Suspected Insect and Arthropod Vectors for Bartonella species
Vector-borne diseases like bartonellosis and Lyme borreliosis require the transfer of pathogens from a reservoir to humans by a “competent” vector.
A competent vector can acquire, carry, and pass on the living pathogen. The vector is generally an insect or arthropod that picks up the pathogen(s) while feeding from a reservoir species, such as deer or mice, and later infects an accidental host (a host that is not the usual reservoir) such as a human via a bite or excretions (feces).
Despite what may seem like an obvious cause and effect relationship, it can be very difficult to prove that a vector is competent. Some scientists have heroically proven vector competency by infecting themselves. You can read more about scientists who died as a result of making themselves their own Bartonella experiments here.
Because of the work of those scientists and others, we know that
Bartonella bacilliformis is transmitted by keds (biting flies)
Bartonella quintana is transmitted by body lice
Bartonella henselae is transmitted by fleas
After that the science becomes more uncertain.
The most controversial vector for Bartonella species is hard-bodied ticks of the genus Ixodes. PCR-based assays that detect fragments of DNA have shown that Bartonella bacteria can be found in their gut. However, the research on how viable bacteria are transmitted is still incomplete.
In one study of Ixodes ricinus collected in France, the authors were able to show that Bartonella henselae could be transmitted using an artificial feeding method. If one were to question whether this were adequate proof, the question would center around the fact that the transmission was observed in a controlled laboratory setting and not in nature.
Patients with Bartonella and other tick-borne infections sometimes recall a single tick bite that may have allowed for multiple pathogens to be transferred. Some scientists see this evidence as circumstantial as well and suggest more research is necessary before ticks are considered a competent vector for Bartonella.
Research and case studies have suggested additional arthropod vectors such as ants, mites, spiders, and more. They are not typically suspected in bartonellosis cases due to the very limited number of cases, but the potential is there. See below for some interesting cases:
A family that lived in a house infested with woodlouse spiders became ill from Bartonella infections. Researchers suggested that the spiders were feeding on woodlice, which are also known as roly-polies or pill bugs but are actually land-dwelling crustaceans and not bugs at all. Woodlice have been shown to carry Bartonella species. Researchers suspected that the spiders fed on the infected woodlice and then transmitted the bacteria to the patients via bites.
A man was hospitalized for encephalopathy due to a Bartonella henselae infection following red ant bites. While in the hospital, he experienced two episodes of cardiac arrest. He recovered after receiving systemic anticoagulatory medications and antimicrobials.
Triatomines or “Kissing bugs”
These biting insects are known to transmit the protozoa Trypanosoma cruzi, which causes Chagas disease. The authors of this paper discuss the role of the sand fly in transmitting Bartonella bacilliformis and suggest Bartonella species could be similarly transmitted in the saliva of other biting insects.
Some studies suggest various species of mites as possible vectors of Bartonella species. DNA from Bartonella quintana was incidentally discovered in Demodex mites of a patient with rosacea. Furthermore, mites found on tropical rats and bats showed evidence of carrying Bartonella species as well.
The development of novel molecular techniques like PCR and its variations have allowed researchers to detect Bartonella species in a wide range of insects, arthropods and crustaceans around the world.
Our ePCR technology is used by research partners around the world to better understand the One Health relationship between people, animals and the environment. Mapping the relationship between reservoirs, vectors and human and animal hosts is an important step in making prevention the best treatment.
