Archive for the ‘Rickettsia’ Category

Start Treatment if TBI’s are Suspected

http://www.mdedge.com/ccjm/article/141387/dermatology/tickborne-diseases-other-lyme-united-states  Cleveland Clinic Journal of Medicine. 2017 July;84(7):555-567

KEY POINTS

  • Tickborne illnesses should be considered in patients with known or potential tick exposure presenting with fever or vague constitutional symptoms in tick-endemic regions.
  • Given that tick-bite history is commonly unknown, absence of a known tick bite does not exclude the diagnosis of a tick-borne illness.
  • Starting empiric treatment is usually warranted before the diagnosis of tickborne illness is confirmed.
  • Tick avoidance is the most effective measure for preventing tickborne infections.

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The article delineates symptoms, transmission, reservoirs, testing, and treatment of the following TBI’s:  Rocky Mountain Spotted Fever, Rickettsiosis, Ehrlichioses, Babesiosis, Tickborne relapsing fever, Borrelia miyamotoi, Southern Tick-associated Rash illness, Tularemia, and Tickborne viral infections.

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I need to address the following statements at the end of the article:

“Knowledge of the geographic locations of potential exposure is paramount to determining which tickborne infections to consider, and the absence of a tick bite history should not exclude the diagnosis in the correct clinical presentation.

Clinicians need to tread carefully here.  Many patients have been denied testing and treatment due to a map.  These maps should be viewed with the same suspicion as the testing.  

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Until you tell the fox, squirrel, bird, deer, lizards, and hundreds of other reservoirs to stay put, ticks will be traveling everywhere along with the pathogens they carry.  Since Lyme Disease (borrelia) has been found in every continent except for Antarctia (it will be found there too), you can assume that means ticks are there too.  

I’m glad the authors stated this:

In addition, it is important to recognize the limitations of diagnostic testing for many tickborne infections; empiric treatment is most often warranted before confirming the diagnosis.”132_fail316x316

For those of us in this war, this “empiric treatment” by mainstream medicine is new.  Patient after patient has had to wait for test results before doctors will treat them.  Often, since the testing is so poor, it comes back negative and the patient is sent packing, even if the patient has every symptom in the book.  The next step is for authorities to admit and acknowledge that diagnosis of Tick borne infections is a clinical one.  This means doctors need to learn a whole lot more.  For docs willing to learn, please see:  https://www.lymecme.info

Even the CDC is stating to treat empirically:  https://madisonarealymesupportgroup.com/2017/07/01/good-morning-america-cdc-advises-multiple-lyme-tests-due-to-false-negative-results/ CDC spokesperson at end of video.

Another very important point needs to be made.  The CDC has pushed this one pathogen for one tick mantra for too long.  Many patients are co-infected making cases infinitely more complex and challenging to treat.  Lyme literate doctors trained by ILADS understand this and treat accordingly.  Until mainstream medicine realizes and admits people can have numerous pathogens, and treat for them, people will not get better.

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One last point is that mycoplasma, Bartonella, and other pathogens are not included here but are quite common in patients.  Both of these pathogens are persistent and adept at surviving.  More research needs to be done on these co-infections.

Please see:

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/  If ticks are co-infected, so are patients.

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

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

 

 

Wolbachia – The Next Frankenstein?

Transmission electron micrograph of Wolachia within an insect cell

Credit:  Public Library of Science/Scott O’Neill

The latest in the effort for world domination over bugs and the diseases they carry is Wolbachia, a Gram-negative bacterium of the family Rickettsiales first found in 1924 and in 60% of all the insects, including some mosquitoes, crustaceans, and nematodes (worms). For those that like numbers, that’s over 1 million species of insects and other invertebrates. It is one of the most infectious bacterial genera on earth and was largely unknown until the 90’s due to its evasion tactics. It’s favorite hosts are filarial nematodes and arthropods.

