Archive for the ‘Testing’ Category

Lyme Neuroborreliosis is a Severe & Frequent Neurological Disease in Mexico

https://www.ncbi.nlm.nih.gov/pubmed/30554857/

2018 Aug;49(6):399-404. doi: 10.1016/j.arcmed.2018.11.007. Epub 2018 Dec 13.

Lyme Neuroborreliosis is a Severe and Frequent Neurological Disease in Mexico.

Gordillo-Pérez G1, Solorzano F2, Cervantes-Castillo A3, Sanchez-Vaca G4, García-Ramirez R4, Díaz AM5, Muñoz O2, Torres J3.

Abstract

OBJECTIVE:

To describe clinical cases with neurological manifestations associated with Borrelia burgdorferi infection in a large cohort of children and adults from Mexico.

MATERIAL AND METHODS:

Patients with neurological manifestation (cranial neuritis, radiculoneuritis, meningitis and encephalomyelitis) were recruited in one pediatric and two general hospitals, during January 2006-December 2015. Blood and cerebrospinal fluid (CSF) samples were drawn from each patient at inclusion. IgM and IgG antibodies against B. burgdorferi were detected using a commercial ELISA test, and confirmed by Western-Blot test (WB) using three different antigens from Borrelia burgdorferi complex. Following CDC criteria were considered true cases with both positive tests.

RESULTS:

Of 606 patients recruited, 403 (66.5%) were adults and 203 (33.4%) children, 50.5% were male.

  • B. burgdorferi infection was diagnosed in 168 patients (27.7%), 97 adults, mean age 42 ± 14.7 years and 71 children, mean age 9.6 ± 5 years;
  • early disseminated disease occurred in 130 cases (77.4 %) and
  • chronic stage in 38 (22.6 %)
  • A previous tick bite was reported by 21% cases, and
  • 5% recalled an erythema migrans lesion
  • Polyradiculoneuropathy and encephalomyelitis were the most common manifestations, whereas
  • 14.8% presented an initial Guillain-Barré Syndrome
  • B. burgdorferi sensu stricto was identified in 142 (84%) cases,
  • B. garinii in 14 (8%),
  • B. afzelii in three, and
  • nine cases presented coinfection with two species

CONCLUSION:

Lyme neuroborreliosis is a frequent condition in patients with neurological diseases in Mexico.

_________________

**Comment**

Although a year old, utilizing even older data, this is HUGE, and I’m sure has only gotten worse. Most don’t even consider Lyme disease in South America, much less a severe and frequent disease.

Please note that they only considered people positive IF they tested positive on the abysmal 2-tiered CDC testing that misses over half of all cases:  https://madisonarealymesupportgroup.com/2018/09/12/lyme-testing-problems-solutions/  It’s interesting to me that they describe “clinical” cases of neurological symptoms, yet continue to utilize abysmal testing as their means of diagnosis. What a shame.

How many infected Mexican patients were missed due to poor testing?

Also, please note only 5% recalled an EM rash. This criteria also needs to be thrown to the way-side as a standard for diagnosis:  https://madisonarealymesupportgroup.com/2019/03/26/formally-challenging-cdc-advice-on-lyme-disease-rashes/  Again, if you are lucky enough to get the EM rash, YOU HAVE LYME DISEASE; however, even if you don’t have the EM rash, you might STILL HAVE LYME DISEASE.

Notice nearly 15% presented with an initial Guillain-Barre Syndrome as well as the fact 9 cases had coinfection with TWO species of borrelia.

For more on Lyme in South America:  https://madisonarealymesupportgroup.com/2018/02/06/lyme-in-the-southern-hemisphere-sexual-transmission/

https://madisonarealymesupportgroup.com/2018/12/07/first-report-of-bb-antibodies-in-south-american-veterinarians/

Also, please remember Lyme (borrelia) is only one of many. Patients are typically coinfected with numerous other pathogens:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  If all they used was CDC 2-tiered Lyme testing, not only did they miss tons of patients who weren’t “positive enough,” yet still infected, they also missed the fact many were probably infected with other pathogens.

