Archive for the ‘Rickettsia’ Category

Emerging Tick-Borne Diseases & Blood Safety: Summary of a Public Workshop

https://pubmed.ncbi.nlm.nih.gov/32208532/

. 2020 Mar 24.

doi: 10.1111/trf.15752. Online ahead of print.

Emerging Tick-Borne Diseases and Blood Safety: Summary of a Public Workshop

Affiliations expand

Abstract

Tick-borne agents of disease continue to emerge and subsequently expand their geographic distribution. The threat to blood safety by tick-borne agents is ever increasing and requires constant surveillance concomitant with implementation of appropriate intervention methods. In April 2017, the Food and Drug Administration organized a public workshop on emerging tick-borne pathogens (excluding Babesia microti and Lyme disease) designed to provide updates on the current understanding of emerging tick-borne diseases, thereby allowing for extended discussions to determine if decisions regarding mitigation strategies need to be made proactively. Subject matter experts and other stakeholders participated in this workshop to discuss issues of biology, epidemiology, and clinical burden of tick-borne agents, risk of transfusion-transmission, surveillance, and considerations for decision making in implementing safety interventions. Herein, we summarize the scientific presentations, panel discussions, and considerations going forward.

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**Comment**

I only had access to the abstract, but Dr. Cameron writes more fully on the workshop here:  https://danielcameronmd.com/babesia-infection-transmitted-blood-supply/

Interestingly, according to the abstract, they excluded Babesia and Lyme, which are arguably two of the largest problems. It was pointed out that 200 cases of Babesia were transmitted through blood transfusions at the time of the workshop and that Anaplasma is next with increasing clinical cases.

Evidently there have been no reported cases of Lyme transmitted through the blood supply.

 

Other tick-borne pathogens have been transmitted through donated blood, but these occurrences are rare. (Or rarely reported)

  • 11 cases: A. phagocytophilum, responsible for Anaplasmosis (transmitted by the Ixodes ticks)
  • 2 cases: Tick-borne encephalitis virus complex (TBEV, Powassan virus, DTV), (transmitted by the Ixodes ticks)
  • 1 case: Colorado tick-fever virus (transmitted by Rocky Mountain wood ticks)
  • 1 case: Rickettsia rickettsii, the agent of Rocky Mountain Spotted Fever (transmitted by the Lone Star tick)
  • 1 case: Ehrlichia ewingii (transmitted by the Lone Star tick)

In addition, “two emerging [tick-borne agents] − B. miyamotoi and Powassan virus were discussed − for B. miyamotoi,cases have steadily increased since 2014.”

For more:  https://madisonarealymesupportgroup.com/2019/07/28/tick-borne-infection-risk-in-blood-transfusion/

https://madisonarealymesupportgroup.com/2018/10/11/transfusion-transmitted-babesiosis-one-states-experience/

https://madisonarealymesupportgroup.com/2017/08/08/transfusion-transmitted-babesiosis-in-nonendemic-areas/

https://madisonarealymesupportgroup.com/2019/05/26/fda-recommends-testing-for-tick-borne-illness-in-donated-blood-a-big-duh/

https://madisonarealymesupportgroup.com/2016/06/02/study-showing-results-testing-babesia-microti/

 

Asian Longhorned Tick Able to Transmit RMSF in Lab Setting (Also Transmitted Within Ticks Through Ova)

https://pubmed.ncbi.nlm.nih.gov/32338290/

The Ability of the Invasive Asian Longhorned Tick Haemaphysalis Longicornis (Acari: Ixodidae) to Acquire and Transmit Rickettsia Rickettsii (Rickettsiales: Rickettsiaceae), the Agent of Rocky Mountain Spotted Fever, Under Laboratory Conditions

2020 Apr 27;tjaa076.
doi: 10.1093/jme/tjaa076. Online ahead of print.
  • PMID: 32338290

Abstract

The invasive Asian longhorned tick, Haemaphysalis longicornis Neumann, was first detected in the United States in 2017. It has since been found in 12 states, and there is concern that the tick’s parthenogenetic ability and wide variety of host species may allow for broader dissemination. Of the tick-borne diseases endemic to the United States, Rocky Mountain spotted fever (RMSF), a rapidly progressive and potentially fatal disease caused by Rickettsia rickettsii, is the most severe. There is considerable geographical overlap between spotted fever rickettsioses cases, which include RMSF, and the currently known distribution of H. longicornis, providing the potential for this tick to encounter this pathogen.

