were seropositive for O. tsutsugamushi, B. henselae, or Rickettsia spp. Patients were observed at an average of 24 weeks in our hospital. One patient developed systemic lupus erythematosus after being diagnosed with Epstein-Barr virus-induced infectious mononucleosis, and another patient developed adult-onset Still’s disease after being diagnosed with scrub typhus.

Conclusion: This study showed that various relationships exist between infections and rheumatic diseases. In particular, several patients with a positive ANA test result were found to have intracellular infections such as mycobacterial infections, syphilis, or scrub typhus.






Another Case Report Showing Multiple Pathogens in Lyme Patient

2019 Nov;98(46):e17977. doi: 10.1097/MD.0000000000017977.

Case report: A patient coinfected by Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae in Urumqi, China.

Jiang Y1,2, Hou X1,2, Zhang L1,2, Tan Y3, Lu C3, Xiao D3, Li H3, Hao Q1,2, Wan K1,2.



Both Borrelia burgdorferi sensu lato and spotted fever group Rickettsiae (SFGR) are pathogens carried by ticks. There is a possibility of co-infection with these tick-borne diseases.


Male patient, 63 years-of-age, admitted to hospital with skin rash presenting for 1 week and fever with cough and expectoration for 3 days before admission.


We diagnosed that the patient was co-infected by B burgdorferi sl and SFGR using laboratory test results and the patient’s clinical manifestations.


The patient started therapy with oral minocycline, then levofloxacin by intravenous injection for SFGR. Meanwhile, he was treated with penicillin G sodium, cefoperazone sulbactam sodium and ceftriaxone by intravenous injection for B burgdorferi sl.


After the patient was in stable condition, he was discharged from hospital.


This case report highlights the possibility of co-infection by 2 tick-borne diseases in Urumqi, Xinjiang Uygur Autonomous Region, China. The antibiotic therapy should be based on the detection of pathogenic bacteria, and the different susceptibilities of co-infecting bacteria should be considered.



Very glad these cases are being reported as mainstream medicine has its head completely in the sand regarding tick-borne infections. In 2018 a fantastic study demonstrated that many patients are coinfected with numerous pathogens.  Patients whom are coinfected have more severe illness for a longer duration of time. The idea that 21 days of the mono therapy of doxycycline is a complete joke.

Going back to 1998, it was known that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, causing greater symptoms, disease severity, and duration of illness:  Great example of a previously healthy 39-year-old male presenting to the emergency department (ED) with generalized severe headaches for eight days and fever for four days. Abdominal examination was normal except for a swollen spleen.

THE NUMBER OF SYMPTOMS AND DURATION OF ILLNESS IN PATIENTS WITH CONCURRENT LYME DISEASE AND BABESIOSIS ARE GREATER THAN IN PATIENTS WITH EITHER INFECTION ALONE  It also suggests a synergistic inflammatory response to both a parasitemia and an increased spirochetemia. In addition, babesial infection enhances Lyme disease myocarditis in mice, which suggests that coinfection might also synergize spirochete-induced lesions in human joints, heart, and nerves.

Telling quote:

Persistent and debilitating fatigue characterized coinfection.

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

 Mainstream medicine hasn’t even factored this into the equation yet.






Rickettsia spp. in East Texas With Reduced Tick Density Due to Controlled Burns

2019 Oct 17:101310. doi: 10.1016/j.ttbdis.2019.101310. [Epub ahead of print]

Presence of diverse Rickettsia spp. and absence of Borrelia burgdorferi sensu lato in ticks in an East Texas forest with reduced tick density associated with controlled burns.


As tick-borne diseases continue to emerge across the United States, there is need for a better understanding of the tick and pathogen communities in the southern states and of habitat features that influence transmission risk. We surveyed questing and on-host ticks in pine-dominated forests with various fire management regimes in the Sam Houston National Forest, a popular recreation area near Houston, Texas. Four linear transects were established- two with a history of controlled burns, and two unburned. Systematic drag sampling yielded 112 ticks from two species, Ixodes scapularis (n=73) and Amblyomma americanum (n=39), with an additional 106 questing ticks collected opportunistically from drag cloth operators.

