Archive for the ‘Ticks’ Category

Confused Woman With Anaplasmosis & Babesia Podcast

https://danielcameronmd.com/anaplasmosis-and-babesia-infection-cause-cognitive-impairment/  Go Here for Podcast

LYME PODCAST: A CONFUSED WOMAN WITH ANAPLASMOSIS AND BABESIA INFECTION

confused woman with Anaplasmosis and Babesia infection

Welcome to an Inside Lyme case study. I find that the best way to get to know Lyme disease is through reviewing actual cases.  I will be discussing a 78-year-old confused woman with an Anaplasmosis and Babesia infection.

By
 

A 78-year-old woman was evaluated in an emergency room with fever, chills, lethargy, fatigue, and confusion. Her maximum temperature was 100.6° F.

Her blood tests were quite abnormal. She had severe anemia, low white blood count, and low platelet count.

• Anemia (dropped from 10.5 g/dL to a low of 8 g/dL)
• Leukopenia (dropped from 5.0 × 10 9 /L to 2.6 × 10 9 /L)
• Thrombocytopenia (dropped to 39 × 10 9 /L)

The doctor initially considered sepsis. Sepsis is a potentially life-threatening illness triggered by an infection. The body’s immune response can be so strong that the body can attack itself and can lead to organ damage and death.

ANAPLASMOSIS AND BABESIA INFECTION

She also had multiple tick bites.

The doctors were able to identify the parasite that causes a Babesia infection in the woman’s red blood cells under the microscope. Babesia is a disease transmitted by the same tick that carries Lyme disease.

The doctors prescribed a combination of atovaquone and azithromycin for her Babesia infection. These medications are marketed under the names Mepron and Zithromax in the US.

The doctors were also concerned that the woman might suffer from another tick-borne illness called Anaplasmosis because of her low white blood count and low platelet count. Anaplasmosis had previously been called Ehrlichia.

The combination of atovaquone and azithromycin is not effective for Anaplasmosis. The doctors added doxycycline to the woman’s treatment.

The laboratory test confirmed that she had, in fact, an anaplasmosis and babesia infection. The IgM tests were positive for both conditions consistent with early infection.

The woman’s cognitive function improved dramatically following two weeks of treatment, according to the authors.

What can we learn from these cases?

  1. Tick-borne diseases can lead to confusion in the elderly.
  2. An individual with a tick-borne infection can be confused with sepsis.

What questions do these cases raise?

  1. How many elderly with tick-borne illnesses are confused?
  2. What if the parasites associated with the Babesia infection had not been seen in the red blood cells under the microscope? Would the woman have been diagnosed in a timely manner for Babesia?
  3. What would have happened to the woman if the doctors had not considered Anaplasmosis?
  4. What would have happened to the woman if the doctors had stopped treatment if the tests were negative?
  5. What is the long-term outcome for the elderly with tick-borne infections? Could the woman’s short term confusion described in this case lead to long term confusion?

TREATING TICK-BORNE DISEASE IN MY PRACTICE

In my practice, each individual requires a careful assessment. That is why I order a broad range of blood tests for other illnesses in addition to tick-borne infections. I also arrange consultations with specialists as needed.

Many patients are complex, as highlighted in this Inside Lyme Podcast series.

We need more doctors with skills diagnosing and treating Lyme disease in the elderly. We hope that a professional evaluating the elderly can use this case to remind them to look for Lyme disease and co-infections and treat accordingly.

Inside Lyme Podcast Series

This Inside Lyme case series will be discussed on my Facebook and made available on podcast and YouTube.  As always, it is your likes, comments, and shares that help spread the word about this series and our work. If you can, please leave a review on iTunes or wherever else you get your podcasts.

Sign up for our newsletter to keep up with our cases.

References:
  1. Paparone P, Paparone PW. Variable clinical presentations of babesiosis. Nurse Pract. 2018;43(10):48-54.