We have evaluated the ability of H. longicornis to acquire and transmit R. rickettsii under laboratory conditions. Haemaphysalis longicornis as larvae and nymphs acquired the pathogen while feeding on infected guinea pigs. The infection persisted through every life stage, all of which were able to transmit R. rickettsii to naïve hosts. The pathogen was also transmitted at a low frequency between generations of H. longicornis through the ova. While H. longicornis was demonstrated to be a competent vector for R. rickettsii under laboratory conditions, the probability of its involvement in the maintenance and transmission of this pathogen in nature, as well as its potential impact on human health, requires further study.

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**Comment**

The Asian Long-horned tick used to be known as pretty much just a livestock pest.  Obviously, researchers are changing their tune.  What makes this tick particularly unique and equally terrifying is its ability to reproduce through cloning – making a literal infestation very quickly. It is traipsing through the entire U.S. – having been found in at least 12 states.

Here we see it can also transmit Lyme (although they say “minimally” – whatever that means)  https://madisonarealymesupportgroup.com/2019/10/26/researchers-conclude-asian-longhorned-tick-contributes-minimally-to-lyme-disease-in-the-u-s/

The pressing question is what all do they transmit?  We know this so far:  

It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” causing fever, fatigue, headache, nausea, muscle pain, diarrhea, vomiting, abdominal pain, disease of the lymph nodes, and conjunctival congestion, but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, this Longhorned tick, also called the East Asian or bush tick, has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.  https://madisonarealymesupportgroup.com/2018/06/12/first-longhorned-tick-confirmed-in-arkansas/

For a 2016 literature review on SFTS: http://infectious-diseases-and-treatment.imedpub.com/research-advances-on-epidemiology-of-severefever-with-thrombocytopenia-syndrome-asystematic-review-of-the-literature.php?aid=17986
Although the clinical symptoms of SFTS and HGA are similar to each other, but the treatment methods of the two diseases are totally different. Doctors notice that the biggest difference between the clinical symptom of SFTS and HGA is that SFTS patients generally without skin rash, the dermorrhagia is also not seriously, and few massive hemorrhage cases were reported [23]. It is also reported that SFTS patients had gastrointestinal symptoms, such as nausea, vomiting, and diarrhea, which are rarely observed in HGA patients [2]. So these differences can be used as the auxiliary basis of differential diagnosis.
At present, there is still no specific vaccine or antiviral therapy for SFTSV infection. Supportive treatment, including plasma, platelet, granulocyte colony stimulating factor (GCSF), recombinant human interleukin 11, and gamma globulin is the most essential part of case treatment [44]. Meanwhile, some measures were taken to maintain water, electrolyte balance and treat complications are also very important.
Ribavirin is reported to be effective for treating Crimean-Congo Hemorrhagic Fever (CCHF) infections and hemorrhagic fever with renal syndrome, but it is still inadequate to judge the effect of ribavirin on SFTS patients because of the study limitation without adequate parameters were investigated [45]. Host immune responses play an important role in determining the severity and clinical outcome in patients with infection by SFTSV.
For Viral treatment options:  https://madisonarealymesupportgroup.com/2016/03/28/combating-viruses/

And lastly, please know ticks parasitize one another, potentially spreading all manner of diseases to humans.  This fact also shoots holes in the regurgitated mantra that only certain ticks carry certain pathogens.  If they are feasting on one another, they can potentially infect each other and then us:  https://madisonarealymesupportgroup.com/2018/03/07/tick-bites-tick-hyperparasitism/

https://madisonarealymesupportgroup.com/2018/07/19/rutgers-racing-to-contain-asian-longhorned-tick/

And now it appears to have the ability at least in a lab setting to transmit RMSF.  For more:  https://madisonarealymesupportgroup.com/2018/09/14/rocky-mountain-spotted-fever-rmsf/

https://madisonarealymesupportgroup.com/2019/07/25/kentucky-more-than-two-dozen-rocky-mountain-spotted-fever-cases-reported-in-grayson-county/

https://madisonarealymesupportgroup.com/2017/10/21/mom-got-rocky-mountain-spotted-fever-while-picking-pumpkins/

https://madisonarealymesupportgroup.com/2015/08/13/severe-case-of-rmsf-had-to-remove-patients-arms-and-legs/

https://madisonarealymesupportgroup.com/2018/08/16/new-tick-causes-epidemic-of-rmsf/

 

 

 

 

Rickettsiosis in Children – A Review

https://www.ncbi.nlm.nih.gov/pubmed/32112308/

2020 Feb 28. doi: 10.1007/s12098-020-03216-z. [Epub ahead of print]

Rickettsioses in Children – A Review.