There was a significant difference in systematically-collected questing tick density between unburned (15 and 18 ticks/1000 m2) and burned (2 and 4 ticks/1000 m2) transects. We captured 106 rodents and found 74 ticks on the rodents, predominantly Dermacentor variabilis. One unburned transect had significantly more ticks per mammal than any of the other three transects. DNA of Rickettsia species was detected in 146/292 on and off-host ticks, including the ‘Rickettsial endosymbiont of I. scapularis’ and Rickettsia amblyommatis, which are of uncertain pathogenicity to humans. Borrelia lonestari was detected in one A. americanum, while Borrelia burgdorferi sensu stricto, the agent of Lyme disease, was not detected in any tick samples. Neither Borrelia nor Rickettsia spp. were detected in any of the mammal ear biopsies (n=64) or blood samples (n=100) tested via PCR.

This study documents a high prevalence in ticks of Rickettsia spp. thought to be endosymbionts, a low prevalence of relapsing fever group Borrelia in ticks, and a lack of detection of Lyme disease-group Borrelia in both ticks and mammals in an east Texas forested recreation area. Additionally, we observed low questing tick density in areas with a history of controlled burns. These results expand knowledge of tick-borne disease ecology in east Texas which can aid in directing future investigative, modeling, and management efforts.



Why states do not do seasonal controlled burns is beyond me. It’s inexpensive and doesn’t have the negative side-effects that pesticides do – and it works ticks:

Also, please remember that while Lyme was not found it doesn’t mean it isn’t there.  There are plenty of Texas patients with Lyme disease.

Study Shows: Ticks Can Transmit Rickettsia Immediately

Minimal Duration of Tick Attachment Sufficient for Transmission of Infectious Rickettsia rickettsii (Rickettsiales: Rickettsiaceae) by Its Primary Vector Dermacentor variabilis(Acari: Ixodidae): Duration of Rickettsial Reactivation in the Vector Revisited

Journal of Medical Entomology, tjz191,
05 November 2019


It has been reported that starving ticks do not transmit spotted fever group Rickettsia immediately upon attachment because pathogenic bacteria exist in a dormant, uninfectious state and require time for ‘reactivation’ before transmission to a susceptible host. To clarify the length of reactivation period, we exposed guinea pigs to bites of Rickettsia rickettsii-infected Dermacentor variabilis (Say) and allowed ticks to remain attached for predetermined time periods from 0 to 48 h. Following removal of attached ticks, salivary glands were immediately tested by PCR, while guinea pigs were observed for 10–12 d post-exposure. Guinea pigs in a control group were subcutaneously inoculated with salivary glands from unfed D. variabilis from the same cohort. In a parallel experiment, skin at the location of tick bite was also excised at the time of tick removal to ascertain dissemination of pathogen from the inoculation site. Animals in every exposure group developed clinical and pathological signs of infection. The severity of rickettsial infection in animals increased with the length of tick attachment, but even attachments for less than 8 h resulted in clinically identifiable infection in some guinea pigs. Guinea pigs inoculated with salivary glands from unfed ticks also became severely ill.Results of our study indicate that R. rickettsii residing in salivary glands of unfed questing ticks does not necessarily require a period of reactivation to precede the salivary transmission and ticks can transmit infectious Rickettsia virtually as soon as they attach to the host.



For far too long authorities have told us that there’s something called a “grace period,” in which ticks supposedly delay transmitting pathogens to us and that a period of 24-48 hours is required before we can become infected.

There is only one study which they base that information upon, and there’s never been a study on the minimum time for transmission.

This study blows the “grace period” theory out of the water and proves what we all know to happen in reality. People can become infected in mere hours upon attachment. It also proves another point as well: that some ticks have the pathogens already in their salivary glands making transmission times even shorter.

How many have been sent home with a false sense of security after a doctor, going by information authorities have proliferated, told them they can’t be infected because the tick wasn’t attached for a long enough period of time?  Thousands?
Please spread the word. There shouldn’t be any more patients falling through the cracks.

