Archive for the ‘Testing’ Category

Tick Bites & Coinfections

https://www.globallymealliance.org/blog/dear-lyme-warrior-help-tick-bites-and-co-infections

Dear Lyme Warrior…Help! Tick Bites and Co-Infections

by Jennifer Crystal on May 27, 2022

<span id="hs_cos_wrapper_name" class="hs_cos_wrapper hs_cos_wrapper_meta_field hs_cos_wrapper_type_text" style="" data-hs-cos-general-type="meta_field" data-hs-cos-type="text" >Dear Lyme Warrior…Help! Tick Bites and Co-Infections</span>
Every few months, Jennifer Crystal devotes a column to answering your questions. Do you have a question for Jennifer? If so, email her at lymewarriorjennifercrystal@gmail.com.
Now that tick season is upon us, friends ask me what to do when they find an embedded tick. What should I tell them?

While this question seems like it should have a simple answer, people probably get conflicting information from the internet and even from physicians about what they should do if they find a tick. This is because there is debate about how long a tick needs to be attached to a human or pet in order to transmit the bacteria that causes Lyme disease. The old standard of 36-48 hours doesn’t necessarily apply anymore, now that we know that ticks can transmit bacteria faster if they were already partially fed before biting you, and that some tick-borne diseases can be transmitted much faster than Lyme disease—Powassan virus in as little as 15 minutes.

There are two general rules of thumb that I always tell people: the first is that the longer a tick is attached, the greater chance it has of transmitting pathogens. And unless you see the tick bite you, you can’t really know how long it’s been attached. If you notice it after a long day of hiking, you don’t know if it bit you early in the morning, or just as you were leaving. What if you don’t notice it until the next day, after you’ve done some gardening and walked through the grass? If a tick is engorged, you know it has been feeding, but it can be hard to pinpoint exactly where and when it became attached to you, which makes the certain-number-of-hours recommendation moot.

This leads to my second rule of thumb: with Lyme and other tick-borne diseases, it is always better to be safe than sorry. I tell people that if they find a tick, they should call their doctor and get right on antibiotics. Even if those antibiotics end up being prophylactic, it is safer than the alternative—finding out weeks, months or years later that they’re sick with Lyme and possibly with co-infections, too—and then needing far more extensive treatment than the initial antibiotic course. Waiting for test results (often faulty, especially early in infection), waiting for a rash (which doesn’t appear in up to 30% of people with Lyme), or waiting for other symptoms (different for everyone), is a dangerous approach to Lyme disease. (For more information, see my blog post “The Danger of ‘Waiting and Seeing’ with Lyme Disease”).

The next question is, how long a course of prophylactic antibiotics should you take? The Infectious Diseases Society of America (IDSA) recommendation of a single dose of prophylactic doxycycline is based on one study that showed good efficacy in preventing Lyme rash, but as we’ve established, not everyone with Lyme disease gets a rash. The International Lyme and Associated Diseases Society (ILADS) recommends a 10-20 day course of antibiotics. For me personally, I’d rather have the coverage of a full treatment course that is used for actual Lyme infection, rather than take my chances that a single dose will keep me safe. Each person needs to make their own decision with their doctor, but it’s important that decision be an informed one!

Do other tick-borne diseases have the same treatment as Lyme disease?

This is a great follow-up question to the first, because some people might think, “Well, if I’m taking antibiotics for Lyme disease, then I’ve got other tick-borne diseases covered.” That’s true for some co-infections, but not for all, so this, too, is dangerous thinking. Some co-infections like anaplasmosis and ehrlichiosis are treated with the same antibiotic as Lyme disease, but the length of treatment might be different. Other tick-borne diseases like babesiosis, which is a parasite that infects the red blood cells, require completely different treatment. And still another co-infection, bartonellosis, needs more urgent research for better treatments (learn more about GLA’s Bartonella Discovery Program here). I always tell people, “If you’re being treated for Lyme disease and don’t know you have babesiosis, you’re only fighting half the battle.” If you find a tick attached to you, it’s imperative that you talk to your doctor about other tick-borne diseases, not just Lyme, and know the signs of them (see “Common Tick-Borne Diseases”).

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The Bartonella Discovery Program:

GLA is currently fundraising for The Bartonella Discovery Program, a research project bringing together some of the top researchers world-wide who are experts on Bartonellosis. These researchers will learn more about the bacteria and which treatments are most likely to cure patients like Beth, who are suffering from Bartonellosis.

None of the work GLA has accomplished would be possible without your support. To learn more and fund this project, click on top link.