______________________

**Comment**

https://madisonarealymesupportgroup.com/2016/03/08/anaplasmosis/

Treatment recommendation:

The optimal dose and duration of antibiotic treatment for anaplasmosis has not been definitively established, but it is clear that A. phagocytophilum is highly sensitive to tetracyclines. Thus, oral doxycycline is the recommended treatment, at the same dose used for Ehrlichia infections: 200 mg/day in two divided doses. The usual treatment duration is 5-10 days, which is extended if there is suspected coinfection with B. burgdorferi, the agent of Lyme disease. In any case, treatment should continue for at least three days after the patient’s fever resolves. Response to treatment is usually rapid; if the patient remains febrile more than two or three days after initiation of doxycycline therapy, the diagnosis should be revisited.  As with Ehrlichia infections, rifampin is used in cases where doxycycline is contraindicated, such as pregnancy or allergy.

The CDC recommends a lower dosage. Lyme literate doctors know that some people need higher dosages. This is an important issue that has kept some from getting better. Consider and discuss with your practitioner.

https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

Please see article for various treatments.  Dr. Horowitz states that Babesia is one of the most tenacious coinfections he deals with.  He recommends treatment of 9-12 months.  Studies have also shown that mono therapies like the singular use of Mepron to be ineffective as the pathogens develop resistance to it.  Lyme literate doctors typically utilize an overlapping treatment with numerous modalities to prevent this from happening.  I’ve heard many professionals state that once you start treating Babesia you need to see it through to completion.  So don’t start until you mean business and then stick it out.  Treatment is typically 3 weeks on, one week off.  In this article I state the treatment that worked for both my husband and I.  

FYI: Two weeks of treatment is hardly ever sufficient.

Category:

Anaplasmosis, Babesia, research, Ticks

Removal of Leaf Litter & Snow Reduces Blacklegged Ticks – Webinar

https://www.northeastipm.org/ipm-in-action/the-ipm-toolbox/tick-ipm-7-leaf-litter-snow-removal-for-tick-reduction/

Tick IPM #7: Leaf Litter/Snow Removal for Tick Reduction

http://<iframe width=”925″ height=”520″ src=”https://www.youtube.com/embed/izbHKkYC1OY” frameborder=”0″ allow=”accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture” allowfullscreen></iframe  Approx. 1 Hour

Recorded October 7, 2020

This webinar focuses on developing preventative landscaping methods to reduce blacklegged tick (a.k.a. deer tick) populations. Research has suggested that both leaf litter and snow were overwintering predictors for nymphal tick survival. Dr. Stafford discusses how the removal of leaf litter and snow reduces the survival of blacklegged ticks and, if these preventive management practices were implemented, they could assist in the reduction of tick-borne diseases in the future.

Download presentation slides (PDF, 4.7 MB)

Dr. Kirby C. Stafford III

Dr. Kirby C. Stafford III, Chief Scientist (Head) of the Department of Entomology and State Entomologist (State Plant Regulatory Official) at the Connecticut Agricultural Experiment Station

____________________

**Comment**

I wish that we would also go back to doing prescribed burnings, which work:  https://madisonarealymesupportgroup.com/2019/07/18/frequent-prescribed-fires-can-reduce-risk-of-tick-borne-diseases/

Also, for hunters, put down a permethrin treated tarp when hanging deer to kill any females which may drop off:  https://madisonarealymesupportgroup.com/2020/11/09/moose-ticks-are-dining-on-local-deer/

For more on tick prevention:  https://madisonarealymesupportgroup.com/2019/04/12/tick-prevention-2019/

Category:

Prevention, research, Ticks

Ticks and Tick-Borne Diseases of Colorado, Including New State Records for Areas Radiatus & Ixodes Brunneus

https://academic.oup.com/jme/advance-article/doi/10.1093/jme/tjaa232/5961600?guestAccessKey=0b81625f-4e0a-4a09-aed2-2305b5f035e4

Ticks and Tick-Borne Diseases of Colorado, Including New State Records for Argas radiatus (Ixodida: Argasidae) and Ixodes brunneus (Ixodida: Ixodidae)

H Joel Hutcheson,  James W Mertins,  Boris C Kondratieff,  Monica M White Journal of Medical Entomology, tjaa232, https://doi.org/10.1093/jme/tjaa232Published: 09 November 2020 Article history

Abstract

We report 28 species of ticks (Acari: Ixodida) from Colorado (CO).