Wolachia obtains nutrients through symbiotic relationships with its host. In arthropods it affects reproductive abilities by male killing, parthenogenesis, cytoplasmic incompatibility and feminization. However, if Wolbachia is removed from nematodes, the worms become infertile or die. These abilities are what make it so appealing for insect controlcytoplasmic incompatibility, which essentially means it results in sperm and eggs being unable to form viable offering.

http://www.slideserve.com/babu/wolbachia  (Nifty slide show here)

It also makes it appealing for use in human diseases such as elephantiasis and River Blindness caused by filarial nematodes, which are treated with antibiotics (doxycycline) targeting Wolbachia which in turn negatively impacts the worms. Traditional treatment for lymphatic Filariasis is Ivermectin but they also use chemotherapy to disrupt the interactions between Wolbachia and nematodes. This anti-Wolbachia strategy is a game-changer for treating onchocerciasis and lymphatic filariasis.  https://www.sciencedaily.com/releases/2017/03/170316120451.htm

Lyme/MSIDS patients often have nematode involvement.

https://microbewiki.kenyon.edu/index.php/Wolbachiahttps://www.psychologytoday.com/blog/emerging-diseases/200902/tick-menagerie-lyme-isnt-the-only-disease-you-can-get-tick  Both Willy Burgdorfer, the discoverer of the Lyme bacterium, as well as Richard Ostfeld, an animal ecologist found nematode worms in ticks. Since then, some provocative research involving nematodes, Lyme/MSIDS, dementia, and Alzheimer’s has been done.

https://madisonarealymesupportgroup.com/2016/06/03/borrelia-hiding-in-worms-causing-chronic-brain-diseases/https://madisonarealymesupportgroup.com/2016/08/09/dr-paul-duray-research-fellowship-foundation-some-great-research-being-done-on-lyme-disease/https://madisonarealymesupportgroup.com/2016/07/10/greg-lee-excellent-article-on-strategies-for-neurological-lyme/https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/

https://www.scientificamerican.com/article/how-a-tiny-bacterium-called-wolbachia-could-defeat-dengue/  Yet, according to many, Wolbachia is the next eradicator of Dengue Fever and possibly Malaria, chikungunya, and yellow fever because it stops the virus from replicating inside mosquitoes that transmit the diseases. The approach is also believed to have potential for other vector-borne diseases like sleeping sickness transmitted by the tsetse fly.  Evidently, Wolbachia does not infect the Aedes aegypti mosquito naturally, so researchers have been infecting mosquitoes in the lab and releasing them into the wild since 2011. The article states it hopes that the method works and expects infection rates in people to drop and hopes that the mosquitoes will pass the bacterium to their offspring, despite it disappearing after a generation or two of breeding and needing to “condition” the microbes to get them used to living in mosquitoes before injecting them. They also state Wolbachia is “largely benign for mosquitoes and the environment,” and “To humans, Wolbachia poses no apparent threat.” Their work has shown that the bacterium resides only within the cells of insects and other arthropods. They also state that tests on spiders and geckos that have eaten Wolbachia mosquitoes are just fine and show no symptoms. An independent risk assessment by the Commonwealth Scientific and Industrial Research Organizatioin (CSIRO), Australia’s national science agency, concluded that, “Release of Wolbachia mosquitoes would have negligible risk to people and the environment.”

Interestingly, trials are underway in Vietnam, Indonesia, and now Brazil.

They state that scaling up operations to rear enough Wolbachia mosquitoes is too labor-intensive and in Cairns they are going to put Wolbachia mosquito eggs right into the environment. Evidently, other researchers are wanting to release genetically modified (GMO) mosquitoes that carry a lethal gene, and they’ve done it, and it’s causing an uproar:   http://america.aljazeera.com/articles/2013/11/9/genetically-modifiedmosquitoessetoffuproarinfloridakeys.html

http://www.naturalnews.com/2017-07-25-googles-sister-company-releasing-20-million-mosquitoes-infected-with-fertility-destroying-bacteria-depopulation-experiment.html  As of July 14, 2017, Google’s bio-lab, Verily Life Sciences,  started releasing Wolbachia laced mosquitoes in California as part of project, Debug Fresno to reduce the mosquito population.

http://www.greenmedinfo.com/blog/research-exposes-new-health-risks-genetically-modified-mosquitoes-and-salmon  Numerous studies show unexpected insertions and deletions which can translate into possible toxins, allergens, carcinogens, and other changes.  Science can not predict the real-life consequences on global pattens of gene function.