 

Category:

Lyme, research, Testing

Suspected Insect and Arthropod Vectors for Bartonella Species – Galaxy

https://www.galaxydx.com/suspected-bartonella-vectors/

written on

Suspected Insect and Arthropod Vectors for Bartonella species

Vector-borne diseases like bartonellosis and Lyme borreliosis require the transfer of pathogens from a reservoir to humans by a “competent” vector.

A competent vector can acquire, carry, and pass on the living pathogen. The vector is generally an insect or arthropod that picks up the pathogen(s) while feeding from a reservoir species, such as deer or mice, and later infects an accidental host (a host that is not the usual reservoir) such as a human via a bite or excretions (feces).

Despite what may seem like an obvious cause and effect relationship, it can be very difficult to prove that a vector is competent. Some scientists have heroically proven vector competency by infecting themselves. You can read more about scientists who died as a result of making themselves their own Bartonella experiments here.

Because of the work of those scientists and others, we know that

  • Bartonella bacilliformis is transmitted by keds (biting flies)
  • Bartonella quintana is transmitted by body lice
  • Bartonella henselae is transmitted by fleas

After that the science becomes more uncertain.

The most controversial vector for Bartonella species is hard-bodied ticks of the genus Ixodes. PCR-based assays that detect fragments of DNA have shown that Bartonella bacteria can be found in their gut. However, the research on how viable bacteria are transmitted is still incomplete.

In one study of Ixodes ricinus collected in France, the authors were able to show that Bartonella henselae could be transmitted using an artificial feeding method. If one were to question whether this were adequate proof, the question would center around the fact that the transmission was observed in a controlled laboratory setting and not in nature.

Patients with Bartonella and other tick-borne infections sometimes recall a single tick bite that may have allowed for multiple pathogens to be transferred. Some scientists see this evidence as circumstantial as well and suggest more research is necessary before ticks are considered a competent vector for Bartonella.

Research and case studies have suggested additional arthropod vectors such as ants, mites, spiders, and more. They are not typically suspected in bartonellosis cases due to the very limited number of cases, but the potential is there. See below for some interesting cases:

  • Spiders
    • A family that lived in a house infested with woodlouse spiders became ill from Bartonella infections. Researchers suggested that the spiders were feeding on woodlice, which are also known as roly-polies or pill bugs but are actually land-dwelling crustaceans and not bugs at all. Woodlice have been shown to carry Bartonella species. Researchers suspected that the spiders fed on the infected woodlice and then transmitted the bacteria to the patients via bites.
  • Red ants
    • A man was hospitalized for encephalopathy due to a Bartonella henselae infection following red ant bites. While in the hospital, he experienced two episodes of cardiac arrest. He recovered after receiving systemic anticoagulatory medications and antimicrobials.
  • Triatomines or “Kissing bugs”
    • These biting insects are known to transmit the protozoa Trypanosoma cruzi, which causes Chagas disease. The authors of this paper discuss the role of the sand fly in transmitting Bartonella bacilliformis and suggest Bartonella species could be similarly transmitted in the saliva of other biting insects.
  • Mites
    • Some studies suggest various species of mites as possible vectors of Bartonella species. DNA from Bartonella quintana was incidentally discovered in Demodex mites of a patient with rosacea. Furthermore, mites found on tropical rats and bats showed evidence of carrying Bartonella species as well.

The development of novel molecular techniques like PCR and its variations have allowed researchers to detect Bartonella species in a wide range of insects, arthropods and crustaceans around the world.

Our ePCR technology is used by research partners around the world to better understand the One Health relationship between people, animals and the environment. Mapping the relationship between reservoirs, vectors and human and animal hosts is an important step in making prevention the best treatment.