Writer

Jennifer Crystal

Opinions expressed by contributors are their own. Jennifer Crystal is a writer and educator in Boston. Her work has appeared in local and national publications including Harvard Health Publishing and The Boston Globe. As a GLA columnist for over six years, her work on GLA.org has received mention in publications such as The New Yorker, weatherchannel.com, CQ Researcher, and ProHealth.com. Jennifer is a patient advocate who has dealt with chronic illness, including Lyme and other tick-borne infections. Her memoir about her medical journey is forthcoming. Contact her via email below.

Email: lymewarriorjennifercrystal@gmail.com

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**COMMENT**

Before you take the 10-20 days of doxy too literally, please read this excerpt from the ILADS website:

Treatment Guidelines

  • The optimal treatment regimen for the management of known tick bites, EM rashes and persistent disease has not yet been determined. Accordingly, it is too early to standardize restrictive protocols. However, ILADS does make recommendations for each of these clinical situations

    • ILADS recommends against the use of a single 200 mg dose of doxycycline for the prevention of Lyme disease. Not only is it unlikely to be highly efficacious, in the human trial failed therapy led to a seronegative disease state.

    • Based on animal studies, ILADS recommends that known blacklegged tick bites be treated with 20 days of doxycycline (barring any contraindications).

    • Given the low success rates in trials treating EM rashes for 20 or fewer days, ILADS recommends that patients receive 4-6 weeks of doxycycline, amoxicillin or cefuroxime. A minimum of 21 days of azithromycin is also acceptable, especially in Europe. All patients should be reassessed at the end of their initial therapy and, when necessary, antibiotic therapy should be extended.

    • ILADS recommends that patients with persistent symptoms and signs of Lyme disease be evaluated for other potential causes before instituting additional antibiotic therapy.

    • ILADS recommends antibiotic retreatment when a chronic Lyme infection is judged to be a possible cause of the ongoing manifestations and the patient has an impaired quality of life.

So, there’s a lot of clinical judgement needed here and nothing is straight forward.  Each patient is unique and needs to be treated accordingly.  And please remember, none of this covers coinfections, which often require completely different medications for differing lengths of time and are just as severe if not worse than Lyme disease.

For more on treatments:

Category:

Lyme, Testing, Ticks, Transmission, Treatment

Changes to CDC’s Lyme Case Definition Add Complexity, Case Undercounting

https://invisible.international/changes-to-cdcs-lyme-case-definition-add-complexity-case-undercounting/

Changes to CDC’s Lyme case definition add complexity, case undercounting

Kris Newby on May 24, 2022

In January 2022, the U.S. Council of State and Territorial Epidemiologists (CSTE) published a revision to its 2017 Lyme disease case definition. This definition will soon be integrated into the physician reporting form that is used by the Centers for Disease Control (CDC) to classify, count, and track Lyme disease cases consistently across the country.

The annual Lyme disease case count is an important metric for allocating government research dollars and staff resources. With about 476,000 new cases a year and growing, the CDC’s previous case definition and reporting requirement was already burdensome for both physicians and local health departments. (In 2016, Massachusetts modified the CDC reporting criteria because of this. In 2008, New Jersey wrote about the burdens of the surveillance criteria here.) Unfortunately, the 2022 revision and the public health burden of the COVID-19 pandemic may only make this situation worse. (See link for article & references)

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SUMMARY:

