Archive for the ‘Ticks’ Category

Diagnosing and Treating Lyme: Podcast

https://canlyme.com/2020/09/02/new-podcast-dr-ralph-hawkins-shares-his-medical-expertise-and-hands-on-experience-diagnosing-and-treating-lyme-disease/

New Podcast: Dr. Ralph Hawkins shares his medical expertise and hands on experience diagnosing and treating Lyme disease

https://www.lookingatlyme.ca/2020/09/dr-ralph-hawkins-explains-the-challenges-of-detecting-lyme-disease-through-testing/  Podcast here

September 1st, 2020

In this episode of Looking at Lyme, Sarah speaks with Internal Medicine Specialist and Canadian Lyme expert, Dr. Ralph Hawkins. Dr. Hawkins has been treating Lyme patients in Canada for many years, gaining a wealth of knowledge about the disease. He recounts his introduction to the shortcomings of Lyme disease testing in Canada while treating a patient with a history of multiple previous tick bites, many common symptoms of Lyme disease, but a negative Canadian Lyme test. Dr. Hawkins had the patient’s blood tested at a University Lab in New York, revealing test band patterns consistent with Lyme disease. He referred this patient to Infectious Diseases colleagues for treatment, but quickly found out that the diagnosis of late stage Lyme disease is not generally recognized by the Infectious Diseases community. He was advised to not only drop this case, but to avoid other similar cases. The recommendation to avoid such patients sparked Dr. Hawkins’ curiosity and interest, inspiring him to dive deeply into the research and history of Lyme disease.

Dr. Hawkins walks us through the current testing protocols for Lyme disease in Canada, explaining why some patients with Lyme disease receive a negative test result. He explains the difference between current testing in Canada and tests done in other parts of the world, highlighting a test done in Germany that he often relies on when diagnosing patients, and touching on the approval process for such tests by Health Canada. Without better testing, Canadians with Lyme disease continue to fall through the cracks of the healthcare system. Dr. Hawkins refers to a recent analysis of Lyme diagnosis in Canada in which researchers speculate that in some areas, two thirds of Lyme cases go unreported. With this in mind he points out that, in light of the severity of untreated Lyme disease, a trial period of treatment for Lyme disease would be valid for certain patients with negative Canadian serology. Thank you Dr. Hawkins for walking with us down the bumpy road of Lyme disease testing and treatment in Canada!

Resources and notes

For more:  

Category:

Activism, Lyme, Ticks, Treatment

Putting Lyme Disease on the Map

https://thetyee.ca/News/2020/08/31/Putting-Lyme-Disease-Map/

Putting Lyme Disease on the Map

BC says the debilitating disease isn’t a risk in much of the province. Advocates say that’s a myth and it’s putting people at risk.
Amanda Follett Hosgood 31 Aug 2020 | TheTyee.ca
tick.jpg
The western blacklegged tick (Ixodes pacificus) carries Lyme disease across western North America. Photo from US Centers for Disease Control.

On the BC Centre for Disease Control’s website, a map shows where Lyme disease exists in the province. It highlights isolated areas in the south, mostly focused around Vancouver Island and the Lower Mainland, extending as far north as Clearwater. In the north, there are pockets of “potential” around Williams Lake and in coastal areas.*

But the map, dated 2019, leaves vast swaths unmarked and the impression that Lyme disease is not a risk from tick bites in most of the province.** As a result, it can be hard to get your doctor to listen if you have Lyme symptoms and even harder to get a conclusive diagnosis.

Officially, Lyme, spread by bites from infected ticks, has only been positively diagnosed a handful of times in the northern three-quarters of the province.*** But some experts say that’s because its myriad symptoms — everything from joint pain to facial paralysis — are often misdiagnosed as illnesses like chronic fatigue, fibromyalgia, multiple sclerosis and early dementia. (See link for article)

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**Comment**

Great article highlighting how tick maps have only served to hurt patients for over 40 years.  It is high time researchers and doctors understand the limitations of these maps and while interesting, should NEVER be used to diagnose patients.  

But Muhammad Morshed, a clinical microbiologist with the BCCDC, says private labs are notorious for inaccurate results, with false positives reported up to 50 per cent of the time.