References

Bradley, J. M. et al. (2014). Bartonella henselae infections in an owner and two Papillon dogs exposed to tropical rat mites (Ornithonyssus bacoti). Vector Borne and Zoonotic Diseases, 14(10), 703-709. doi:10.1089/vbz.2013.1492 https://www.ncbi.nlm.nih.gov/pubmed/25325313

Cotté, V. et al. (2008). Transmission of Bartonella henselae by Ixodes ricinus. Emerging Infectious Diseases, 14(7), 1074-1080. doi:10.3201/eid1407.071110 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600320/

do Amaral, R. B. et al. (2018). Molecular detection of Bartonella spp. and Rickettsia spp. In bat ectoparasites in Brazil. PLoS One, 13(6), e0198629. doi:10.1371/journal.pone.0198629 https://www.ncbi.nlm.nih.gov/pubmed/29870549

Guru, P. K. et al. (2018). A miraculous recovery: Bartonella henselae infection following a red ant bite. BMJ Case Reports, 2018, bcr-2017-222326. doi:10.1136/bcr-2017-222326 https://www.ncbi.nlm.nih.gov/pubmed/29728431?fbclid=IwAR0hoMRFwoz5jVPlepkpigJ6A0zuHWrRoRy4vhNIHxNPtEotjXwqrj6NRa4

Hofmeester, T. R. et al. (2018). Role of mustelids in the life-cycle of ixodid ticks and transmission cycles of four tick-borne pathogens. Parasites & Vectors, 11(1). doi:10.1186/s13071-018-3126-8 https://www.ncbi.nlm.nih.gov/pubmed/30458847

Mascarelli, P. E. et al. (2013). Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasites & Vectors, 6, 98. doi:10.1186/1756-3305-6-98 https://www.ncbi.nlm.nih.gov/pubmed/23587343

Murillo, N. et al. (2014). Bartonella Quintana detection in Demodex from erythematotelangiectatic rosacea patients. International Journal of Infectious Diseases, 29, 176-177. https://doi.org/10.1016/j.ijid.2014.07.021 https://www.ijidonline.com/article/S1201-9712(14)01606-3/fulltext

Viera, C. B. et al. (2018, November). Triatomines: Trypanosomatids, bacteria, and viruses potential vectors? Frontiers in Cellular and Infection Microbiology [Online]. doi:10.3389/fcimb.2018.00405 https://www.ncbi.nlm.nih.gov/pubmed/30505806

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**Comment**

One thing’s for sure – patients in Lyme-land OFTEN have Bartonella as well. Mainstream medicine/research doesn’t even contemplate or consider this well established fact and continues to treat this as a one-pathogen, one-drug disease when nothing could be further from the truth: https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  This recent paper sums it up nicely:

“Our findings recognize that microbial infections in patients suffering from TBDs (tick borne diseases) do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

And, according to this review, 83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe.  The review also states it takes 11 different visits to 11 different doctors, utilizing 11 different tests to be properly diagnosed.  https://www.news-medical.net/news/20181101/Tick-borne-disease-is-multiple-microbial-in-nature.aspx?

Thousands of patients are flying under the radar.

https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

https://madisonarealymesupportgroup.com/2019/06/06/high-titers-of-bartonella-found-in-patients-with-musculoskeletal-complaints/

https://madisonarealymesupportgroup.com/2019/03/21/bartonella-sudden-onset-adolescent-schizophrenia-a-case-study/

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

https://madisonarealymesupportgroup.com/2018/03/15/risk-of-transmission-of-bartonella-via-blood-transfusion-chile/

https://madisonarealymesupportgroup.com/2019/05/09/bartonella-transmitted-to-children-at-birth-causing-chronic-infections/

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

Category:

Bartonella, research, Testing, Ticks, Transmission

Is it Bartonella?

Bartonella is Hard to Diagnose in Chronic Lyme Disease

In this article Dr. Marty Ross describes how to diagnose Bartonella in chronic Lyme disease. There are a lot of controversies in this area. These include:

  • whether Bartonella is transmitted by ticks,
  • poor testing, and
  • a wide range of symptoms that look like other illnesses.