  • The 2 biggest changes are the inclusion of Borrelia mayonii in the Lyme case count, and the option to use a cheaper, simpler test in the 2nd part of the standard 2-tiered testing.
  • The problems are with these changes are:
    • There are no FDA-approved Bm tests and traditional testing only picks up about half of all cases.
    • Replacing the Western blot with antibody EIA tests, while cheaper and easier to interpret, eliminates useful clinical data that can shed light on late-stage disease. The revision only uses the IgG or “late stage” EIA test which doesn’t acknowledge the dormant and relapsing nature of Lyme.
    • The EIA tests must be FDA approved which will discourage accurate, validated testing done at smaller specialty labs.  These smaller CIA-certified labs are what LLMDs use, but are shunned by mainstream medicine due to this “FDA-approved” issue.
  • Leading to further under-reporting is utilizing CDC data that is more than a year old as well as utilizing a “reporting decision trees” for low and high incidence cases areas and other complicated matrices when Lyme has been detected in ALL 50 states and the District of Columbia and the fact people can get infected while traveling.
  • The positive changes include:
    • Inclusion of symptoms other than Lyme arthritis such as neurological symptons.
    • Highlighting the fact surveillance case definitions are not to be used for making clinical diagnoses or treatment decisions.
  • Overall, the CSTE & CDC have added burdensome complexity and have ignored new sources of data and analytical tools to make case counting more accurate.
Newby feels that the CDC’s Data Modernization Initiative, a disease tracking system, is a light at the end of the tunnel.  I disagree, here’s why:
  • This multi-year, billion-plus dollar effort to ‘modernize’ core data and surveillance infrastructure will effectively monopolize/centralize data giving the corrupt and inept CDC far too much power.  They have clearly demonstrated their inability to effectively deal with a ‘pandemic’ and have numerous conflicts of interest.  The agency, along with the FDA & NIAD should be completely disbanded.  We need to learn from COVID and stop history from repeating itself.
  • The following excerpt from the CDC website is telling: “CDC is connecting with partners from across public health and the private sector – including in healthcare, research, and academia — to make sure we get this right.”
  • Lyme/MSIDS patients and advocates daily feel the results of centralized/controlled medicine as it severely limits and hampers our ability to get diagnosed and treated.  The similarities between the handling of Lyme and COVID can not be overstated.
    • Politicization of disease puts undue pressure on physicians, making them afraid to treat patients. Doctors would prefer to diagnose you with anything but Lyme/MSIDS – it’s safer.
    • This fact is clearly seen by the formation of ILADS which is comprised of health professionals whom disagree with how Lyme/MSIDS is handled and have chosen to break off and form their own group with their own education and training to train physicians and to give patients a better way.
    • Yet, Lyme patients and advocates continue to want to crawl in bed, support, and even fund science with the very enemy that is suppressing true science and patient help.
Please see my comments after this article for more on this matter.
It defies all logic and reason, but this is the current state of affairs unless we wake up and smell the coffee.

Category:

Activism, Borrelia Miyamotoi (Relapsing Fever Group), Lyme, Testing

Tick-borne Diseases & Coinfection: Current Considerations

https://www.sciencedirect.com/science/article/abs/pii/S1877959X20304775

Tick-borne diseases and co-infection: Current considerations

https://doi.org/10.1016/j.ttbdis.2020.101607Get rights and content

Abstract

Over recent years, a multitude of pathogens have been reported to be tick-borne. Given this, it is unsurprising that these might co-exist within the same tick, however our understanding of the interactions of these agents both within the tick and vertebrate host remains poorly defined. Despite the rich diversity of ticks, relatively few regularly feed on humans, 12 belonging to argasid and 20 ixodid species, and literature on co-infection is only available for a few of these species. The interplay of various pathogen combinations upon the vertebrate host and tick vector represents a current knowledge gap. The impact of co-infection in humans further extends into diagnostic challenges arising when multiple pathogens are encountered and we have little current data upon which to make therapeutic recommendations for those with multiple infections. Despite these short-comings, there is now increasing recognition of co-infections and current research efforts are providing valuable insights into dynamics of pathogen interactions whether they facilitate or antagonize each other. Much of this existing data is focussed upon simultaneous infection, however the consequences of sequential infection also need to be addressed. To this end, it is timely to review current understanding and highlight those areas still to address.

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**Comment**

Timely is an understatement.  Long over due is more appropriate.

For more:

Category:

Lyme, research, Testing, Ticks

Bartonella With Dr. Brian Plante, ND

https://www.betterhealthguy.com/episode165

Episode #165: Bartonella with Dr. Brian Plante, ND

Last Updated: May 11 2022

Why You Should Listen

In this episode, you will learn about the vector-borne infection Bartonella.

Watch The Show

Listen To The Show
About My Guest

My guest for this episode is Dr. Brian Plante. Brian Plante, ND is a licensed naturopathic doctor with extensive training in integrative healthcare approaches. He specializes in working with patients suffering from complex immune dysfunction such as Lyme disease, chronic viral infections, environmental toxicity (such as from mold and heavy metals), autoimmune disease, Mast Cell Activation Syndrome, and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis. Additionally, Dr. Plante helps patients recover from functional gastrointestinal conditions, adrenal and thyroid disorders, and neuropsychiatric disorders. With each patient Dr. Plante meets, he conducts a comprehensive evaluation in order to get a complete picture and then creates individualized treatment plans to address that patient’s specific concerns. Dr. Plante is a graduate of the National University of Natural Medicine in Portland, OR, as well as a member of the International Lyme and Associated Diseases Society (ILADS). He believes that one integral step in helping patients heal from complex chronic illness is by empowering them with knowledge and understanding. He facilitates this by patiently taking however much time is needed to investigate a patient’s symptoms and concerns thoroughly. Through compassionate listening, thoughtful instruction, and a steadfast commitment to helping patients experience lasting, positive change, Dr. Plante can combat the frustration patients often experience in their struggle to find answers. His goal with every patient with whom he interacts is to provide support and guidance in their journey toward achieving optimal health.