This belief is a HUGE problem.  The CDC used to have a blurb right on their website calling CLIA-certified labs “home-brewed.”  From the top down, our public health ‘authorities’, which by the way own patients on Lyme tests, are educating doctors that these smaller specialty labs, which have to jump through the toughest lab standards on the planet to be certified, are substandard.  Please see:  https://madisonarealymesupportgroup.com/2019/06/28/who-owns-the-elisa-patents/

As to ticks – the idea they only exist in certain areas needs to die.  Perhaps that used to be the case, but migrating birds and rodents are taking them everywhere.  Not to mention :  https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

Not to mention ticks have been dropped from airplanes:  https://madisonarealymesupportgroup.com/2019/07/31/tick-expert-admits-to-working-on-ticks-dropping-them-out-of-airplanes/

Category:

Activism, Testing, Ticks

Tick Bite – Letter to the Editor

https://www.bmj.com/content/370/bmj.m3029/rr-3

Tick bite

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3029 (Published 13 August 2020)Cite this as: BMJ 2020;370:m3029

21 August 2020
Habib ur Rehman
Physician
Saskatchewan Health Authority
Suite 100, 2550 12th Ave, Regina, SK, S4P 3X1, Canada

Rapid Response:

Re: Tick bite

Dear Editor

Razai et al, in their consultation on tick bite, missed an important message to learners (1).

  • As the incidence of Lyme disease increases, there is also greater likelihood of co-transmission of other pathogens carried by I scapularis and I pacificus ticks.
  • Since symptoms of these co infections are non-specific and may overlap with Lyme’s disease, accurate diagnosis becomes more difficult. It is therefore important that a high level of suspicion is maintained for these co-infections so patients receive accurate diagnosis and adequate treatment.

The most common infectious agents transmitted by Ixodes species ticks in North America that have the potential for co-infection with B burgdorferi are Anaplasma phagocytophilum, Babesia species, deer tick (Powassan) virus, Borrelia miyamotoi, and the Ehrlichia muris–like agent (2).

A phagocytophilum is transmitted by the same Ixodes ticks as B burgdorferi in the United States and causes fever, chills, headache, myalgia, and fatigue arising 1 to 3 weeks following tick exposure. Most cases are mild and self-limited. However, severe manifestations may include respiratory failure, adult respiratory distress syndrome, peripheral neuropathy, rhabdomyolysis, acute renal failure, pancreatitis, and coagulopathies.

It has been found that in Wisconsin, approximately 3% of I scapularis ticks examined were co-infected with B burgdorferi and A phagocytophilum (3). A similar study in 11,000 ticks in public parks of New York State’s Hudson Valley Region found that co-infection rates of nymphs and adults were 0.5% and 6.3%, respectively (4).

The frequency of humans with Lyme disease simultaneously co-infected with A phagocytophilum from various studies ranges from 2% to 10% (5,6). Similirly, Babesiosis is transmitted through the bite of infected I scapularis and I pacificus ticks. Most patients are asymptomatic or have mild, self-limited disease but may be complicated by renal failure, acute respiratory distress, and shock.

In a study of patients with Lyme disease from southern New England, approximately 10% were co-infected with babesiosis (7).

Unlike Lyme disease and Anaplasmosis, doxycycline is not an effective treatment of babesiosis and requires atovaquone and azithromycin or combination of clindamycin with quinine, making it imperitive to consider this diagnosis in mind in patients with tick bite.

Of the 3 species of Ehrlichia in United States, only E muris–like (EML) agent is transmitted by I scapularis is the vector of this emerging pathogen(8).

Possible co-infections should be considered in any patients who are diagnosed with tick bite or Lyme disease, especially those who have unexplained leukopenia, thrombocytopenia, or anemia, or who fail to respond to treatment for Lyme’s disease.

References:
1- Razai MS, Doerholt K, Galiza E, Oakeshott P. Tick bite. BMJ 2020;370:m3029
2- Caulfield AJ, Pritt BS. Lyme disease Coinfections in the United States. Clin Lab Med 2015;35:827–846.
3- Lee, X, Coyle DR, Johnson DK, et al. Prevalence of Borrelia burgdorferi and Anaplasma phagocytophilum in Ixodes scapularis (Acari: Ixodidae) nymphs collected in managed red pine forests in Wisconsin. J Med Entomol 2014;51:694-701.
4- Prusinski MA, Kokas JE, Hukey KT, et al. Prevalence of Borrelia burgdorferi (Spoirochets: Spirochaetaceae), Anaplasma phagocytophilum (Rickettsiales: Anaplasmataceae), and Babesia microti (Piroplasmida: Babesiidae) in Ixodes scapularis (Acari: Ixodidae) collected from recreational lands in the Hudson Valley Region, New York State. J Med Entomol 2014;51:226-36.
5- Horowitz HW, Aguero-Rosenfeld ME, Holmgren D, et al. Lyme disease and human granulocytic anaplasmosis coinfection: impact of case definition on coinfection rates and illness severity. Clin Infect Dis 2013;56;93-9.
6- Steere AC, McHugh G, Suarez C, et al. Prospective study of coinfection in patients with erythema migrans. Clin Infect Dis 2003;36:1078-81.
7- Krause PJ, Telford SR, Spielman A, et al. Concurrent Lyme disease and babesiosis – evidence for increased severity and duration of illness. JAMA 1996;275:1657-60.
8- Pritt BS, McFadden JD, Stromdah E, et al. Emergence of a novel Ehrlichia sp. agent
pathogenic for humans in the Midwestern United States. 6th International Meeting
on Rickettsiae and Rickettsial Diseases. Heraklion (Greece), June 5–7, 2011.