So, why question the use of Wolbachia as a bio-control?

For Lyme/MSIDS patients, 3 words: worms and inflammation.

Dogs treated for heart worm (D. immitis) have trouble due to the heart worm medication causing Wolbachia to be released into the blood and tissues causing severe Inflammation in pulmonary artery endothelium which may form thrombi and interstitial inflammation. Wolbachia also activates pro inflammatory cytokines. Pets treated with tetracycline a month prior to heart worm treatment will kill some D. immitis as well as suppress worm production. When given after heart worm medication, it may decrease the inflammation from Wolbachia kill off.
http://www.critterology.com/articles/wolbachia-and-their-role-heartworm-disease-and-treatment

The words worms and inflammation should cause every Lyme/MSIDS patient to pause. Many of us are put on expensive anthelmintics like albendazole, ivermectin, Pin X, and praziquantel to get rid of worms and are told to avoid anything causing inflammation due to the fact we have enough of it already. We go on special anti-inflammatory diets and take systemic enzymes and herbs to try and lower inflammation.   https://madisonarealymesupportgroup.com/2016/04/22/systemic-enzymes/

Seems to me, many MSIDS/LYME patients when treated with anthelmintics, will have Wolbachia released into their blood and tissues causing wide spread inflammation, similarly to dogs.

And that’s not all.

According to a study by Penn State, mosquitoes infected with Wolbachia are more likely to become infected with West Nile – which will then be transmitted to humans.“This is the first study to demonstrate that Wolbachia can enhance a human pathogen in a mosquito, one researcher said. “The results suggest that caution should be used when releasing Wolbachia-infected mosquitoes into nature to control vector-borne diseases of humans.” “Multiple studies suggest that Wolbachia may enhance some Plasmodium parasites in mosquitoes, thus increasing the frequency of malaria transmission to rodents and birds,” he said.  The study states that caution should be used when releasing Wolbachia-infected mosquitoes into nature. https://www.sciencedaily.com/releases/2014/07/140710141628.htm

So besides very probable wide spread inflammation, and that other diseases may become more prevalent due to Wolbachia laced mosquitoes, studies show Wolbachia enhances Malaria in mosquitos. Lyme/MSIDS patients are often co-infected with Babesia, a malarial-like parasite that requires similar treatment and has been found to make Lyme (borrelia) much worse. It is my contention that the reason many are not getting well is they are not being treated for the numerous co-infections.  Some Lyme/MSIDS patients have Malaria and Lyme.

Regardless of what the CDC states, all the doxycycline in the world is not going to cure this complicated and complex illness.

Lastly, with Brazil’s recent explosion of microcephaly, the introduction of yet another man-made intervention (Wolbachia laced mosquitos) should be considered in evaluating potential causes and cofactors. And while the CDC is bound and determined to blame the benign virus, Zika, there are numerous other factors that few are considering – as well as the synergistic effect of all the variables combined. Microcephaly could very well be a perfect storm of events.
https://madisonarealymesupportgroup.com/2016/12/21/how-zika-got-the-blame/https://madisonarealymesupportgroup.com/2016/03/04/health-policy-recap/https://madisonarealymesupportgroup.com/2016/03/08/fixation-on-zikapolio/

I hate bugs as much as the next person, but careful long-term studies of Wolbachia are required here.

https://www.ncbi.nlm.nih.gov/pubmed/20394659  “Despite the intimate association of B. burgdorferi and I. scapularis, the population structure, evolutionary history, and historical biogeography of the pathogen are all contrary to its arthropod vector.

In short, borrelia (as well as numerous pathogens associated with Lyme/MSIDS), is a smart survivor.

While borrelia have been around forever with 300 strains and counting worldwide, epidemics, such as what happened with Lyme Disease in Connecticut are not caused by genetics but by environmental toxins – in this case, bacteria, viruses, funguses, and stuff not even named yet.

Circling back to Wolbachia.