Key Takeaways

  • What symptoms provide clues for the potential of Bartonella?
  • Could Bartonella be an explanation for many neuropsychiatric conditions?
  • Might Bartonella play a role in SIBO?
  • What are the vectors through which Bartonella may be acquired?
  • What labs are useful for exploring the potential presence of Bartonella?
  • How often does mold exposure play a role in Bartonella patients?
  • Can Bartonella be a trigger for MCAS?
  • Can Bartonella be a driver of autoimmunity and immune dysregulation?
  • Might Bartonella play a role in hypermobility syndromes and Ehlers-Danlos Syndrome?
  • What role does Bartonella play in Morgellons?
  • What is the foundation for treating Bartonella?
  • What modalities can be helpful for terrain optimization?
  • What role do nutritional IVs play in Bartonella treatment?
  • Are antibiotics necessary in treating Bartonella?
  • What herbs may be helpful for addressing Bartonella?
  • How might oxidative therapies such as ozone, EBOO, and ozone plasmapheresis be used?
  • How often do biofilms need to be addressed?
  • What antimicrobial and immune-modulating peptides have a role?
  • Can Bartonella be fully eradicated?
  • Once a patient has recovered, can treatment be stopped? Or is there a maintenance strategy for longer-term support?

Connect With My Guest

http://BioResetMedical.com

See top link for transcript.

For more:

Category:

Bartonella, Herbs, Psychological Aspects, Testing, Treatment

Gundersen Still Giving Wrong Advice About Tick Bites

Please see my comment after the article.

https://www.gundersenhealth.org/health-wellness/be-well/how-to-remove-an-embedded-tick/

Removing ticks: The right way and the wrong way

Tick season is here! While most tick bites are harmless, some ticks can carry diseases, such as Lyme disease. Knowing what steps to take following a tick bite can reduce your risk of infection.

Remove the embedded tick as soon as possible. The longer a tick is attached, the higher the risk of transmitting tick-borne illnesses.

Follow these steps:

  • Gently pull the tick out with tweezers by grasping its head as close to the skin as possible.
  • If the head remains, try to remove with a sterile needle.
  • Wash the bite site with soap and water. Rubbing alcohol may be used to disinfect the area.
  • Apply an ice pack to reduce pain.

Avoid the following:

  • Do not grab the tick at the rear of the body
  • Do not twist or jerk tick while pulling it out
  • Do not use alternative methods to remove it; such as fingernail polish, alcohol, petroleum products, or a hot match.

Identify the tick. Take note of the size and color of the tick, whether it was attached to the skin (ticks must bite you to spread their germs), if it was engorged (full of blood) and about how long it was attached. A healthcare provider may ask you these questions if you begin to experience symptoms.

Watch for symptoms. If signs of infection, rash or flu-like symptoms occur within 30 days of the tick bite, seek medical attention.

Remember, a tick that is crawling on you but has not attached to your skin cannot infect you. However, if you find one tick, there could be more. Check your body carefully and use these tips to prevent future bites. Prevention is the best medicine.

If you have questions regarding tick bites or bug bites, contact our 24/7 Nurse Advisor Line at (608) 775-4454.

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**Comment**

Taking the “wait and see” approach has doomed thousands to a life-time of misery.  Wisconsin has a high rate of infected ticks, which simply means you have a higher likelihood of becoming infected. Any risk involved with taking a few weeks of antibiotics is well worth it.  This 5 year old article states:

On average, about 22 percent of deer tick nymphs in Wisconsin have been found to be infected with Borrelia burgdorferi. The infection rate for adults is about twice as high, around 40-45 percent. In some locations, though, researchers have found infection rates as high as 75 percent of the tick population.

I assure you, it’s only getting worse.

ILADS recommends at least 20 days of doxycycline for an acute tick-bite. It’s important to remember that this mono therapy will not cover many of the confections so it’s important to track symptoms and keep in close contact with your doctor – preferably an ILADS-trained doctor who understand the nuances of treatment.  And coinfections are just as bad if not worse than Lyme disease.  Some of these infections can be transmitted within minutes and have a high mortality rate, so each and every tick bite needs to be taken as seriously as a heart attack.

This article is much more thorough.  Please file it away for future reference if you get a tick bite.

Also, go here for prevention methods.

Category:

Lyme, Prevention, Testing, Ticks, Transmission