Archive for the ‘Testing’ Category

Lyme Disease-Causing Bacteria Spotted on Routine Blood Films

https://news.mayocliniclabs.com/2021/08/11/rare-lyme-disease-causing-bacteria-spotted-on-routine-blood-films/

Rare Lyme Disease-Causing Bacteria Spotted on Routine Blood Films

Eye on Innovation features exciting advances taking place at Mayo Clinic Laboratories. This monthly series shines a spotlight on recently developed tests and highlights how Mayo Clinic translates ideas and discoveries into testing resources that improve diagnosis and care for patients across the globe.

The bacterium was revealed through Mayo Clinic Laboratories’ polymerase chain reaction (PCR) blood test for Lyme disease (Test ID: PBORR). That PCR testing is the preferred method for differentiating between the two bacteria. People who have B. mayonii infection also may test positive with the Lyme disease serology test (Test ID: LYME), but the test will not distinguish a B. mayonii infection from a B. burgdorferi infection.

It’s long been known that Lyme disease is caused by bacteria transmitted through the bite of an infected black-legged tick (otherwise known as the deer tick). The understanding for many years was that one species of bacteria was the main culprit behind Lyme disease in the United States: Borrelia burgdorferi.

But in 2016, researchers at Mayo Clinic discovered a new species of bacteria that causes Lyme disease. They named it Borrelia mayonii, after Mayo Clinic’s founders, Drs. William and Charles Mayo.

A key difference that has been noted between B. mayonii and B. burgdorferi is that B. mayonii spirochetes are found at high levels in peripheral blood, whereas B. burgdorferi spirochetes are not. Researchers surmised that meant the B. mayonii spirochetes potentially could be found on routine peripheral blood smears.

http://

Borrelia mayonii, Aug. 18, 2021

“IT IS IMPORTANT FOR PATHOLOGISTS AND LABORATORIANS TO KNOW THAT SPIROCHETES OF BORRELIA MAYONII CAN OCCASIONALLY BE SEEN ON ROUTINE PERIPHERAL BLOOD SMEARS,” SAYS BOBBI PRITT, M.D., CHAIR OF MAYO’S DIVISION OF CLINICAL MICROBIOLOGY AND THE PAPER’S LEAD AUTHOR. “OTHERWISE, THEY WOULD PROBABLY ASSUME THAT THE SPIROCHETES WERE FROM THE BORRELIA SPECIES THAT CAUSE RELAPSING FEVER, WHICH IS VERY DIFFERENT FROM LYME DISEASE.”

Because B. mayonii has only been found in the Upper Midwest of the United States, it remains a rare cause of Lyme disease and may frequently go undetected. Understanding that its spirochetes can occasionally be visualized in routine blood films may raise awareness and recognition of the uncommon bacterium, and it could point the way to more consistent and accurate diagnosis of this cause of Lyme disease.

That proved to be true earlier this year when staff in Mayo Clinic’s Division of Clinical Microbiology observed several spirochaetes on thin blood films from a specimen that had tested PCR positive for B. mayonii. The bacteria were confirmed to be B. mayonii through genome sequencing. The findings were published in July in the journal Clinical Microbiology and Infection.

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**Comment**

Since Borrelia miyamotoi is not a reportable illness to the CDC, no one has any clue about prevalence, and despite authorities continually stating it’s “rare,” reports are coming in continually that it’s highly likely to be a much bigger problem than ‘authorities’ believe.  Also, despite their statement that Bm has only been found in the upper midwest in the U.S., California ticks have carried Bm for a long time, and there are reports of it worldwide.

It was recently discovered that:

For more:

Category:

Borrelia Miyamotoi (Relapsing Fever Group), research, Testing

With Three Invasive Tick Species Thriving in Connecticut, State Scientist Warns of Major Public Health Hazard

https://www.courant.com/news/connecticut/hc-news-ct-more-ticks-20210816-eafwrhehkbhspacc7r5qrw4m4m-story.html

With three invasive tick species thriving in Connecticut, state scientist warns of major public health hazard

By 
HARTFORD COURANT 
AUG 16, 2021 
Stratford, Ct. - 08/13/2021 - Dr. Goudarz Molaei, with Connecticut's Agricultural Experiment Station, searches for ticks trapped on a canvas dragged through shoreline vegetation. Photograph by Mark Mirko | mmirko@courant.com
Stratford, Ct. – 08/13/2021 – Dr. Goudarz Molaei, with Connecticut’s Agricultural Experiment Station, searches for ticks trapped on a canvas dragged through shoreline vegetation. Photograph by Mark Mirko | mmirko@courant.com (Mark Mirko/The Hartford Courant)

State scientist Goudarz Molaei pulled a square of cloth through brush and grass on the Stratford coast recently, then stopped and pointed to a crawling smear of larvae on the white fabric.

