Archive for the ‘Testing’ Category

Bartonella Found in Deer Flies, Deer & Moose

https://www.ncbi.nlm.nih.gov/m/pubmed/30245047/

Infections with Bartonella spp. in free-ranging cervids and deer keds (Lipoptena cervi) in Norway.

Razanske I, et al. Comp Immunol Microbiol Infect Dis. 2018.

Abstract

Bartonella bacteria are arthropod-borne and can cause long-term bacteremia in humans and animals. The predominant arthropod vectors and the mode of transmission for many novel Bartonella species remain elusive or essentially unstudied. The aim of this study was to investigate the prevalence of Bartonella spp. in Norwegian cervids and deer keds (Lipoptena cervi) and to characterise the bacteria by sequencing of the partial gltA gene and 16 S-23 S rRNA intergenic spacer region (ITS) in order to evaluate a possible transmission route.

A total of 260 spleen samples and 118 deer keds were collected from cervids by hunters in the Southern part of Norway. Bartonella DNA was detected in 10.5% of spleen samples of roe deer (n = 67), in 35.1% red deer (n = 37), in 35.9% moose (n = 156), and in 85% pools of adult wingless deer ked (n = 59). Two Bartonella lineages were identified based on phylogenetic analysis of the gltA gene and ITS region sequences.

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**Comment**

Bartonella is a HUGE player in Lyme/MSIDS.  More and more is coming out on it’s impact in human disease; however, so much more needs to be done.

Critical information on Bartonella such as transmission studies on possible vectors including congenitally, via breast milk, as well as effective treatments and testing MUST be done.  This type of information is critical to relieve patient suffering.  Climate data WILL NOT move us forward.  There’s only so many research dollars.  Make them count.

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

https://madisonarealymesupportgroup.com/2018/09/20/humana-bartonellosis-perspectives-of-a-veterinary-internist/

https://madisonarealymesupportgroup.com/2017/07/31/shedding-light-on-bartonella/

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

https://madisonarealymesupportgroup.com/2018/05/24/help-support-the-study-of-bartonella/

https://madisonarealymesupportgroup.com/2018/09/25/galaxy-awarded-grant-to-develop-bartonella-testing-in-endocarditis-patients/

 

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

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

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

October 1, 2018

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

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

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

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

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

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

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

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

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

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

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

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

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**Comment**

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

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

More on Ehrlichiosis:

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

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

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

 

 

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

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

Tickology

 Approx. 9 Min

Tick Identification & Ecology

Take aways:

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

 Approx. 12:30 Min.

Tick Borne Diseases

Take aways:

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

  Approx. 8 Min.

Lone Star Tick – The New Tick in Town

Part 3 of the Tickology video project.

Take aways:

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

 Approx. 13:22 Min

Permethrin Treated Clothing & Footwear

Take aways:

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

 Approx. 6 Min

Skin Repellents

Take aways:

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

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

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

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

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

 

 

Road Kill Provides Insight into Tick-borne Pathogens

https://www.ncbi.nlm.nih.gov/m/pubmed/30230270/

Road-killed mammals provide insight into tick-borne bacterial pathogen communities within urban habitats.

Szekeres S, et al. Transbound Emerg Dis. 2018.

Abstract

Small and medium-sized mammals play an important role in the life cycle of tick-borne pathogens in urban habitats. Our aim was to apply the general protocol, DAMA (documentation-assessment-monitoring-action), which is an integrated proposal to build a proactive capacity to understand, anticipate, and respond to the outcomes of accelerating environmental change. Here we tested whether road killed carcasses in urban areas are useful sources of tissue and parasite samples to investigate these species’ contribution to the epidemiology of vector-borne diseases.

We collected 29 road-killed and 6 carcasses with different causes of mortality (23 northern white-breasted hedgehogs and twelve from seven other mammal species) mainly from Budapest, Hungary. We used quantitative and conventional PCRs to determine pathogens in 90 collected tissues (52 from hedgehogs; 38 from other species) and 417 ticks that were only found on hedgehogs.

Tissue samples revealed a wide range of bacteria including human zoonotic pathogens identified as Anaplasma phagocytophilum ecotype I, Borrelia afzelii, B. spielmanii, B. miyamotoi, Rickettsia helvetica and Bartonella species. Among the twenty-three collected hedgehog carcasses 17 (74%) were infected with A. phagocytophilum, six (26%) with B. burgdorferi s.l., 12 (52%) with R. helvetica and 15 (65%) with Rickettsia sp. Furthermore, we report the first detection of Rickettsia sp. infection in European moles and lesser weasel and R. helvetica in stone marten. Through sequencing B. afzelii, R. helvetica, R. monacensis and A. phagocytophilum ecotype I were identified in the ticks removed from the carcasses. We showed that road-killed urban mammal species are exposed to multiple tick-borne pathogens but further studies have to clarify whether they, in fact, also have a role in their maintenance and spread. Our study also demonstrates that roadkill can be used in the risk assessment of potential human infection and in the implementation of the DAMA protocol.

 

 

 

Lyme & Reason: Interviews with Advocates & Researchers

 Approx. 20 Min

Lyme & Reason: Battles & Breakthroughs Against Lyme Disease

Published on Sep 5, 2018

It’s a battle that has been raging for decades – the battle against Lyme Disease. Over the years, progress has been made against this dreaded tick-borne illness. But with breakthroughs come even more barriers. Watch this early peek at a new Fox 5 News special on the fight that could be signaling a new chapter in the ongoing bout against Lyme.
  • Interview with President and CEO of Valneva, Thomas Lingelbach on the Lyme Vaccine
  • Interview with Dr. Sung Lee on Lyme testing and his lawsuit against the CDC
  • Interview with Olivia Goodreau of LivLyme – an organization that raises money for research