Hopefully it is evident that many man-made interventions have been introduced into the environment causing important health ramifications: Wolbachia laced mosquitoes and eggs, GMO mosquitoes including CRISPR, and in the case of Zika in Brazil, whole-cell pertussis vaccinations (DTap) for pregnant women up to 20 days prior to expected date of birth, a pyriproxyfen based pesticide applied by the State in Brazil on drinking water, as well as aerial sprays of the insect growth regulators Altosid and VectoBac (Aquabac, Teknar, and LarvX, along with 25 other Bti products registered for use in the U.S.) in New York (Brooklyn, Queens, Staten Island, and The Bronx) to combat Zika. “We feel it’s critical that the scientific community consider the potential hazards of all off-target mutations caused by CRISPR, including single nucleotide mutations and mutations in non-coding regions of the genome … Researchers who aren’t using whole genome sequencing to find off-target effects may be missing potentially important mutations. Even a single nucleotide change can have a huge impact.”  http://articles.mercola.com/sites/articles/archive/2017/06/13/crispr-gene-editing-dangers.aspx?utm_source=dnl&utm_medium=email&utm_content=art3&utm_campaign=20170613Z1_UCM&et_cid=DM147520&et_rid=2042753642

All of this is big, BIG business.

Is the introduction of Wolbachia another puzzle piece in the perfect storm of events causing or exacerbating human health issues?

The jury’s still out, but it’s not looking good – particularly for the chronically ill.

Two Deaths From RMSF & Indiana Has TBI’s

https://www.lymedisease.org/tick-related-deaths/

Two deaths from tick-borne Rocky Mountain spotted fever (RMSF) have been reported recently, one a 2-year-old girl in Indiana, and the other a 20-year-old woman in Tennessee. In both cases, the patients were initially diagnosed as having the flu.

In the Indiana case, young Kenley Ratliff developed a high fever about 10 days after her family had returned from a camping trip. She tested positive for strep, and antibiotics were administered. But the fever kept rising over the next several days. By the time doctors suspected RMSF and changed to an appropriate medication, it was too late. More details about Kenley’s case here.

Tennessee health officials confirmed this week that Katie Underhill died from RMSF on May 20. News reports say she battled the disease for five weeks, also after initially being treated for the flu. More details here.

Rocky Mountain spotted fever is caused by the bacterium Rickettsia rickettsii, and is spread to humans by the bite of an infected tick.

Medical experts say RMSF can be fatal within the week, if not treated appropriately. The CDC recommends that doctors administer doxycycline immediately if the disease is suspected, and not wait for confirming lab work.

These cases underscore the need for people to become much more tick-aware when spending time outdoors, and for doctors to consider tick-borne illness as a possibility when patients present with flu-like symptoms in spring and summer.

Read more about rickettsial illnesses here.

Another case of RMSF where the patient survived:  https://www.washingtonpost.com/national/health-science/rocky-mountain-spotted-fever-isnt-limited-to-the-rockies-and-its-deadly/2015/11/16/a447c5a6-531d-11e5-933e-7d06c647a395_story.html?utm_term=.891b5d16b7f8

This Indiana family also shares their story of Lyme Disease.  Four of Five children in the family have LD.  Indiana has LD and RMSF and I’m sure other TBI’s (tick borne illness). Video found here:  http://wishtv.com/2017/05/10/family-shares-story-of-lyme-disease-a-tick-borne-illness/

 

Review of Tick Attachment Time For Different Pathogens

http://dx.doi.org/10.3390/environments4020037

Stephanie L. Richards, Ricky Langley, Charles S. Apperson and Elizabeth Watson 

Abstract

Improvements to risk assessments are needed to enhance our understanding of tick-borne disease epidemiology.

We review tick vectors and duration of tick attachment required for pathogen transmission for the following pathogens/toxins and diseases: (1) Anaplasma phagocytophilum (anaplasmosis); (2) Babesia microti (babesiosis); (3) Borrelia burgdorferi (Lyme disease); (4) Southern tick-associated rash illness; (5) Borrelia hermsii (tick-borne relapsing fever); (6) Borrelia parkeri (tick-borne relapsing fever); (7) Borrelia turicatae (tick-borne relapsing fever); (8) Borrelia mayonii; (9) Borrelia miyamotoi; (10) Coxiella burnetii (Query fever); (11) Ehrlichia chaffeensis (ehrlichiosis); (12) Ehrlichia ewingii (ehrlichiosis); (13) Ehrlichia muris; (14) Francisella tularensis (tularemia); (15) Rickettsia 364D; (16) Rickettsia montanensis; (17) Rickettsia parkeri (American boutonneuse fever, American tick bite fever); (18) Rickettsia ricketsii (Rocky Mountain spotted fever); (19) Colorado tick fever virus (Colorado tick fever); (20) Heartland virus; (21) Powassan virus (Powassan disease); (22) tick paralysis neurotoxin; and (23) Galactose-α-1,3-galactose (Mammalian Meat Allergy-alpha-gal syndrome).