We include the soft ticks (Argasidae):

Argas (Argas) cooleyi Kohls and Hoogstraal, Argas (Persicargas) radiatus Railliet, Carios (Alectorobius) concanensis (Cooley and Kohls), Carios (Alectorobius) kelleyi (Cooley and Kohls), Ornithodoros(Pavlovskyella) hermsi Wheeler et al., Ornithodoros (Pavlovskyella) parkeri Cooley, Ornithodoros (Pavlovskyella) turicata (Dugès), Otobius (Otobius) lagophilus Cooley and Kohls, and Otobius (Otobius) megnini (Dugès).

We include the metastriate hard ticks (Ixodidae) Dermacentor (Americentor) albipictus (Packard), Dermacentor (Dermacentor) andersoni Stiles, Dermacentor (Dermacentor) parumapertus Neumann, Dermacentor (Dermacentor) variabilis (Say), Haemaphysalis (Aboimisalis) chordeilis (Packard), Haemaphysalis (Gonixodes) leporispalustris (Packard), and Rhipicephalus (Rhipicephalus) sanguineus Latreille.

Prostriate hard ticks include Ixodes (Ixodiopsis) angustus Neumann, Ixodes (Phoeloioxdes) baergi Cooley and Kohls, Ixodes (Trichotoixodes) brunneus Koch, Ixodes (Scaphixodes) howelli Cooley and Kohls, Ixodes (Phoeloioxdes) kingiBishopp, Ixodes (Phoeloioxdes) marmotae Cooley and Kohls, Ixodes (Ixodiopsis) ochotonae Gregson, Ixodes (Phoeloioxdes) sculptus Neumann, Ixodes (Ixodiopsis) soricis Gregson, Ixodes (Ixodes) spinipalpis Hadwen and Nuttall, Ixodes(Phoeloioxdes) texanus Banks, and Ixodes (Ixodiopsis) woodi Bishopp. Argas radiatus and Ixodes brunneus represent new state records.

Review of collection reports revealed that inclusion of Ixodes (Multidentatus) auritulus (Neumann), Ixodes (Phoeloioxdes) cookei Packard, Ixodes (Phoeloioxdes) marxi Banks, and Ixodes (Ixodes) pacificus Cooley and Kohls is dubious or unconfirmed and, conversely, that C. concanensis and H. chordeilis have distributions that include CO.

We list an additional five species occasionally detected and 13 exotic species intercepted in CO.

Tick-host associations, geographical distributions, and medical/veterinary importance are included.

Category:

research, Ticks

Moose Ticks Are Dining on Local Deer

https://www.telegram.com/story/sports/2020/10/29/outdoors-moose-ticks-dining-our-deer/

Moose ticks are dining on local deer

Back-breaking work begins after succeeding in hunt
By Mark Blazis
Correspondent
Tufts University infectious disease authority Dr. Sam Telford collects a vial of engorged moose ticks from a local white-tailed deer.Tufts University Infectious disease authority Dr. Sam Telford Collects a vial of engorged moose ticks from a local white-tailed deer.Photo/Mark Blazis

Any time you shoot a deer that’s heavier than you are is worthy of celebration. So I was ecstatic when I dropped a big buck with my arrow last Monday evening. Few events are more exciting than finally getting a deer you’ve worked hard for. But once he’s down, the reality of potentially backbreaking work just begins.  (See link for article)

_____________________

**Comment**

Excerpt:  

Besides the ubiquitous moose ticks — also called winter ticks — there were many lice, louse flies and only male deer ticks, which are of no value to Sam’s research. “The female deer ticks must have already engorged and dropped off,” Sam concluded disappointingly.