See link for more:  https://www.treatlyme.net/guide/diagnose-bartonella

For more on Bartonella: 

https://madisonarealymesupportgroup.com/2018/05/07/fox-news-bartonella-is-the-new-lyme-disease/

https://madisonarealymesupportgroup.com/2019/05/09/bartonella-transmitted-to-children-at-birth-causing-chronic-infections/

https://madisonarealymesupportgroup.com/2019/04/24/human-bartonellosis-an-underappreciated-public-health-problem/

https://madisonarealymesupportgroup.com/2019/02/27/advanced-imaging-found-bartonella-around-pic-line/

https://madisonarealymesupportgroup.com/2018/05/24/help-support-the-study-of-bartonella/  Chip in and help Dr. Ericson with Bartonella research. Ericson has a vested interest in getting to the bottom of this tenacious pathogen – her son has chronic bartonellosis.

https://madisonarealymesupportgroup.com/2016/12/29/cardinal-state-bartonella/

https://madisonarealymesupportgroup.com/2019/02/06/uh-study-shows-hawaii-kids-more-vulnerable-to-bartonella/

https://madisonarealymesupportgroup.com/2019/03/24/cat-scratch-disease-caused-teens-schizophrenia-like-symptoms-report-says/

 

Category:

Bartonella, Testing, Ticks, Treatment

Characteristics of Transfusion-Transmitted Babesia Microti, American Red Cross 2010-2017

https://www.ncbi.nlm.nih.gov/pubmed/31250463/

2019 Jun 27. doi: 10.1111/trf.15425. [Epub ahead of print]

Characteristics of transfusion-transmitted Babesia microti, American Red Cross 2010-2017.

Tonnetti L1, Townsend RL1, Dodd RY1, Stramer SL1.

Abstract

BACKGROUND:

Babesia microti, a red blood cell (RBC) parasite transmitted naturally to vertebrate hosts by ixodid ticks, is endemic to the northeastern and upper midwestern United States, with the geographic range of infected ticks expanding. B. microti is a blood safety issue with >200 transfusion-transmissions reported.

METHODS:

The American Red Cross’s Hemovigilance program investigated hospital-reported transfusion-transmitted babesiosis (TTB) cases. Follow-up samples from involved donors were tested for B. microti antibodies and parasite DNA, the latter by real-time polymerase chain reaction (PCR). Test-positive donors were permanently deferred from future donations.

RESULTS:

B. microti-positive donors were implicated in 77 of 143 suspect TTB cases investigated from 2010 through 2017. In four cases, two positive donors were identified for a total of 81 positive donors. In three cases, a RBC unit was split and components transfused multiple times to the same pediatric recipient. RBCs were the transmitting product in all cases. At follow-up, all involved donors were antibody positive; 25 donors were also PCR positive. Positive donations were collected throughout the year, peaking in the summer. Most donors (78) were resident of, or traveled to (2), an endemic state. One donor resided in a non-endemic state without relevant travel history. One fatality listed babesia as a contributing factor. No implicated donation was screened by an investigational protocol.

CONCLUSIONS:

Babesiosis remains a blood safety issue. Prior to FDA-licensed screening test availability and final FDA Guidance, blood collectors in endemic states investigationally tested none, a portion, or all collections. Future expanded testing will reduce the frequency of TTB cases.

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**Comment**

This clearly shows there were more than 200 Babesia transfusion-transmissions reported. It also shows you don’t have to reside in an endemic area or travel to an endemic area to get it. The article also clearly points out that the geographic range of ticks is expanding, which means the pathogens they carry will as well.

More on Babesia:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

Babesia, as well as Lyme is under reported. Research hardly exists on those with both. We desperately need to know what concurrent infection is doing to patients. It only makes logical sense that their cases are more severe and of greater duration, yet mainstream research and medicine doesn’t blink at this issue:

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:  https://reference.medscape.com/medline/abstract/8637139

What happens when a patient has Lyme, Babesia, and Bartonella and maybe a few viruses thrown in for good measure?  Nobody’s studied this, yet it is common scenario in Lyme-land:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

Category:

Babesia, research, Testing, Ticks

Seroepidemiological & Molecular Investigation of Spotted Fever Group Rickettsiae & Coxiella Burnetii in Sao Tome Island: A One Health Approach

https://www.ncbi.nlm.nih.gov/pubmed/31231971

Seroepidemiological and molecular investigation of spotted fever group rickettsiae and Coxiella burnetii in Sao Tome Island: A One Health approach.