For more on transmission times:

Microbiologist Holly Ahern on what’s currently wrong with diagnostics and treatment:

Is Rickettsia the Same as Lyme Disease?

Is Rickettsia The Same As Lyme Disease?

What Is Rickettsia?

Rickettsial diseases or rickettsioses are infections caused by various bacteria belonging to the genus Rickettsia. These bacteria are transmitted through the bites of certain hard-bodied ticks and some other arthropods. Rickettsial diseases are not to be confused with rickets, which is a condition affecting the bones and resulting from vitamin D deficiency.

The infections caused by Rickettsia bacteria have traditionally been classified into two groups: spotted fever and typhus. However, they’re sometimes divided into further categories. Either way, all groups include species of pathogens that can infect humans. Although Rickettsia bacteria can be found worldwide, the most common rickettsial illnesses are normally contracted in Africa and Asia.

Lyme disease is also transmitted to humans by ticks. It’s the most common tick-borne illness in the northern hemisphere. However, Lyme isn’t a rickettsial disease, since it’s caused by a bacterium of a different genus: Borrelia burgdorferi.

However, the same tick that carries Rickettsia bacteria might also be infected with Borrelia burgdorferi. Therefore, it’s possible to contract both illnesses via one tick bite. Therefore, the answer to question ‘is Rickettsia a Lyme co-infection?’ is that yes – rickettsiosis can be a potential co-infection of Lyme disease.

What Are The Symptoms of Rickettsia Diseases?

Some of the most common rickettsial diseases are Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis and typhus. All of these are generally difficult to diagnose. Some of them rarely cause symptoms, and most of them only cause moderate illness even when symptomatic. However, certain forms of spotted fever and typhus may be fatal if left unrecognised and untreated. The sooner these illnesses are diagnosed, the easier they are to treat using antibiotics.

The clinical presentation of rickettsial diseases varies greatly. Even infections caused by the same species of bacteria may produce different symptoms in different patients. Nonetheless, the most common symptoms include

  • fever
  • headache
  • fatigue
  • malaise
  • nausea
  • vomiting
  • rashes and eschar (a piece of dry and dark dead skin at the site of the bite). These tend to develop within two weeks after the bacteria have entered the body.

African tick bite fever is one of the mildest forms of rickettsiosis. Patients usually present with fever, headache, muscle pain and an eschar shortly after contracting the disease during a visit to southern Africa.

Fever is a common symptom of all rickettsial diseases.


Mediterranean spotted fever is a serious and potentially life-threatening illness. It’s prevalent in the Mediterranean region, including northern Africa. In addition to fever, rashes and an eschar are typical signs of the illness.

Patients with Rocky Mountain spotted fever often experience fever, headache, nausea, and stomach pain. A rash at the site of the bite is also commonly seen, but eschars aren’t usually present.

The only common symptom of murine or endemic typhus is fever. About half of all patients also develop a rash. Scrub typhus can be contracted in Asia, and it’s characterised by a severe fever, headache and muscle pain. An eschar, cough, enlarged lymph nodes and encephalitis (inflammation of the brain) may also occur in some patients.

The symptoms of ehrlichiosis and anaplasmosis are similar to those of other rickettsial diseases. However, they’re also known to significantly reduce white blood cell count in affected people.

Is Rickettsia The Same As Lyme Disease?

Rickettsiosis and Lyme disease share several symptoms in their early stages, such as fever, headache, fatigue, malaise and muscle pain. Moreover, all of these symptoms also overlap with those of the flu and other non-specific viral infections, making diagnosis even more challenging.

The only distinctive sign of Lyme disease is the circular bull’s eye rash that develops around the tick bite within a few weeks. However, the rash can also appear elsewhere on the body, and in 20-30% of patients it’s not seen at all.