Published studies for 12 of the 23 pathogens/diseases showed tick attachment times. Reported tick attachment times varied (<1 h to seven days) between pathogen/toxin type and tick vector. Not all studies were designed to detect the duration of attachment required for transmission. Knowledge of this important aspect of vector competence is lacking and impairs risk assessment for some tick-borne pathogens.

**Highlights**

The researchers point out that unlike mosquitoes which rely on saliva for transmission, ticks can transmit via saliva, regurgitation of gut contents, and also via the cement-like secretion used to secure itself to the host (hard ticks).  Published data on transmission times relies upon rodent studies showing 15–30 min for Powassan, anywhere from 4-96 hours for bacteria, 7–18 days for the protozoan Babesia microti, and 5-7 days for neurotoxin (Tick Paralysis). For soft ticks, attachment time of 15 sec–30 min was required for transmission of Borrelia turicata (Tick Relapsing Fever).

The challenge with these studies, and there are many, is that most placed multiple ticks on multiple rodents.  Multiple ticks may be transmitting different pathogens.  It has also been shown that ticks feeding on mice coinfected with B. microti and B. burgdorferi were twice as likely to become infected with Bb compared to B. microti, suggesting that coinfection can amplify certain pathogens – which is another reason to only use one rodent and one pathogen to separate out multiplying factors to muddy the waters.  Also, rarely do studies record the titer of both tick and host – again, making it nearly impossible to determine what’s what.  It was also noted that transmission times are unknown for many pathogens.

**And as always:  if you are the ONE person who contracted Lyme Disease in 10 minutes, all these numbers are essentially meaningless.  The frightening truth is that these numbers, along with geographical information regarding tick habitats, are often used against patients.  It is beyond time for doctors to listen, educate themselves, and treat patients with the respect they deserve – not to mention it’s time for them to treat patients clinically and not based on tests that are wrong over half the time and with the knowledge that ticks are spreading everywhere and bringing the pathogens with them. (In other words, throw the maps away!)

The review essentially gives the following transmission times for various pathogens. Again, please know these numbers are not definitive and many, many cases have proven this fact.

Take each and every tick bite seriously and don’t mess around and take a “wait and see approach.”  There is too much at stake.

Transmission Times noted in review:

Anaplasmosis: 24 hours and increased dramatically after 48-50 hours.  It is possible for it to be transmitted transovarially (from mom to baby tick) and it inhabit’s the salivary glands more frequently than the mid-gut.

Babesiosis:  Greater than 36 hours, 17% after 48 hours, and 50% after 54 hours.  Can be transmitted transovarially and transstadially (pathogen stays with tick from one stage to the next).  Ticks feeding on mice coinfected with B. microti and B. burgdorferi were twice as likely to become infected with Bb compared to B. microti.

Lyme Disease (Borrelia burgdorferi):  24 hours; however, the researchers comment that there are questions regarding previous transmission studies.  They also commented that there may be a difference in attachment time between nymphs and adult females. Transovarian transmission is unknown.

Tick Relapsing Fever (Borrelia turnicatae, B. hermsii):  15 and 30 seconds respectively.  Transovarian transmission is unknown.

Borreliosis (Borrelia mayonii):  24 hours.  Transovarian transmission is unknown.

Borrelia myamotoi Disease:  24 hours.  Transovarial transmission occurs.

Tularemia (Francisella tularensis):  Not assessed.  Can be transmitted mechanically by deer flies, horse flies, mosquitoes, aerosol/ingestion when processing/eating infected animal tissues.  Can be transmitted transtadially and transovarially.

Rocky Mountain Spotted Fever (Rickettsia rickettsii):  10-20 hours.  Can be transmitted transovarially.

