Archive for the ‘Ticks’ Category

California’s First CDC-Confirmed Case of Borrelia Miyamotoi

https://www.lymedisease.org/californias-first-cdc-confirmed-case-of-borrelia-miyamotoi/

California’s first CDC-confirmed case of Borrelia miyamotoi

By Lonnie Marcum

May 4, 2023

A recent case reminds us that Lyme disease isn’t the only tick-borne disease we need to worry about.

Last year, the CDC confirmed California’s first known case of Borrelia miyamotoi—a tick-borne pathogen that causes a relapsing-fever illness in humans.

This discovery highlights the need for increased awareness and surveillance of emerging tick-borne illnesses across the United States.

In this case, a man from Marin County, California, sought care at a neurology clinic in San Francisco. His symptoms included recurring fever, night sweats, mild vision changes and nausea. The fevers typically lasted one day and would recur every 10-14 days. At the time, he was also undergoing monoclonal antibody therapy for multiple sclerosis.

His standard blood work was negative for fungi, Lyme disease, brucellosis and leptospirosis. Chest x-rays and abdominal CT scans were negative as well.

The only notable blood findings were a positive antigen for Epstein-Barr virus, a low platelet count (thrombocytopenia), an elevated C-reactive protein (an inflammatory marker), and an elevated procalcitonin—a biomarker that is released in response to bacterial infections.

Specialty lab testing

Considering the patient’s immunocompromised status and continued relapsing fevers, his blood was sent to a specialty lab for next-generation DNA sequencing. The specialty lab, Karius,  says it can identify over 1000 clinically relevant pathogens including bacteria, DNA viruses, fungi, and parasites from a single blood sample.

The DNA test results came back positive for Borrelia miyamotoi and were sent to the CDC for confirmation. The CDC confirmed the patient’s blood was positive for Borrelia miyamotoi and 100% identical to an isolate that had been previously collected from an Ixodes pacificus tick in Marin County. This indicates the patient acquired the infection in California.

Borrelia miyamotoi, first identified in Japan in 1995, is considered an emerging infectious disease in Asia, Europe and the United States.

A recent study found widespread evidence of Borrelia miyamotoi in human blood samples of people living in the northeastern United States. An earlier study found evidence of tick-borne relapsing fever (TBRF) Borrelia, including Borrelia miyamotoi in the blood of 26 out of 101 samples of residents of Mendocino County, California in the 1980s.

Another study found multiple species of relapsing fever Borrelia in blood samples drawn from patients in 16 out of 24 California counties. And a 13-year-long study found Borrelia miyamotoi in ticks found in 24 out of 48 counties in California (see map below).

Borrelia miyamotoi is transmitted to humans through the bite of infected blacklegged ticks. These are the same  hardbodied ticks (Ixodes scapularis, Ixodes pacificus) that transmit Lyme disease to humans and animals. Other types of North American tick-borne relapsing fever Borrelia (B. hermsii, B. turicatae, B. parkeri), are transmitted by soft-bodied ticks.

The symptoms of Borrelia miyamotoi disease are similar to those of other tick-borne illnesses, such as Lyme disease. But standard Lyme tests will be negative, making the diagnosis challenging.

TBRF

According to the CDC, the main symptoms of TBRF are high fever, headache, muscle and joint pain. Fewer than 1 in 10 patients will develop a rash. Left untreated, the symptoms typically repeat, producing a telltale pattern of relapsing fever lasting 1-3 days, followed by 7-10 days without a fever, followed by another 1-3 days of fever.

The CDC website says: “Confirmation of a diagnosis relies on 1) the use of polymerase chain reaction (PCR) tests that detect DNA from the organism or 2) antibody-based tests. Both types of tests are under development and not widely commercially available but can be ordered from a limited number of CLIA-approved laboratories.”

Treatment for TBRF involves the use of antibiotics, such as doxycycline, amoxicillin or cefuroxime . In this case the man was given a 4-week course of doxycycline and achieved complete resolution of his symptoms. One month after completing antibiotics ,follow-up laboratory testing showed complete resolution of thrombocytopenia and normalization of inflammatory markers.