This article mentions a very practical tip: spraying the area under dead bucks with permethrin or other acaricide right away to kill any females that drop off that could lay 2,000-3,000 eggs infesting your yard.
Hanging deer in the backyard can unintentionally spread ticks and disease.

Laying the ground with an insecticide-sprayed tarp is the answer to this.

Telford states that moose ticks in Northern New England suck the blood of 1st year moose enough to cause over half of them to die every winter. He states they don’t prefer human blood but the native Americans had an expression for them that translates, “bite like fire,” so they evidently DO bite humans!

Moose ticks also typically spend their entire life on one host.

The article states there were abundant, wingless louse flies or keds – which unfortunately Telford did not collect. The female releases her young on the forest floor where they attach to bedded deer, which they feed on almost exclusively.  Again, the article states they don’t care for humans but they CAN carry bacteria and their potential disease threat remains unclear.

Yet, the following articles show THEY DO TRANSMIT TO HUMANS:

It’s truly unfortunate that transmission studies remain in infancy.  The one all the researchers refer to has an inch of dust on it.

Category:

Ticks, Transmission, Uncategorized

Study Shows Cloth Dragging for Ticks Only Catch A Minority

https://pubmed.ncbi.nlm.nih.gov/33128644/

One out of ten: low sampling efficiency of cloth dragging challenges abundance estimates of questing ticks

Siiri Nyrhilä 1, Jani J Sormunen 1 2, Satu Mäkelä 1, Ella Sippola 1 2, Eero J Vesterinen 1 2 3, Tero Klemola 4
Affiliations expand

Abstract

Hard ticks (Acari: Ixodidae) act as important vectors of zoonotic pathogens. For instance, Borrelia burgdorferi s.l. spirochetes pose a severe health risk as aetiological agents of Lyme borreliosis. Commonly, to study the abundance of questing (host-seeking) ticks, a 1 m2 piece of cloth is dragged over vegetation for a determined distance. Here, we designed a tick-sampling study to estimate the sampling efficiency of this standard method. We established 10 m dragging transects in a hemiboreal mixed forest patch in SW Finland for a 5-day monitoring period.

  • Five of the transects were cloth-dragged 3× a day,
  • whereas another five transects were dragged 6× a day in a manner that after each morning, midday and afternoon dragging, a second dragging was conducted on the same transect immediately.

Captured Ixodes ricinus ticks were subsequently analyzed for tick-borne pathogens. The initial population size of nymphal ticks on a transect was approximated by the accumulated nymph catch from the dragging sessions. The sampling efficiency of the cloth dragging was low, as

  • a single dragging in a previously untouched vegetation strip always caught less than 12% (mean 6%) of the estimated population of active nymphs that were assumed to be questing during the study.
  • Clear results were not found for daily activity rhythm, as ticks were caught in all daily dragging sessions.
  • Approximately every third nymph and every second adult carried a pathogen, but nothing indicated that the occurrence of a pathogen affected the likelihood of the tick being caught by cloth dragging.
Our results suggest that only a minority of active ticks can be caught by a single cloth dragging. The abundance estimates in many tick investigations might thus be downward biased.

____________________

**Comment**

Cloth dragging to estimate tick prevalence has been used worldwide.  Similarly to the CDC’s past vastly low estimates of those infected with Lyme disease, and then having to increase this number 10-fold (which is still probably low), this study reveals tick prevalence to be much higher than we’ve been told due to single cloth dragging missing many ticks.  This in turn means there are more infected ticks that can transmit disease to animals and humans.

Such a simple study, yet profound in its findings.

Category:

research, Ticks