Abstract

Rickettsial diseases, caused by a variety of obligate intracellular, Gram-negative bacteria from the genera Rickettsia, Orientia, Ehrlichia, Neorickettsia, Neoehrlichia, and Anaplasma are considered some of the most covert emerging and re-emerging diseases. Scrub typhus, murine flea-borne typhus and Indian tick typhus are commonly being reported and during the last decade. Scrub typhus (ST) has emerged as a serious public health problem in India. Rickettsial infections are generally incapacitating and difficult to diagnose; untreated cases have case fatality rates as high as 30-45% with multiple organ dysfunction, if the specific treatment is delayed. Early clinical suspicion, timely diagnosis followed by institution of specific antimicrobial therapy shortens the course of the disease, lowers the risk of complications and reduces morbidity and mortality due to rickettsial diseases. Still there is large gap in our knowledge of Rickettsioses and the vast variability and non-specific presentation of these have often made it difficult to diagnose clinically. The present review describes the epidemiology, clinical manifestations, diagnostic modalities and treatment of Scrub typhus which is a vastly underdiagnosed entity and clinicians should suspect and test for the disease more often.

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For more:  https://madisonarealymesupportgroup.com/2019/11/14/study-shows-ticks-can-transmit-rickettsia-immediately/

https://madisonarealymesupportgroup.com/2019/11/11/is-rickettsia-the-same-as-lyme-disease/

https://madisonarealymesupportgroup.com/2019/01/03/tick-bite-in-ear-gave-uk-teacher-rickettsial-typhus-infection/

 

Dogs With Proteinuria Found to Have Exposure to Rickettsia, Ehrlichia, and Lyme Disease

https://www.ncbi.nlm.nih.gov/pubmed/31916316/

2020 Jan 8. doi: 10.1111/jvim.15610. [Epub ahead of print]

A retrospective study of vector-borne disease prevalence in dogs with proteinuria: Southeastern United States.

Abstract

BACKGROUND:

Proteinuria is a risk factor for progressive kidney injury in dogs. Enhanced understanding of potential associations between canine vector-borne diseases (CVBD) and proteinuria is needed.

OBJECTIVES:

To determine the proportion of evaluated proteinuric dogs exposed to ≥1 CVBD, including Babesia spp., Ehrlichia spp., spotted-fever group Rickettsia, Bartonella spp., Anaplasma spp., hemotropic Mycoplasma spp., Borrelia burgdorferi, and Dirofilaria immitis, and to determine if demographic or clinicopathologic differences exist between proteinuric dogs exposed to CVBD versus proteinuric dogs with no evidence of CVBD exposure.

ANIMALS:

Two-hundred nine proteinuric dogs, concurrently tested for CVBD, which were examined at a single academic veterinary hospital between January 2008 and December 2015.

METHODS:

Retrospective cross-sectional study. Demographic, clinicopathologic, and CVBD test results were extracted from medical records. A multivariable logistic regression model was used to assess associations between CVBD and selected variables.

RESULTS:

Based on serology and polymerase chain reaction testing,

  • 34% of proteinuric dogs (72/209) were exposed to ≥1 CVBD
  • Exposure to Rickettsia spp. (19%)
  • Ehrlichia spp. (12%)
  • B. burgdorferi (9%)

The CVBD exposure was lower in dogs tested in autumn or spring, higher in intact dogs, and higher in dogs with lower serum albumin and higher serum creatinine concentrations.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Exposure to CVBD, particularly exposure to Rickettsia spp., Ehrlichia spp., and B. burgdorferi was found in proteinuric dogs from the southeast United States. Additional controlled prospective studies examining a potential causal relationship between CVBD and proteinuria are warranted.

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**Comment**

The question of course is – does this also happen in humans and to what degree?

 

Bartonella Found in Dogs After Infection With Rickettsia

https://www.ncbi.nlm.nih.gov/pubmed/31891215/

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

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

Abstract

BACKGROUND:

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

OBJECTIVES:

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

ANIMALS:

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

METHODS:

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).

RESULTS:

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.

CONCLUSIONS AND CLINICAL IMPORTANCE:

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.

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**Comment**

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:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Others have found that vaccines have reactivated dormant infections:  https://madisonarealymesupportgroup.com/2016/04/24/gardasil-and-bartonella/

Excerpt:

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.

https://madisonarealymesupportgroup.com/2017/12/02/scottish-doctor-gives-insight-on-lyme-msids/

Excerpt:

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.