All tick-borne diseases are a significant health concern worldwide, particularly in areas where ticks are prevalent. These illnesses can present with a range of symptoms, some of which can be mysterious and difficult to diagnose.

While relapsing fever Borrelia has been detected in California before, this is the first CDC-confirmed case of Borrelia miyamotoi in California.  This case highlights the need for continued education and awareness of tick-borne diseases.

As with all tick-borne illnesses, prevention is key. To reduce the risk of tick bites, take precautions when spending time outdoors, such as pre-treating shoes and clothing with permethrin, using insect repellant on yourself, your children and your pets, and performing thorough tick checks after being outdoors.

LymeSci is written by Lonnie Marcum, a Licensed Physical Therapist and mother of a daughter with Lyme. She served two terms on a subcommittee of the federal Tick-Borne Disease Working Group. Follow her on Twitter: @LonnieRhea  Email her at: lmarcum@lymedisease.org.

Reference

Rubio LA, Kjemtrup AM, Marx GE, Cronan S, Kilonzo C, Saunders MEM, et al. Borrelia miyamotoi infection in immunocompromised man, California, USA, 2021. Emerg Infect Dis. 2023 May https://doi.org/10.3201/eid2905.221638 DOI: 10.3201/eid2905.221638

Padgett K, Bonilla D, Kjemtrup A, Vilcins I-M, Yoshimizu MH, Hui L, et al. (2014) Large Scale Spatial Risk and Comparative Prevalence of Borrelia miyamotoi and Borrelia burgdorferi Sensu Lato in Ixodes pacificus. PLoS ONE 9(10): e110853. https://doi.org/10.1371/journal.pone.0110853

Additional Resources

Stanford: Tick-borne disease risk high in SF Bay Area

Yale: Tick-borne Borrelia miyamotoi widespread in northeastern US

LYME SCI: Infected ticks in California? It’s complicated.

LYME SCI: B. miyamotoi has been in California ticks for a long time

LYME SCI: Lyme-carrying ticks in West differ from their Eastern cousins

LYME SCI: How many “negative” Lyme tests are due to B. miyamotoi?

LYME SCI: Tick infection rates as high as 31% in some coastal areas of California

BALF: New interactive maps show where citizen scientists found infected ticks

For more:

And the question begging to be asked is: how many people with B. miyamotoi are falling through the cracks?  It isn’t even reportable to the CDC yet (which notoriously undercounts all things tick-borne-related).

For more:  https://igenex.com/tick-talk/what-you-need-to-know-about-borrelia-miyamotoi/

This article points out the confusion with B. miyamotoi: 

  • many separate it from other tick-borne relapsing fevers
  • while it can cause relapsing fevers, it sometimes doesn’t
  • it appears to be the only TBRF transmitted from a hard bodied tick, unlike TBRF which is mainly transmitted from a soft bodied tick (I remain skeptical of this as ticks have repeatedly been found to transmit things they shouldn’t – just like they are found in places they shouldn’t be.)
  • symptoms often resemble Lyme disease
  • you can be infected with BOTH B. miyamotoi AND Lyme disease (as well as numerous other coinfections) which will complicate symptom presentation
  • testing for B. miyamotoi is just as abysmal as it is for Lyme/MSIDS:  https://madisonarealymesupportgroup.com/2020/03/01/study-cdcs-2-tier-lyme-testing-inaccurate-in-more-than-70-of-cases/

Category:

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

Study: Bait Boxes and Met52 Not Effective in Controlling Tick Populations

https://danielcameronmd.com/tick-control-methods-not-effective-residential-neighborhoods/

TICK CONTROL METHODS NOT EFFECTIVE IN RESIDENTIAL NEIGHBORHOODS

Mouse with tick embedded on shrub branch.

Controlling tick populations can help reduce the likelihood of individuals being bitten by an infected tick and developing a tick-borne illness, such as Lyme disease. Multiple types of tick control methods have been employed but with varying degrees of success. This study explores the effectiveness of bait boxes and the biopesticide spray Met52 in reducing tick abundance and tick encounters with humans.