Heartland Virus:  Not assessed.  Can be transmitted transovarially and transstadially.

Powassan Virus:  15 Minutes; however, it is possible it was sooner since the first they checked for transmission was 15 minutes.  Can be transmitted transovarially.

Tick Paralysis (Neurotoxin):  2-6 days.

Alpha Gal/Mammalian Meat Allergy (Galactose-a-1,3-Galactose):  Not assessed.  Transovarian transmission is unknown.

For more on transmission times, please read:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/

 

 

Minocycline for MS and Much More

https://www.sciencedaily.com/releases/2017/06/170601124019.htm

Canadian researchers have discovered that minocycline, a common acne medication, can slow relapsing-remitting multiple sclerosis in those with initial symptoms.

Standard treatment costs for MS treatment in Canada range from $20,000 to $40,000 per year, with the cost tripled in the U.S.  Treatment using minocycline would cost about $600 per year.  

According to lead author, Dr. Luanne Metz, neurologists will be able to give mino to patients who have MRI results suggesting an MS cause and who are suffering with initial symptoms of demyelination.  

In the study, http://www.nejm.org/doi/full/10.1056/NEJMoa1608889 one group was given 100mg twice a day of minocycline while the other group was given a placebo.  Over six months there was a 27.6% reduction in full blown MS.  (Risk was 61% in placebo group and 33.4% in the mino group).

Minocycline has been used safely and effectively for over 30 years and has many anti-inflammatory and antioxidant properties, chelates calcium and is well-tolerated.  A Tetracycline drug that is bacteriostatic, it is widely used against both gram negative and gram positive pathogens including Rickettsia, Chlamydia, Plasmodium spp., and Mycoplasma pneumoniae.

Minocycline, as most Lyme/MSIDS patients know, is one of the most effective antibiotics which crosses the blood brain barrier, due to its high lipid solubility.  It is one of my personal favorites and the most effective drug for the excruciating occipital (base of the skull) headaches I get due to Tick-borne infections.  If you experience these, please read:  https://madisonarealymesupportgroup.com/2016/04/02/chiari/ as brain infections can cause Chiari.

According to Spanish researchers, Minocycline is much more than just an antibiotic.  Minocycline far beyond an antibiotic  Not only is it antimicrobial and anti-inflammatory, it has also been shown to be neuroprotective, anti-apoptotic, and it inhibits proteolysis, angiogenesis and tumor metastasis.  Preclinical trials have shown it to inhibit malignant cell growth and activation and repletion of HIV, and  prevents bone resorption.  It has helped those with Parkinson’s, Huntington’s, ALS, Alzheimer’s, and spinal cord injury.  The link in blue demonstrates minos effectiveness against dermatitis, periodontal disease, rheumatoid arthritis, and CNS (central nervous system) pathologies, osteoporosis, and autism, as well as has potential to help atherosclerosis, inflammatory bowel disease, and allergic asthma.  The researchers also feel mino is a rational treatment for neuropathic pain, something Lyme/MSIDS patients understand up close and personal.

Mino is inexpensive, has a known side-effect profile, and is well-absorbed (95-100%).  It, along with doxycycline, due to their ability to penetrate the cell wall, is commonly used for Lyme disease treatment:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

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?

Podcast: Lyme Disease and Tick-Borne Co-infections

https://globallymealliance.org/podcast-lyme-disease-tick-borne-co-infections/

PODCAST: LYME DISEASE AND TICK-BORNE CO-INFECTIONS
January 17, 2017

The most common tick-borne infection is Lyme disease. However, infected ticks also carry and spread numerous co-infections.

The newest Global Lyme Alliance podcast, with GLA’s Dr. Harriet Kotsoris and Dr. Mayla Hsu, discusses Lyme disease and the co-infections that are often transmitted along with the initial tick bite. Below is an excerpt.  https://soundcloud.com/user-988784721/lyme-disease-and-tick-borne-co-infections  (Click on this link for the entire podcast or you can fast forward to 13:15 and it will pick up at Bartonella which is where the transcript stops below.  It also goes into viruses and STARI).