The tiny arachnids were either Gulf Coast or lone star ticks, two of three invasive species, along with the Asian long-horned tick, that have recently established footholds in Connecticut.

First seen only in pockets near the coast, the blood-sucking, disease-carrying ticks have spread into other parts of the state. Compared with past years, many more worried residents and visitors have submitted ticks to the Connecticut Agricultural Experiment Station, mostly deer ticks that may carry Lyme disease, Molaei said. The tally so far in 2021 is 4,700 tick submissions to the testing laboratory, compared with a total annual average of 3,000 submissions.

Milder winters and warmer temperatures overall are helping the ticks survive and thrive in Connecticut.

“This is going to be a major public health concern in the near future, if it is not already,” Molaei said.  (See link for article)

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**Comment**

Important takeaways:

  • Previously only .2% of submitted ticks were lone star ticks which increased to 4.2% this year. They transmit ehrlichiosis, STARI, spotted fever rickettsiosis, tularemia, Alpha-gal allergy, and Heartland and Bourbon Viruses.
  • The researcher states that it’s a matter of time before the entire state of Connecticut will be infested with Asian long-horned tick – the tick that can reproduce by cloning. It is supposedly less attracted to human skin but can spread diseases that make both animals and humans seriously ill.
  • The Gulf Coast tick overwintered successfully in Connecticut but currently is limited to coastal areas.  Thirty percent tested there were infected with rickettsiosis, which is similar to but less serious than Rocky Mountain Spotted Fever.
  • The deer tick, or blacklegged tick transmits Lyme disease and is active any time temperatures are above freezing.  All life stages bite humans.
  • The following percentages of ticks were sent to the Experiment Station this year:
    • 72.8% deer ticks (32% were positive for Lyme, 10% for Babesia, 4% for Anaplasmosis – and 2% tested positive for at least 2 disease agents concurrently)
    • 23.1% American dog ticks
    • the rest were lone star ticks

Category:

Alpha Gal Meat Allergy, Anaplasmosis, Babesia, Ehrlichiosis, Lyme, research, Rickettsia, Testing, Ticks, Tularemia, Viruses

What is Borrelia miyamotoi?

https://danielcameronmd.com/what-is-borrelia-miyamotoi/

WHAT IS BORRELIA MIYAMOTOI?

What is Borrelia miyamotoi

What is Borrelia miyamotoi? This tick-borne illness, transmitted by deer ticks, is believed to be underrecognized and a growing concern, as studies indicate a B. miyamotoi infection may be as common as anaplasmosis and babesiosis. Researchers randomly tested 250 individuals living in Manitoba, Canada and found that 10% were seropositive for B. miyamotoi. [1]

By 

Borrelia miyamotoi (B. miyamotoi) was first reported in the United States in 2013 but has become increasingly more common.  The tick-borne illness can be transmitted by the same tick that carries Borrelia burgdorferi, the Lyme disease pathogen. In their article, Della-Giustina and colleagues² address the question, “What is Borrelia miyamotoi?” and concerns surrounding this growing threat.

Where is B. miyamotoi found?

Borrelia miyamotoi (B. miyamotoi) can be found in various ticks including the deer tick. It has been detected in ticks located in the northeastern and northern Midwestern United States, California, Europe, and Asia.

What stage of deer ticks transmit B. miyamotoi?

Borrelia miyamotoi can be transmitted from all stages of a tick including the larval stage. The larval tick can harbor and transmit B. miyamotoi by passing the pathogen from the parent to the offspring, a process called transovarial transmission.

How fast can B. miyamotoi be transmitted?

Quickly, according to the authors.  “B. miyamotoi can be transmitted 10% of the time within the first 24 hours of attachment, increasing steadily to reach 73% for a complete feeding.  Thus, transmission of B. miyamotoi is more rapid than transmission of B. burgdorferi.”²

Symptoms of B. miyamotoi

The symptoms that have been described include fever, malaise, headache, and myalgias.  Some cases present with an elevated liver test, low white count and abnormal liver tests that have been described in Anaplasmosis, another tick-borne illness.  Only 11% of patients presented with an erythema migrans rash, according to findings from a case series.

