Archive for the ‘Ticks’ Category

Concurrent Babesiosis and Lyme in Patient

http://www.tandfonline.com/doi/full/10.1080/20009666.2017.1299398

Mark Adler, Thein Swe, and Akari Thein Naing
Journal of Community Hospital Internal Medicine Perspectives Vol. 7 , Iss. 1,2017

 

Abstract

Human babesiosis co-infected with Lyme disease in a young patient is an important condition. Here, we describe a case of a 39-year-old male patient with concurrent babesiosis and Lyme disease. Co-infections of tick borne diseases are often difficult to diagnose and underreported, and resulting in significant morbidity and mortality to patients. While co-infections have been infrequently described, it is of paramount importance that clinicians should be able to diagnose early and treat them effectively according to the patient geographical area and history of tick bite.

 

**Comment**

“The powers that be” have their heads in the sand when it comes to all things TBI (tick borne infections).  They speak of Lyme in terms of a single organism when most are infected with multiple organisms which complicate cases exponentially.  https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/  This link shows that 45% of tested ticks were coinfected and carried up to 5 different pathogens.  This directly translates to human infection and a survey substantiates this:  https://madisonarealymesupportgroup.com/2014/11/14/studies-show-why-its-tough-to-treat-lyme-and-co/  The most common co-infections in the LDo study were Babesia (32%), Bartonella (28%), and Ehrlichia (15%) while a study by Dr. Janet Sperling in Canada found that the most common were Bartonella (36%), Babesia (19%), and Anaplasma (13%).

Besides the fact it is a misnomer to think it novel that a patient has concurrent Lyme and Babesiosis, it is also a huge mistake to base treatment on geographical area as time and time again, entomologists are finding ticks in places they just shouldn’t be and ticks that shouldn’t be carrying pathogens, carrying them.  Also, using logic, until every bird, fox, squirrel, lizard, deer, and every other rodent on the earth read the memo that they are not supposed to cross state and country boundaries, ticks are going to continue to defy the box “experts” put them into.  And, there are other ways for pathogens to travel across state lines:  https://doi.org/10.1111/tid.12741

Abstract

The potential for transmission of Babesia microti by blood transfusion is well recognized. Physicians may be unaware that products used for transfusion may be collected from geographically diverse regions. We describe a liver transplant recipient in South Carolina who likely acquired B. microti infection from a unit of blood collected in Minnesota.

 Also, one must be careful of the “history of tick bite,” as well, as many never see the tick or subsequent bite, and fail to get a rash.  A nymphal tick is nearly impossible to see.  Lyme/MSIDS is a CLINICAL diagnosis.

Accurately, the authors advise diagnosing and treating early, but herein lies the catch-22, if practitioners continue to follow the outdated and unscientific IDSA/CDC guidelines and take a “wait and see” approach, waiting for positive serology from tests which are so stringent and biased, most patients will be missed.  

This is the topsy-turvy world Lyme/MSIDS patients live in.

 

 

Category:

Babesia, Lyme, research, Ticks

First Report of Dwarf Deer Tick

https://entomologytoday.org/2017/06/07/first-report-of-dwarf-deer-tick-comes-as-overall-population-soars/   June 7, 2017 by

The Connecticut Agricultural Experiment Station has identified a dwarf deer tick, which is identical to a typical adult female deer tick but is half the size.

Oh goody, if ticks weren’t hard enough to see, now they can be harder to find.

A typical deer tick is 3 millimeters, whereas the dwarf deer tick is just 1.5 millimeters, with the nymph tinier yet.

The finding, reported in the Journal of Medical Entomology, https://academic.oup.com/jme/article/3859660/The-First-Evidence-of-Nanism-in-Ixodes-Ixodes states that additional studies of teratology (abnormal development) in ticks and the implications in disease transmission are needed.

Category:

research, Ticks

LDA President Pat Smith on Contagion Live


Patricia Smith, President of the Lyme disease Association, discusses Lyme disease has spread throughout the United States in the past decade. Part 1

Lyme Disease: What Makes Diagnosis & Treatment Difficult? Part 2

How Have Tick-Borne Diseases Grown in the United States? Part 3

What Do I Need to Know About Lyme Transmission Time? Part 4

Are Patients Facing Difficulties in Accessing Treatment for Lyme? Part 5

Why is May Lyme Disease Awareness Month? Part 6

How Does Government Acknowledgement of Lyme Affect Patient Care? Part 7

The Current State of Lyme Disease Prevention. Part 8

Lyme Disease Legislation May Advance Patient-Centered Research. Part 9

Category:

Activism, Lyme, Lyme Vaccine, research, Testing, Ticks, Transmission, Treatment, vaccines

Review of Tick Attachment Time For Different Pathogens

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

Environments 2017, 4(2), 37; https://doi.org/10.3390/environments4020037

Do Tick Attachment Times Vary between Different Tick-Pathogen Systems?

Stephanie L. Richards 1,* , Ricky Langley 2, Charles S. Apperson 3and Elizabeth Watson 4

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/

 

 

Category:

Anaplasmosis, Babesia, Lyme, research, Rickettsia, Ticks, Transmission, Tularemia, Viruses

Case Reports of Tick Bites and Illness in Two Central North Carolina Residents

http://www.ncmedicaljournal.com/content/78/3/156

Retrospective Case Reports of Two Central North Carolina Residents

Frequency of Tick Bites and Associated Illnesses, 2001-2014

  1. Marcia. E. Herman-Giddens, PA, MPH, DrPH, D. Marcus Herman-Giddens⇑

Abstract

BACKGROUND Tick bites are a source of illness and disease agents that may lead to morbidity and occasional fatalities in North Carolina. Public health interest in tick-borne illness and disease has increased due to continuing discoveries of tick-borne diseases and their increasing geographic spread and disease incidence. There are no data published on lay individuals with cumulative tick bites and associated illnesses over a period of years.

METHODS We learned of a married couple living on a central North Carolina property who had used reasonable bite prevention methods, kept attached ticks after removal, and recorded dates and related illness records from 2001–2014. We obtained permission to analyze their records. Ticks were identified by an entomologist.

RESULTS The male subject had a total of 219 bites from identifiable ticks comprising 213 Amblyomma americanum, 4 Dermacentor variabilis, and 2 Ixodes scapularis. He was treated for possible Rocky Mountain spotted fever once and presumed Southern Tick Associated Rash Illness once. The female subject had 193 bites comprising 168 A. americanum, 23 D. variabilis, and 2 I. scapularis. She was treated for 4 episodes of presumed Southern Tick Associated Rash Illness and one possible case of a tick-borne infection. Several years of data were missing for both subjects.

LIMITATIONS This retrospective report relied on the subjects’ own records for much of the data. The experience of these individuals cannot be generalized. Diagnoses of these tick-related illnesses are inexact due to lack of tests for the Southern Tick Associated Rash Illness and cross-reactivity in tests for spotted fever rickettsiosis.

CONCLUSIONS This report demonstrates that tick-associated illnesses, including episodes fitting the Center for Disease Control and Prevention’s definition of the Southern Tick Associated Rash Illness, may be more common than realized. Use of personal tick protection measures for tick bite illness and disease prevention may not be sufficiently protective. Further subject-based research on tick and disease burden on selected populations would be informative, and could aid in planning appropriate actions to mitigate the effects of tick-borne disease in North Carolina.

 

Category:

Lyme, research, Ticks