Bradley, J. M. et al. (2014). Bartonella henselae infections in an owner and two Papillon dogs exposed to tropical rat mites (Ornithonyssus bacoti). Vector Borne and Zoonotic Diseases, 14(10), 703-709. doi:10.1089/vbz.2013.1492 https://www.ncbi.nlm.nih.gov/pubmed/25325313
do Amaral, R. B. et al. (2018). Molecular detection of Bartonella spp. and Rickettsia spp. In bat ectoparasites in Brazil. PLoS One, 13(6), e0198629. doi:10.1371/journal.pone.0198629 https://www.ncbi.nlm.nih.gov/pubmed/29870549
Hofmeester, T. R. et al. (2018). Role of mustelids in the life-cycle of ixodid ticks and transmission cycles of four tick-borne pathogens. Parasites & Vectors, 11(1). doi:10.1186/s13071-018-3126-8 https://www.ncbi.nlm.nih.gov/pubmed/30458847
Mascarelli, P. E. et al. (2013). Bartonella henselae infection in a family experiencing neurological and neurocognitive abnormalities after woodlouse hunter spider bites. Parasites & Vectors, 6, 98. doi:10.1186/1756-3305-6-98 https://www.ncbi.nlm.nih.gov/pubmed/23587343
Viera, C. B. et al. (2018, November). Triatomines: Trypanosomatids, bacteria, and viruses potential vectors? Frontiers in Cellular and Infection Microbiology [Online]. doi:10.3389/fcimb.2018.00405 https://www.ncbi.nlm.nih.gov/pubmed/30505806
“Our findings recognize that microbial infections in patients suffering from TBDs (tick borne diseases) do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”
For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.
“Ticks are in more places than they’ve ever been before,” says Thomas Mather, PhD, known as “The Tick Guy,” director of the University of Rhode Island’s TickEncounter Resource Center. “Not necessarily more ticks, but in more places. This leads to more people having an encounter.”
Cases of tick-borne diseases have been increasing in the United States for the last 25 years; in 2017, state and local health departments reported a record number to the CDC. Lyme disease in particular has exploded, increasing by 300% in the Northeast and 250% in North-Central states.
Here’s what else you need to know about ticks:
Q. What’s the forecast for ticks this year?
That depends on where you live and a variety of other things, including the number of host animals that the ticks feed on (such as deer), temperature, rainfall, and humidity. Some types, like the black-legged tick (also known as the deer tick — the one that carries Lyme disease), thrive in humid conditions. Others, like the Lone Star and American dog ticks, prefer a dry climate. The life cycle for disease-spreading ticks can be 2 to 3 years, so last year’s weather conditions matter, too.
Q. How many types of tick are there?
In the United States, nine different species are known to transmit diseases to humans. Recently a 10th species, the Asian longhorned tick, was found here for the first time. In other countries, it has made humans and animals seriously ill.
Q. Is their territory expanding?
Each species of tick claims a different area of the country, with plenty of overlap. For some types, their reach is growing. For instance, the Lone Star tick, which carries diseases like ehrlichiosis, which causes flu-like symptoms, originated in the southeastern U.S. It has expanded into Northern and Midwestern states. And the black-legged tick, which transmits Lyme, has more than doubled its range over the last 20 years. One species, the brown dog tick, is found in every state except Alaska.
One reason for the black-legged tick’s expansion is the spread of white-tailed deer. They act as the reproductive host for the tick, and they’ve been found in more urban settings — even in New York City.
Climate change also affects tick activity. Milder winters mean that fewer disease-carrying ticks die in the winter, while hotter, more humid summers give them more time to find hosts and feed.
Q. Can ticks live indoors?
Yes. If you have a pet that lives indoors and out, ticks can catch a ride into your home and stay there.
Depending on the species, they may last for 24 hours or up to several days.
Q. Can ticks survive cold weather?
Yes. Think about it: If ticks die when the temperature drops below freezing, where would next year’s ticks come from?
In fact, black-legged ticks can emerge in a winter thaw — and they’ll be looking for a meal.
Q. What diseases do ticks transmit?
Those nine species carry a dozen different diseases, and disease cases from tick bites have doubled in the United States over 12 years. Over the past 2 decades, scientists have identified another seven tick-borne germs that can make you sick.
Lyme disease is by far the most common. In 2017, there were more than five times as many cases as the next most common, anaplasmosis and ehrlichiosis. Others include spotted fever rickettsiosis, babesiosis, and tularemia.
Q. How do ticks transmit disease?
It sounds gross, but they spit germs into your body. Ticks eat blood to survive. They wait on the tips of grasses and shrubs until a human or animal host brushes by, then scramble aboard. From there, the tick seeks out a safe spot and inserts a feeding tube into the skin, which may have barbs to keep it attached, or the tick may secrete a cement-like substance to hold it there. That’s when the tick starts sucking blood, which can go on for several days. While it’s sucking, it’s also spitting saliva. If the tick is carrying a disease, the saliva carries it into your body. The longer the tick stays attached, the greater your risk.