By 

In their study, “Impacts Over Time of Neighborhood-Scale Interventions to Control Ticks and Tick-Borne Disease Incidence,” Ostfeld and colleagues examined the effectiveness of tick control methods in 24 residential neighborhoods endemic for Lyme disease in New York.¹

The study, conducted over several years, assessed the impact of tick control system (TCS) bait boxes and Met52 spray on reducing tick abundance and tick encounters with people and outdoor pets. And whether these interventions led to a decrease in reported cases of tick-borne diseases.

“Rapid increases in incidence rates and geographic ranges of tick-borne diseases have stimulated efforts to reduce human exposure.”

The authors examined two interventions:

TCS Bait Boxes

TCS bait boxes attract small animals to a food source inside an enclosed device and apply the tick-killing chemical, fipronil. (Fipronil is lethal to ticks but harmless to mammals.)

Met52 Spray

Met52 spray is a biopesticide, which consists of spores of the F52 strain of the fungus Metarhizium brunneum. The solution, mixed with water, is sprayed on the ground and low-lying vegetation.

Impact varies with type of tick control intervention

“By killing ticks attached to small mammals, TCS bait boxes are expected to affect the abundance of host-seeking (questing) ticks the following year,” the authors explain.

Whereas, “Met52 targets host-seeking ticks, with impacts expected within days to weeks after deployment.”

Unfortunately, interventions were unable to control tick populations in 24 residential neighborhoods in New York over a 4-to-5-year period.

“… the lack of association between reduced abundance of host-seeking nymphal blacklegged ticks in residential areas receiving acaricidal treatments and the incidence of tick-borne diseases in those areas … suggests that tick control for disease reduction needs new approaches.”

STUDY FINDINGS:

  • The study found that in neighborhoods with active bait boxes, questing blacklegged ticks and ticks attached to small mammals were reduced by approximately 50%.
  • These interventions “significantly reduced owner-reported cases of tick-borne diseases in outdoor pets,” the authors point out.
  • However, “neither intervention (nor both combined) was associated with reductions in either human encounters with ticks or self-reported cases of tick-borne disease.”
  • “In neighborhoods with active TCS bait boxes, populations of blacklegged ticks (Ixodes scapularis) were not reduced over time in any of the three habitat types tested (forest, lawn, shrub/garden).”
  • “There was no significant effect of Met52 on tick abundance overall…”
Related Articles:

Tick prevention for humans vary between socio-economic levels

How to protect yourself from ticks with permethrin-treated clothing

Preventing tick bites on a child proves challenging

References:
  1. Ostfeld RS, Mowry S, Bremer W, et al. Impacts Over Time of Neighborhood-Scale Interventions to Control Ticks and Tick-Borne Disease Incidence. Vector Borne Zoonotic Dis. Mar 2023;23(3):89-105. doi:10.1089/vbz.2022.0094

For more:

Category:

Activism, Prevention, research, Ticks

May 3, 2023 Tick Boot Camp Podcast: Eva Sapi, PhD

https://tickbootcamp.com/eva-sapi-geneticist-and-molecular-biologist-at-university-of-new-haven/

April 1, 2023

Eva Sapi, Geneticist And Molecular Biologist At University Of New Haven

Eva Sapi

Tick Boot Camp Podcast
Dr. Michael Snyder was featured on the Tick Boot Camp Podcast:

Launching May 3…

Background
Professor Eva Sapi is a Hungarian-American microbiologist and researcher who has dedicated her career to advancing our understanding of Lyme disease.

Early Life and Career
Born in Hungary, Sapi comes from a family of engineers and scientists. She studied biology at a university in Hungary from 1987 to 1995 and earned her Ph.D. in biology from the same university. She went on to complete postdoctoral work in Germany and Switzerland, where she focused on studying gene regulation in bacteria, and understanding how genes are turned on and off in response to environmental cues.

Early Research
Professor Sapi started her research career studying breast cancer until she was hit with chronic Lyme disease and it paused her life. After finally getting a proper Lyme diagnosis and spending years trying many different pharmaceutical and herbal treatments, Sapi began to feel better and started collecting and studying ticks. She discovered that ticks carry Bartonella and that ticks could carry many different species of bugs that can infect humans, which was not received well by the medical community at the time.