Hsi TE1, Hsiao SW1, Minahan NT1, Yen TY1, de Assunção Carvalho AV2, Raoult D3, Fournier PE4,5, Tsai KH1,6.

Abstract

Spotted fever group rickettsiae (SFGR) and Coxiella burnetii are intracellular bacteria that cause potentially life-threatening tick-borne rickettsioses and Q fever respectively. Sao Tome and Principe (STP), small islands located in the Gulf of Guinea, recently experienced a dramatic reduction in the incidence of malaria owing to international collaborative efforts. However, unexplained febrile illnesses persist. A One Health approach was adopted to investigate exposure to SFGR and C. burnetii in humans and examine the diversity of these bacteria in ticks parasitizing domestic ruminants. A cross-sectional human serological study was conducted in Agua Grande district in Sao Tome Island from January to March 2016, and ticks were collected from farmed domestic ruminants in 2012 and 2016. In total, 240 individuals varying in age were randomly screened for exposure to SFGR and C. burnetii by indirect immunofluorescence assay. Twenty of 240 individuals (8.3%) were seropositive for SFGR (4 for Rickettsia africae and 16 for R. conorii) and 16 (6.7%) were seropositive for C. burnetii. Amblyomma astrion were collected exclusively in 2012, as were A. variegatum in 2016 and Rickettsia spp. were detected in 22/42 (52.4%) and 49/60 (81.7%) respectively. Sequence analysis of multiple gene targets from Rickettsia spp. detected in ticks suggests the presence of a single divergent R. africae strain (Sao Tome). While no ticks were found positive for C. burnetii, Coxiella-like endosymbionts were detected in nearly all ticks.

This is the first study in STP to provide serological evidence in humans of SFGR and C. burnetii and additional molecular evidence in ticks for SFGR, which may be responsible for some of the unexplained febrile illnesses that persist despite the control of malaria. Future epidemiological studies are needed to confirm the occurrence and risk factors associated with SFG rickettsioses and Q fever in both humans and animals.

____________________

For more:  https://madisonarealymesupportgroup.com/2019/03/20/rocky-mountain-spotted-fever-is-not-the-only-rickettsiosis/

Great article on SFGR: https://www.galaxydx.com/rickettsia-spp/

C. burnetii:  https://madisonarealymesupportgroup.com/2019/03/28/human-tick-borne-diseases-in-australia/

https://madisonarealymesupportgroup.com/2018/10/18/study-finds-q-fever-rickettsia-typhus-in-australian-ticks-and-people/

https://madisonarealymesupportgroup.com/2018/02/03/understanding-q-fever-risk-to-minnesotans/  Excerpt: 

The CDC reports that 60% of cases are in patients without livestock contact (CDC unpublished data, 2010) and the need for health-care professionals to consider Q fever in the differential diagnosis in patients with a compatible illness, even in the absence of occupational risk or history of direct contact with animal reservoirs.

Supposedly, he United States ended its biological warfare program in 1969. When it did, C. burnetii was one of seven agents it had standardized as biological weapons.  https://en.wikipedia.org/wiki/Coxiella_burnetii

Q Fever can cause acute or chronic illness.

https://www.medscape.com/viewarticle/803800
Excellent video by Alicia Anderson, DVM, MPH on new CDC guidelines for Q Fever

https://madisonarealymesupportgroup.com/2019/06/24/other-arthropod-borne-bacteria-causing-nonmalarial-fever-in-ethiopia/  African patients presenting with fever but testing negative for malaria had DNA for these pathogens: Borrelia spp., Francisella spp. Rickettsia spp. and Bartonella. Thus, in this rural area of Africa, febrile symptoms could be due to bacteria transmitted by arthropods.

 

 

 

Category:

Q Fever, research, Rickettsia, Testing, Ticks