Q. How small can ticks be?
Over the course of their life cycle, ticks come in three sizes. Among the ones that bite humans, black-legged ticks are the smallest. Their larvae are tiny, nearly microscopic, but they don’t transmit diseases — they pick them up from host animals while feeding. The next stage, nymph, is about the size of a poppy seed. They’re hard to see on your body, which may be why nymph black-legged ticks are most likely to transmit Lyme disease to humans. Adult ticks can also give you Lyme, but they’re bigger, about the size of a sesame seed, so they’re easier to spot and remove before they can pass along the bacteria.
Q. How do ticks compare to fleas?
They’re both small, and they both bite humans, but fleas mostly just make you itch. They can carry plague, a potentially deadly disease, but only 89 cases were reported in the United States between 2004 and 2016.
More common — but still unlikely — is murinetyphus, which mostly happens in the southern U.S., particularly Texas and California.
Q. How do ticks reproduce?
Most ticks that transmit disease mate while on a host’s body. (Yes, that can mean they’re getting it on, on you.) After feeding on a host animal’s blood, the adult female lays eggs — from 1,500 to as many as 5,000. Those eggs hatch several months later, and the life cycle starts again: larva, nymph, adult, eggs.
Q. Where do ticks lay eggs?
Not on you! Once the adult female is full of blood, she’ll drop off to lay her eggs somewhere sheltered.
Q. What do baby ticks look like?
Larvae are very small dots, barely visible. But if you look at them under a microscope, you’ll see six legs. Nymph ticks, the next stage, have eight.
Q. Will you feel it when a tick bites?
Probably not. When they’re attaching themselves to a host, ticks secrete saliva that acts like an anesthetic. So if they’re in a hard-to-see spot on your body, you may not notice.
Q. What should you do if you find a tick on your body?
Remove it as soon as possible. But don’t just yank; use a pair of pointy-tipped tweezers. They’ll give you the control you need to grab the tick as close as you can get to the skin. Pull straight up, steadily, without twisting or jerking. The idea is to remove the whole tick in one go, without leaving any of its mouth parts behind.
Because it can take a while for a tick-borne disease to emerge, it’s a good idea to hold on to the tick, says Mather. The TickEncounter Resource Center offers “TickSpotters,” a crowdsourcing tool that helps you identify what type of tick you found. “We can’t help you if it doesn’t have a picture,” he says. “Put it in a Ziploc bag. It doesn’t take much space, you can write on it, and you’ll have it if you want to get it tested.”
Q. How can you avoid being bitten?
Ticks can’t jump or fly — they start from ground level and climb. If you never brush up against grasses or shrubs, you should be fine. But for most of us, that’s easier said than done. When you’re walking through an area with heavier brush, take extra precautions: Tuck your pants legs into your socks, so the tick can’t get to your skin. And if you know you’re in a tick-infested area, wear clothing — especially shoes, socks, and pants — treated with permethrin, which repels and kills ticks. Insect repellents containing DEET, which you put on your skin, add more protection, but DEET alone is nowhere near as effective as permethrin.
Once you get home, check your body for ticks: under your arms, in and around your ears, inside your bellybutton, behind your knees, between your legs, around your waist, and on your hairline and scalp.
Telling quote that the climate change issue would:
“explain to the public a reason for not tackling this serious health care issue earlier. The tick problem was programmed for the future.Thus, ill-founded statistical analyses culminated in fabricated erroneous data and, ultimately, resulted in a series of maps that turned out to be flawed science.” John Scott
The reason this is important is four-fold:
Regarding ticks and Lyme/MSIDS, it’s fake science
Climate data has not and will not help sick patients one iota
The reason behind this popular climate-change agenda is to obtain research grants. Climate change for ticks and Lyme/MSIDS is akin to the latest fashion in Paris. It’s a buzzword that attracts funding, despite the lack of true science backing it up
It is a bait and switch technique to keep research funding diverted to a non-issue while neglecting important issues that are screaming to be done on: effective testing and treatments, the sordid history surrounding it, the mismanagement of a disease that’s become a true pandemic, the neglect and death of patients, transmission studies, the large subset of patients with chronic/persistent symptoms, the connection between Alzheimer’s/dementia, ALS, MS, fibromyalgia, heart issues, and on and on….