Host: In this podcast we’re going to expand our discussion to include co-infecting tick-borne diseases that are often transmitted along with Lyme. I’m in our studio with Dr. Harriet Kotsoris and Dr. Mayla Hsu who are science and research officers at the Global Lyme Alliance. I’ll start off by asking, what is a tick-borne infection?
Dr. Harriet Kotsoris: A tick-borne infection is an infectious disease spread by the bite of an infected tick. The most common is Lyme disease but many others are present in the same tick bite. Depending on the location and the season, up to half of all ticks may have had more than one kind of microbe or disease producing organism that can make humans very sick. The list of microbes is expanding up to 11 or 12 at last count, but we’ll focus today on the major ones. These are called co-infections, the simultaneous infection of a host by multiple pathogenic or disease producing organisms.
There is an increasing number of ticks that are multiply infected as we just said. In a recent west European study of Ixodes ricinus ticks, very similar to the American black legged deer tick, up to 45% of those ticks were co-infected with up to five pathogens or disease producing organisms. We have a similar experience here in the United States.
Host: How many people get tick-borne infections?
Dr. Kotsoris: The Centers for Disease Control calculates about 330,000 Lyme disease cases per year but it may be even over 400,000. It’s not really understood how many of these are also infected with other microbes, which in some cases cause different illnesses that require different diagnostic tests and different treatments.
Host: What can you tell us about the ticks that spread these diseases?
Dr. Mayla Hsu: Well in the United States there are different families of ticks that may be co-infected with various pathogens. As Harriet just mentioned, the Ixodes ticks or the black-legged ticks are now in half of all United States counties. There’s another tick that is further south, known as the Lone Star and there is also an American dog tick called Dermacentor that also harbors infectious microbes.
Host: How about internationally?
Dr. Hsu: Well it seems that ticks are generally found in all temperate climate zones, so there are the Ixodes species in North America, these are also found in Europe and Asia, there are other ticks found in Africa, parts of temperate Africa, that infect humans as well as animals there, and they’re responsible for causing relapsing fevers. There are soft ticks, Ornithodoros, the Ornithodoros family of ticks, that are found in South America and Western Africa, and these too are associated with causing diseases in humans. The jury is still out in Australia. There are ticks there but it’s not known whether or not they’re correlating with human disease.
Host: What do we know about changing tick geography?
Dr. Kotsoris: It seems that in the United States, the geographic range where ticks are found is expanding and we know that with climate change the range is also changing, so for instance, it is expanding northwards into Canada where Lyme disease was never a concern, it now is starting to emerge. We can expect and see more tick-borne diseases elsewhere, also spreading in through the United States. These are now classified as emerging infections and so public health authorities are very concerned about this and tracking the emergence of more tick-borne illnesses.
Host: What are some of the emerging tick-borne diseases and again we’re going to focus only on the major ones about which the most is known.
Dr. Hsu: One of the more interesting tick-borne illnesses that has been emerging in recent years is called babesiosis. This is an illness caused by a parasite that’s very similar to malaria. It’s called Babesia, Babesia microti. This is characterized by recurrent fevers, so people get fevers that spike and then go away and then come back over and over again, chills, muscle and joint aches and pains and it can be actually fatal in rare cases. The diagnostic test for this is not a blood test looking for antibodies, rather the blood is examined under a microscope and here you can see the organism actually growing in red blood cells, so just like malaria it grows in red blood cells and you can see it in a blood smear and the treatment required for this is also very similar to anti-malaria therapies, so that’s drugs that are similar to quinine but also anti-protozoan drugs like Atovaquone, also known as Mepron, and antibiotics, azithromycin and clindamycin.
About 1,800 people were reported to have gotten babesiosis in the year 2013, and the numbers are rising so where we see Lyme disease we are also starting to see more and more Babesia, and it’s important to point out that the treatment and diagnostic for Babesia is different from that of Lyme disease, so if Lyme disease is suspected and is looked for, and treated, a person who also has Babesia will not get adequately diagnosed or treated and can continue to be ill.
Host: There are several bacterial diseases that are spread by ticks that have been getting more attention in recent years, Anaplasma and Ehrlichia.