The diagnosis of Lyme and rickettsial diseases is usually based on a combination of factors, including signs, symptoms, patient history and laboratory tests. Unfortunately, currently there aren’t any completely reliable diagnostic tests available for Lyme disease: in the first weeks after infection, there’s a 60% rate of false negative results. Serological assays for rickettsiosis are more reliable, but these can take 10–12 days to provide a decisive result.

Tests such as serological assays are required to identify rickettsiosis.

What To Do If You Think You’ve Been Infected With Rickettsia

Ticks are very tiny, and their bites aren’t painful. Many people don’t even realise they’ve been bitten.

It’s important to note that being bitten by a tick doesn’t mean you’ve contracted an illness. In fact, out of the approximately 800 different tick species in the world, less than 60 can transmit infections to humans and animals. Most types of tick also have to be attached to the host’s body for an extended period of time in order to pass on any bacteria.

Nevertheless, you must see your doctor if you have a fever and any other flu-like symptoms or a rash shortly after being bitten by a tick. You should also arrange a medical appointment if you don’t recall being bitten but you do experience some suspicious symptoms within a few weeks of returning from a high-risk area. Be sure to tell your doctor about your recent travels, so that they can evaluate the probability of a tick-borne infection and order any appropriate diagnostic tests.



According to information written in Carl Tuttle’s petition against the IDSA, he mentions an article that indicates the persistent form of Lyme disease might be caused by another organism altogether.  By Lorraine Johnson Oct 12, 2016


“The STAT article reports that both Jorge Benach and Allen Steere now say it is time to take a closer look at Rickettsia helvetica’s role in Lyme disease. Benach says the research “should be done” because public health concerns warrant a closer look.”

Tuttle also discusses correspondence between Dr. Alan Steere and Willy Burgdorfer dating back to 1980 discussing serological results of sera tested for various Rickettsia and the Swiss Agent (cgP-09) and (TC P-17) being identified in a number of patients:

And according to Allison Caruana, President of The Mayday Project, borrelia associated with Lyme disease are unlike other borrelia, as these organisms are known for an amorphous slime layer:

She states:

“Dr. Willy Burgdorfer reviewed and tested patient blood samples from Dr. Anderson for C9P09, which is a rickettsial helical Mycoplasma; P09 being a Rickettsia bellii and C9 being a Mycoplasma (FIG. 2).35 This is further supported by the theory that an endosymbiotic infection produces spirochetes that are uncultivable Mycoplasmas, which are also called spirochetes. 1, 22, 31, 32

The “Swiss Agent” is documented by Dr. Willy Burgdorfer (FIG. 3),25 who also wrote a speech on “Pandora’s Box”.5 Although the Swiss Agent paper is associated with the suspected African Swine Flu, Dr. Willy Burgdorfer appears to be famous for leaving clues throughout his work regarding Lyme disease. Upon reviewing the structure of the Lyme disease “Swiss Agent” and the “Pandora Giant Virus”, there is a striking resemblance that deserves further examination.”

I don’t think we actually know precisely what the agent(s) causing Lyme disease is. This would explain why it can’t be picked up in current testing and why many fail treatment.

While it’s true that the early stages can often yield unspecific symptoms, an experienced eye will be able to diagnose a patient with tick borne illness.  Also, please remember that in some patients their only symptoms are psychological:  Any acute onset behavior changes should be suspect. Please don’t mess around with mainstream medicine should this occur. Get to an experienced and recommended ILADS practitioner who understands the mental illness aspect of tick borne disease.

Regarding the “classic” bullseye rash, please know that while it is diagnostic of Lyme disease, in the first ever patient sample, only a quarter had it:

Here this nifty table shows that anywhere from 27-80% get it depending upon who’s counting:


The article’s statement that 20-30% of patients don’t get the rash must be taken from the inaccurate CDC count which is always abysmally low.  No one I work with gets the rash.  No one!

Please read this well written article on why we need to stop treating tick-borne illness like a typical infectious disease:

More on Rickettsia:

Seventeen (6.8%) samples were seropositive for antibodies against at least one pathogen: five for A. phagocytophilum, eight for B. burgdorferi, and four for Rickettsia spp.