Official Lyme Career Pivot
Next, Professor Eva Sapi joined the University of New Haven in Connecticut as an Associate Professor in the Department of Biology and Environmental Science. She was also appointed as the Director of the Lyme Disease Research Group at the university, where she continued her research on Lyme disease and other tick-borne illnesses.

Popular Work
Sapi is known for her groundbreaking research on the persistence and treatment of Lyme disease. She was the first to discover that Borrelia burgdorferi can form biofilms that protect it from antibiotics and the immune system. Her current research, with James Goldman, a Columbia University professor of pathology and cell biology, centers on a case in which a woman received 16 years of antibiotic therapy and still died from Lyme disease. Their findings – published in Healthcare 2018 – supported her earlier discoveries that Borrelia can form biofilm, a protective layer around itself, making it extremely resistant to antibiotics.

Notable Achievements
Professor Sapi has authored 70 peer-reviewed scientific papers on Lyme disease and trained more than 100 graduate students in Lyme disease research. She is a sought-after speaker and presenter and has appeared on radio and television programs. Her groundbreaking research has earned her several recognitions, including the research trailblazer award from LymeDisease.org in 2018, and the Courage Award from Lyme Connection of Ridgefield. Her ultimate goal is to identify novel antibacterial agents that are effective in killing all forms of Borrelia.

Recent Breakthroughs
Sapi’s research has also shown that some herbal remedies, such as Stevia, can be effective in treating Lyme disease. Her recent breakthrough, with her students, is in the potential of liquid, whole-leaf Stevia extract in reducing biofilm mass. In a recent study, they found that liquid, whole-leaf Stevia extract is an effective treatment for Lyme biofilm. This finding is significant because Borrelia biofilm is a protective layer around itself, making it extremely resistant to antibiotics.

Lyme and Cancer
Sapi’s research has also found evidence that Borrelia may be present in breast cancer tissues, as well as ovarian and endometrial cancer. She and her students are focusing on Borrelia, examining more than 400 invasive breast cancer tissues. A significant number of samples were positive for Borrelia, suggesting that the bacteria may play a role in breast cancer development and metastasis.

Looking Ahead
Professor Eva Sapi’s work on breast cancer and its link to Lyme disease has opened new avenues for research and has the potential to lead to novel discoveries in the field. The scientific community and the Lyme disease community are fortunate to have such a dedicated and passionate researcher leading the charge in advancing Lyme disease research, including its role in cancer.

Listen on Apple Podcasts, Spotify, or Google Podcasts

Listen on Apple Podcasts
Listen on Spotify
Listen on Google Podcasts

Category:

Activism, Bartonella, Cancer, Lyme, research, Ticks

May is Lyme Awareness: How to Prevent Tick Bites

https://www.treatlyme.net/guide/how-to-prevent-tick-bites-and-lyme-disease  Video Here

Strategies to Prevent Lyme & Tick Borne Infections

Lyme disease and tick borne infections are spread through tick bites. The best way to prevent Lyme disease and related infections is to stop ticks from attaching to you. Another strategy is to quickly remove attached ticks before they spread infection. Here are some specific actions you can take to prevent Lyme and related infections.

Marty Ross MD Discusses Lyme Disease Prevention
Video Thumbnail

Actions While Outdoors Where Ticks LiveONE – Use A Good Tick Repellent On Your Skin

Before going into tick habitats, spray your skin with a tick repellent. Ticks are repelled by certain chemicals which limit their chances of getting on your skin or biting you. Common repellants include

  • picaridin,
  • DEET, and
  • essential oils.

Of these, picaridin and DEET work best because they last longer.

Research shows essential oils only work up to 20 minutes after application. Picaridin 20% can last 12 to 14 hours depending on whether a spray or lotion is used. The length of effect of DEET depends on the concentration. DEET 30% can last for 8 hours – while DEET 98% in Backwoods OFF can last for 10 hours.  (See link for article and video)

__________________

**Comment**

The best way to protect yourself from Lyme/MSIDS is to prevent being bitten by a tick in the first place.  Lyme/MSIDS can also be passed congenitally and very probably sexually.