Dr. Kotsoris: Yes, historically these started out as veterinary diseases. They were identified in the late 80s and early 1990s, after having been studied as long-standing veterinary problems. These organisms belong to a group known as the Rickettsiae, Anaplasma, Ehrlichia, and Rickettsia itself. These are what we call obligate intracellular parasites. They’re bacteria that only live inside the cells of another organism, and that’s how they affect humans. Human granulocytic anaplasmosis is what we call a gram-negative bacterium of the rickettsia family. It invades white blood cells after a tick bite by an infected tick and it travels and lodges within granulocytes or the neutophils, the white blood cells of the human being.
About one to two weeks after the bite, the patient will develop spiking fevers, headache, drop in white blood count, drop in platelet count…the platelets are responsible for clotting blood, and a rise of liver function tests indicative of an inflammation of the liver. These organisms are very smart and release a chemical substance known as a chemokine, or a cytokine, interleukin-8 that actually is an attracting chemical for white blood cells to help propagate the infection throughout the body. The diagnosis has to be made by blood smear because the comparison of acute and convalescent sera that is the development of convalescent antibodies may be too late in the game, that the patient will have been compromised medically and treatment will have been delayed. The diagnosis can also be made by something known as polymerase chain reaction and the treatment is doxycycline, 100 milligrams twice a day, similar to what’s used in acute Lyme disease and the treatment is until three days after the disappearance of the fever.
Related is something known as human monocytic ehrlichiosis. Ehrlichia and Anaplasma were used interchangeably in the past, but now they’ve been divided into separate categories because of the bacterial composition. Human granulocytic anaplasmosis is carried by the black legged deer tick, Ixodes scapularis, Ixodes pacificus on the west coast, but this vector for human monocytic ehrlichiosis is the Lone star tick, or Amblyomma americanum and Dermacentor variabilis, the American dog tick. The classic infection in the Midwest in particular is by Ehrlichia chaffeensis and Ehrlichia ewingii, more so chaffeensis. Usually peaking in July, usually affecting males older than 50 years old, and again, within a few weeks of the tick bite, the patient develops headaches, muscle aches, otherwise known as myalgias, fatigue, a drop in white blood count, a drop in platelet count, fever, gastrointestinal systems, which may lead to also respiratory insufficiency and kidney failure.
The three states most affected by Ehrlichia chaffeensis and ewingii are Oklahoma, Missouri, and Arkansas. They account for 30% of the reported cases of these bacterial species. The numbers have been reported in the low thousands over the last few years. In 2009, a third cause of human ehrlichiosis was identified in the upper Midwest. This has been known as Ehrlichia muris-like agent. Interestingly, it also exists in Eastern Europe and Asia. The detection of this pathogen or disease producing organism is by looking for the DNA, that is the genetic material, of this organism in the blood of patients. About 2.5% of Ixodes scapularis ticks are infected by this E. muris type agent. Note that this one is spread by Ixodes scapularis, the black legged deer tick, not the Lone Star tick as in human monocytic ehrlichiosis.
One of the better known bacterial infections that people read about, hear about, especially with people traveling into the Rocky Mountain area, into the Midwest, into the Southeast, is something known as Rocky Mountain Spotted Fever. This is Rickettsia rickettsia…it is spread by the American dog tick, by the Rocky Mountain wood tick, and by the brown dog tick. There are reported 14 cases per million population, peaking in April through September. Despite its name, as I said before, it’s not confined to the Rocky Mountains, it’s also found in the southeastern United States. These bacteria, after the tick bite, travel within the blood stream and lodge within endothelial cells, that’s the lining cells of small blood vessels, and elicit inflammatory changes and make the blood vessels leaky, affecting all organs infected, especially the skin and the adrenal glands. The platelets responsible for clotting are consumed and you may have kidney malfunctioning.
Patient will present with severe headaches, high fevers, a few days after the bite and a few days after that, a spotted rash on the wrists, palms, and ankles. Patient may also have abdominal pain, nausea, vomiting, and other generalized symptoms. The mortality rate can be as high as 4% and this is caused by a delay in diagnosis and treatment. The treatment is doxycycline and patients do best, and have a much lower morbidity and mortality if they’re treated within five days of being infected.
Below is the full podcast with Dr. Kotsoris and Dr. Hsu. They continue their overview of Lyme and co-infections, specifically Bartonella and the Powassan virus.

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