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**Comment**

This important letter to the editor highlights many contentious issues Lyme/MSIDS patients have to muddle through.  From where I sit, I disagree with the author’s statements that these infections are ‘mild and self-limited’, but I deal with sick people – not healthy.  If there’s one thing I DO know, it’s that these infections have been downplayed for far too long, and it’s been a real problem.  Patients haven’t been taken seriously for over 40 years!

The consideration of coinfections; unfortunately, is not common in mainstream medicine regarding Lyme/MSIDS.  They still treat this as a one germ disease with doxycycline curing it, when nothing could be further from the truth:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

Category:

Activism, Anaplasmosis, Babesia, Ehrlichiosis, Lyme, Testing, Ticks

Dogs Are Testing Positive For New Tick-Borne Bacteria

https://thebark.com/content/dogs-are-testing-positive-new-tick-borne-bacteria

Dogs Are Testing Positive For New Tick-Borne Bacteria

New species of bacteria identified that may cause disease in dogs and humans.
By Tracey Peake, November 2020

Researchers have identified a new species of Rickettsia bacteria that may cause significant disease in dogs and humans.

This new, yet-unnamed species, initially identified in three dogs, is part of the spotted-fever group Rickettsia which includes Rickettsia rickettsii, the bacteria that cause Rocky Mountain Spotted Fever (RMSF).

(See link for article)

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**Comment**

These poor dogs suffered from loss of appetite, lethargy, lameness, painful elbows, fever, dehydration, thrombocytopenia, and abdominal tenderness among other symptoms.  While I appreciate the authors’ desire to determine tick species and geography, these details have often been used against patients by hampering diagnosis and treatment.  We must stop trying to put this into a four-cornered box.  

Ticks and animals, including birds travel everywhere taking ticks with them.  You can get infected anytime, anywhere.

Study here:  https://madisonarealymesupportgroup.com/2020/11/17/novel-rickettsia-species-infecting-dogs-united-states/

Importantly, https://madisonarealymesupportgroup.com/2019/11/14/study-shows-ticks-can-transmit-rickettsia-immediately/ ..ticks can transmit infectious Rickettsia virtually as soon as they attach to the host.

Category:

Activism, research, Rickettsia, Ticks

Interactions Between Borrelia Burgdorferi & Ticks

https://pubmed.ncbi.nlm.nih.gov/32651470/

Interactions between Borrelia burgdorferi and ticks

Cheyne Kurokawa 1, Geoffrey E Lynn 1, Joao H F Pedra 2, Utpal Pal 3 4, Sukanya Narasimhan 1, Erol Fikrig 5 6

    Free PMC article

    Abstract

    Borrelia burgdorferi is the causative agent of Lyme disease and is transmitted to vertebrate hosts by Ixodes spp. ticks. The spirochaete relies heavily on its arthropod host for basic metabolic functions and has developed complex interactions with ticks to successfully colonize, persist and, at the optimal time, exit the tick. For example, proteins shield spirochaetes from immune factors in the bloodmeal and facilitate the transition between vertebrate and arthropod environments. On infection, B. burgdorferi induces selected tick proteins that modulate the vector gut microbiota towards an environment that favours colonization by the spirochaete. Additionally, the recent sequencing of the Ixodes scapularis genome and characterization of tick immune defence pathways, such as the JAK-STAT, immune deficiency and cross-species interferon-γ pathways, have advanced our understanding of factors that are important for B. burgdorferi persistence in the tick. In this Review, we summarize interactions between B. burgdorferi and I. scapularis during infection, as well as interactions with tick gut and salivary gland proteins important for establishing infection and transmission to the vertebrate host.

    Category:

    Lyme, research, Ticks