Making the diagnosis

It can be difficult to diagnose B. miyamotoi.  “No test specific to B. miyamotoi has been approved by the United States Food and Drug Administration as of October 2020,” the authors explain.

“The most specific test currently available in several public health and commercial laboratories is polymerase chain reaction (PCR) testing of blood or cerebrospinal fluid for the B. miyamotoi GlpQ enzyme.”

“Serologic testing of B. miyamotoi IgM and IgG antibodies is possible by a few commercial laboratories.” Unfortunately, it can be hard to interpret these tests, as they may cross-react to other spirochetes.  (The authors did not address the risk of cross reactions.)

“One test using this approach, the TBD serochip, is an array-based assay testing for 8 different tick-borne diseases, including B. miyamotoi. Developed in 2018, it is promising but has not yet become widely available.”

Treatment of B. miyamotoi 

There are no evidence-based trials to determine the best treatment for B. miyamotoi. Doxycycline has been suggested, as Lyme disease patients have improved with doxycycline.  “In vitro analysis has shown the susceptibility of B. miyamotoi to ceftriaxone, azithromycin, and doxycycline, with resistance to amoxicillin,” the authors explain.

Prophylactic treatment

Since B. miyamotoi can be transmitted rapidly, it may be prudent to consider prophylactic antibiotic treatment immediately, even if the tick has not been attached for 24 to 36 hours.

“Understanding this more rapid transmission of infection of B. miyamotoi may be a consideration in determining prophylactic treatment for tick bites with a shorter time of attachment in endemic areas for B. miyamotoi.”

Related Articles:

Could Borrelia miyamotoi infections explain persistent symptoms in Lyme disease patients?

C6 peptide test may indicate Borrelia miyamotoi infection

The best antibiotics to treat Borrelia miyamotoi?

References:
  1. Kadkhoda K, Dumouchel C, Brancato J, Gretchen A, Krause PJ. Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study. CMAJ Open. 2017;5(3):E690-E693.
  2. Della-Giustina D, Duke C, Goldflam K. Underrecognized Tickborne Illnesses: Borrelia Miyamotoi and Powassan Virus. Wilderness Environ Med. Jun 2021;32(2):240-246. doi:10.1016/j.wem.2021.01.005

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**Comment**

I’m always extremely skeptical of ALL information given on transmission times as reality has shown a far different picture.  For more on this:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/   Important to note: minimum transmission time has never been determined and reality shows it can happen within a few hours.  Certain coinfections can happen within minutes.

Since Borrelia miyamotoi is not a reportable illness to the CDC, no one has any clue about prevalence but reports are coming in continually that it’s highly likely to be a much bigger problem than ‘authorities’ believe.

It was recently discovered that:

Category:

Borrelia Miyamotoi (Relapsing Fever Group), research, Testing, Ticks, Transmission, Treatment

Assessing the Need for Multiplex & Multifunctiounal Tick-borne Disease Test in Routine Clinical Lab Samples From Lyme Disease & Febrile Patients With History of Tick Bite

https://pubmed.ncbi.nlm.nih.gov/33803065/

Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite

Kunal Garg 1, T Sakari Jokiranta 2, Sanna Filén 2, Leona Gilbert 1
Affiliations expand

Free PMC article

Abstract

Human polymicrobial infections in tick-borne disease (TBD) patients is an emerging public health theme. However, the requirement for holistic TBD tests in routine clinical laboratories is ambiguous. TICKPLEX® PLUS is a holistic TBD test utilized herein to assess the need for multiplex and multifunctional diagnostic tools in a routine clinical laboratory. The study involved 150 specimens categorized into Lyme disease (LD)-positive (n = 48), LD-negative (n = 30), and febrile patients from whom borrelia serology was requested (n = 72, later “febrile patients”) based on reference test results from United Medix, Finland. Reference tests from DiaSorin, Immunetics, and Mikrogen Diagnostik followed the two-tier LD testing system.

  • A comparison between the reference tests and TICKPLEX® PLUS produced 86%, 88%, and 87% positive, negative, and overall agreement, respectively.
  • Additionally, up to 15% of LD and 11% of febrile patients responded to TBD related coinfections and opportunistic microbes.

The results demonstrated that one (TICKPLEX® PLUS) test can aid in a LD diagnosis instead of four tests. Moreover, TBD is not limited to just LD, as the specimens produced immune responses to several TBD microbes. Lastly, the study indicated that the screening of febrile patients for TBDs could be a missed opportunity at reducing unreported patient cases.