SUMMARY:

  • Ross recommends Picaridin over Deet due to Deet leaving an oil on the skin that is potentially neurotoxic.
  • You can use the EPA search tool to find approved tick repellents.
  • After spraying exposed skin, you next spray your clothing, including socks and shoes and hats/gloves with Permethrin (which is not to be put on the skin).  It remains active for 6 weeks or 6 washes.
  • Wear light colored clothing so you can see ticks.  Also tuck shirt into pants and pants into socks to create a barrier.
  • Do regular tick checks and get a person to help you look in places you can’t see.
  • If a tick is attached, remove it quickly and properly.
  • Remove clothing and put them in a hot drier for 15-20 min.
  • Take a shower to remove all sprays and to see any ticks.
  • Decrease ticks on your property and on your pets.

For more specifics on how to do the above things:  https://madisonarealymesupportgroup.com/2019/04/12/tick-prevention-2019/

For more on repellents:  

Category:

Activism, Prevention, research, Ticks

CPAC Warns: Lyme Risk Higher Than Ever

https://www.lymedisease.org/capc-parasite-forecast-2023/

CAPC warns that Lyme disease risk is higher than ever

April 20, 2023

The nonprofit Companion Animal Parasite Council (CAPC) — the nation’s leading source on parasitic diseases that threaten the health of pets and people — is warning that the risk of Lyme disease is higher than ever.

In its 2023 Parasite Forecast, CAPC documents how the blacklegged ticks that spread Lyme disease are expanding into new geographical areas. This increases the risk of Lyme disease outside of historically endemic places like the Northeast and Upper Midwest.

Parasite infections are real and can be harmful and even deadly to pets and people. Lyme disease is a predominant One Health issue, an approach calling for the collaborative efforts of multiple disciplines working to attain optimal health for animals, people and the environment.

11 years of forecasts

“Because of the zoonotic potential of pathogens like Lyme disease, we started providing annual forecasts eleven years ago to alert communities about the risks they pose to people and pets,” says Dr. Christopher Carpenter, DVM, and Chief Executive Officer of CAPC.

“Lyme disease, in particular, is an important One Health pathogen that occurs in both veterinary and human medical settings. CAPC’s Pet Parasite Forecast is critical to alerting pet owners, veterinarians and physicians to the risks this year and reinforcing CAPC’s recommendation that all pets need to be annually tested and protected year-round.”

In its 2023 annual forecast, CAPC reports the risk of acquiring Lyme disease in 2023 is elevated due to the expansive nature of the blacklegged tick vector (Ixodes scapularis).

This increase in Lyme prevalence can be attributed to land use, human population growth, urbanization, and changes in wildlife host density and location. Risks have also increased due to rehoming of pets, as well as changes in:

  • Distribution and prevalence of vector (tick) populations
  • Shifting wildlife populations and their infiltration into newly developed and reclaimed areas
  • Short- and long-term changes in climatic conditions
  • Changes in habitat due to natural or human-induced processes

Lyme Disease Forecast

For 2023, CAPC predicts Lyme disease is a high threat and continues to expand southward and westward outside of the historically high-risk areas in the Northeast and Upper Midwest, including Wisconsin, Minnesota and the upper peninsula of Michigan.

There is a higher-than-average seroprevalence predicted in northeastern Tennessee, western Michigan and Ohio, with high-risk “hot spots” expected in northwestern and southwestern Michigan, and southern and northeastern Ohio.

A higher-than-normal risk is also expected in North Dakota, northeastern South Dakota, Iowa, Illinois, and eastern Kentucky. The southward movement of Lyme is evident in the increasing risk in the Carolinas and Tennessee.

In addition, CAPC reports a northern expansion into Canada, including southern regions of Ontario, Quebec and Manitoba, as well as on New Brunswick and Nova Scotia, due to increased Lyme detection in Canadian dogs. Pets living in or traveling to these areas are considered at high risk.

Testing and Prevention Strategies

The 2023 forecasts – supported by ongoing research by parasitologists and statisticians in leading academic institutions across the United States – highlight areas where more should be done to lower the risk of companion animals’ exposure to disease vectors, such as ticks.

The foundation of these prevention strategies are recommendations that veterinarians and pet owners test their pets annually for disease and protect their pets with products that kill or repel ticks year-round.

A vaccination for Lyme disease should always be considered for pets in high-risk areas. Lyme disease, in particular, is an important One Health pathogen that impacts the health of both pets and people.

Veterinarians play an important role in preventing zoonotic disease in pets, as well as people, by implementing effective parasite control programs. In regions with historically high prevalence and in forecasted regions of increased risk, veterinarians should reinforce their recommendations of aggressive tick control.

CAPC One Health Study

Research conducted by CAPC underscores the value of CAPC’s prevalence maps and emphasizes the importance of a One Health approach to tick-borne diseases. In 2019, a CAPC study confirmed dogs safeguard humans serving as sentinels to alert humans where they are at greatest risk for tick-borne Lyme disease.

“With dogs being tested annually for exposure to the pathogen that causes Lyme disease, we were able to study over seven years of nationwide canine diagnostic data, representing more than 16 million data points — something difficult to achieve when studying ticks and the environment directly. And unlike the challenges with access to human medical records, anonymous veterinary data does not have these privacy concerns,” said Dr. Michael Yabsley, a CAPC Board Member and professor in the Department of Population Health, College of Veterinary Medicine and Warnell School of Forestry and Natural Resources at the University of Georgia.

Results from the study – “Quantifying the relationship between human Lyme disease and Borrelia burgdorferi exposure in domestic dogs” – published in the prestigious, peer-reviewed Geospatial Health quantified the relationship between incidences of tick exposure in domestic dogs to human Lyme disease. The model established in this research broke new ground by giving residents, travelers and health care providers a county-level map to help them identify areas of high Lyme risk across the country.

“By combining sophisticated statistical modeling with this invaluable canine data, we’re enabling veterinary medicine to benefit human medicine,” said Dr. Stella Self, assistant professor in the Department of Epidemiology and Biostatistics at University of South Carolina. “This research represents the first step on the long road to developing a forecast for human Lyme disease.”

30-Day Forecast Maps for Pet Owners

Pet owners who want to monitor the activity in their county throughout the year have access to 30-Day Parasite Forecast Maps at http://www.petdiseasealerts.org. These maps, developed exclusively by CAPC, provide a local forecast for every county in the continental United States on a monthly basis. This free service helps to remind pet owners of the continuous risk in their area and the importance of annual parasite testing and year-round protection.

“Because tick-borne diseases like Lyme are ever-changing, the 30-Day Pet Parasite forecasts at http://www.petdiseasealerts.org are an invaluable tool to protect both pets and people with monthly updates that show the risk for Lyme disease in their area,” said Dr. Rick Marrinson, Past President/Board Member for CAPC and owner of Longwood Veterinary Clinic in Longwood, Florida.

Other Parasite Spread in 2023

In addition to Lyme disease, CAPC forecasts that heartworm disease, which is transmitted by mosquitoes, and tick-borne diseases ehrlichiosis and anaplasmosis, continue to spread throughout the United States in 2023. Veterinarians and pet owners are encouraged to discuss how to effectively address the increased prevalence. Annual testing and year-round use of preventive products remains the best means of providing comprehensive parasite control and disease prevention.

How the Forecasts are Created

The annual CAPC Pet Parasite Forecasts are a collaborative effort between parasitologists and statisticians in leading academic institutions across the United States. These scientists engage in ongoing research and data interpretation to better understand and monitor vector-borne disease agent transmission and changing life cycles of parasites. The forecasts are based on many factors, including temperature, precipitation, and population density.

About the Companion Animal Parasite Council

The Companion Animal Parasite Council is an independent not-for-profit foundation comprised of parasitologists, veterinarians, as well as medical, public health and other professionals, who provide information for the optimal control of internal and external parasites that threaten the health of pets and people.

Formed in 2002, CAPC works to help veterinary professionals and pet owners develop the best practices in parasite management that protect pets from parasitic infections and reduce the risk of zoonotic parasite transmission.

SOURCE OF PRESS RELEASE: The Companion Animal Parasite Council 

Category:

Activism, Anaplasmosis, Ehrlichiosis, Lyme, research, Testing, Ticks