Conflict of interest statement

K.G and L.G. have a financial and business interest in Tezted Ltd. Further, S.J and S.F do not have commercial or financial relationships that could be construed as potential conflicts of interest. The funding source mentioned in the Funding and Acknowledgements section and Tezted Ltd. had no role in the experimental design, reporting of the results, or the decision to publish.

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For more:

Category:

Lyme, research, Testing

Can A Tick Be Tested For Lyme Disease? And How I Overcame My Fear of Ticks

https://danielcameronmd.com/cant-count-testing-engorged-ticks/

CAN A TICK BE TESTED FOR LYME DISEASE?

Researchers examined the prevalence of ticks in the Quebec region, along with the frequency of engorged ticks carrying Borrelia burgdorferi (Bb), the causative agent of Lyme disease. Their findings suggest that tick testing may not always be an effective tool in determining the risk of infection.

By 
Ticks can be tested for the Lyme disease bacteria and other tick-borne pathogens. But the accuracy of test results may depend on a ticks lifecycle stage.

A study by Gasmi et al. found that results may not be accurate when testing ticks which are engorged. [1] The authors examined 4,596 I. scapularis (blacklegged) ticks removed from individuals living in Quebec.

They found that 24.9% of the non-engorged blacklegged ticks were infected with Borrelia burgdorferi (Bb), the causative agent of Lyme disease.

Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower with only 8.9% of engorged ticks testing positive for the Lyme disease agent. These findings are consistent with those from another Canadian study. [2]

Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower.

It is still unclear why testing of engorged ticks is not accurately revealing the higher prevalence of Bb infection. The authors suggest that it could be due to the presence of inhibitors in the blood meal [3] or problems with the collection and transportation of engorged ticks.

Perhaps these findings were “due to simpler reasons such as the greater likelihood that un-engorged ticks remained alive up to DNA extraction, while engorged ticks may well have died days or weeks before testing,” noted Gasmi.

In other words, a tick can be tested for Lyme disease but it isn’t always a reliable tool in determining your risk of infection. If an engorged tick is removed and tested, it is likely to be negative for the Borrelia burgdorferi bacteria.

References:
  1. Gasmi S, Ogden NH, Leighton PA, Lindsay LR, Thivierge K. Analysis of the human population bitten by Ixodes scapularis ticks in Quebec, Canada: Increasing risk of Lyme disease. Ticks Tick Borne Dis. 2016.
  2. Dibernardo A, Cote T, Ogden NH, Lindsay LR. The prevalence of Borrelia miyamotoi infection, and co-infections with other Borrelia spp. in Ixodes scapularis ticks collected in Canada. Parasit Vectors. 2014;7:183.
  3. Wilson IG. Inhibition and facilitation of nucleic acid amplification. Appl Environ Microbiol. 1997;63(10):3741-3751.

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**Comment**

Great reminder that yet again, testing is an imperfect tool for all things Lyme/MSIDS related. This inability to positively identify the presence of infections has plagued doctors and patients alike, but must be accepted and contended with, which is why experienced doctors understand the importance of diagnosing patients clinically based upon symptoms.

Further, I often remind frustrated patients that even IF their test or tick test were to come back positive, it’s highly unlikely they will be treated appropriately as there is often coinfection involvement which requires different medications as well as the fact 28 days or less of the doxycycline monotherapy has failed repeatedly – yet is still used despite evidence to the contrary.  

If you suspect you are infected, get to a Lyme literate doctor asap.  It will save you money, time, and heartache in the end.

For more:

https://rawlsmd.com/health-articles/overcome-your-fear-of-ticks-and-get-outside?

by Dr. Bill Rawls
Updated 6/25/21

Considering that my life was totally disrupted by chronic Lyme disease for more than ten years, you might find it alarming to learn that I walk in the woods with bare legs. And although this might sound risky, I haven’t had any tick bites since my recovery. I’ve had ticks on me, but I haven’t been bitten.

Like many people who contract Lyme, my aversion to ticks kept me removed from nature. So what finally changed my fear?

I became tick aware — doubling down on prevention and keeping tabs on where I go, how I go, when I go, and what I do before and after I go to minimize risk factors. And in the end, my love of the outdoors prevailed. Being in nature is where I’ve always gained strength, and I had to find my way back to heal fully.

Finding My Way Back Nature

My first foray back into nature began at the beach at a state park near my home. Long walks were perfect for generating endorphins, and the sea air did me good. However, as my strength improved, I needed more of a challenge, so I began venturing onto the trails that wove through the tall grasses of the sand dunes and maritime forests of the park.  (See link for article)

Category:

Lyme, research, Testing, Ticks