Do not be duped. Climate change is all a ruse.
Don’t you find it interesting that 40 plus years into this plague and we have hardly budged in our knowledge and treatment of it? Patients are still fighting to be heard and believed, are not being treated appropriately, and yet the numbers of infected continue to grow unabated?
“The climate change range expansion model is what the authorities have been using to rationalize how they have done nothing for more than thirty years. It’s a huge cover-up scheme that goes back to the 1980’s. The grandiose scheme was a nefarious plot to let doctors off the hook from having to deal with this debilitating disease. I caught onto it very quickly. Most people have been victims of it ever since. This climate change ‘theory’ is all part of a well-planned scheme. Even the ticks are smarter than the people who’ve concocted this thing. Climate change has nothing to do with tick movement. Blacklegged ticks are ecoadaptive, and tolerate wide temperature fluctuations…..It’s all a red herring to divert your attention.”- John Scott
PLATTSBURGH, N.Y. (WCAX) Ticks are gaining ground in the Adirondacks like never seen before and experts are trying to get the word out.
Courtesy: Adirondack Watershed Institute
They want to make sure people living there including visitors and medical providers know how to spot and treat ticks.
Paul Smith’s College tick researcher Lee Ann Sporn helped organize a panel this week — “A Ticking Time Bomb: The Tick Crisis in the Adirondacks” — and is traveling around different parts of the North Country presenting her latest research.
“The lore, the common lore is still that there isn’t ticks and there are no risk of tick borne diseases here in the North Country. Physicians are still failing to treat people with tick bites because they say this is a no risk, or low risk tick borne disease area, which now is really untrue, so we’re really trying to get that word out,” Sporn said.
The best way to protect yourself from ticks includes covering your skin by wearing light and bright colors, use an insecticide like pyrethrin, and do a tick check from head-to-toe when you get home.
At this point, any doctor who fails to treat people with tick bites should be turned into the medical board.
It’s a good thing they don’t fly. But, they do blow in the wind. Advocates have told me stories of ticks blowing into their swimming pools. My neighbor with a farm field mowed his lawn, blowing the grass toward my house. I found ticks crawling on my basement screens and a few found their way inside the house on the walls.
The tick maps should be thrown into the trash.
For far too long patients have been denied diagnosis and treatment based on a piece of paper telling them where ticks are supposed to be.
OPINION: How many cases of Lyme disease are we missing?
Published: June 27, 2019
I participated in a “Tick Talk” in Bedford with Lisa Ali Learning of AtlanTick on June 25. One takeaway from that meeting, for me anyway, is that we are not doing enough to ensure Nova Scotians are adequately aware of the risks associated with tick bites. One family, new to the country, had never even heard of ticks before one recently attached to their child.
Although there has been a steady increase in awareness initiatives over the past few years, we need to continue to do more to reduce the number of new cases of Lyme and tick-borne diseases. One way to do this is through more “in your face” awareness, such as signage, print media and radio/TV alerts. Nova Scotians need to reach out to all three levels of government to request that more is done.
Nova Scotians need to know that any tick that bites them could potentially transmit an illness. Black-legged (deer) ticks are not the only kind of tick that can transmit disease, and Lyme is not the only thing we need to worry about. Dog (wood) ticks have been found to carry a number of things, and Lone Star ticks have been found sporadically within the province. As well, migratory birds could be dropping other types of ticks within the province that we haven’t even discovered yet. Any tick that bites a human could potentially be carrying disease — sometimes multiple illnesses.
Symptoms can vary from person to person, with some not showing any outward, visible signs, so medical professionals need to listen to their patients and start to put two and two together.
The fact that the test is performed too early (which most are aware of)
It could be a different strain of the Borrelia bacteria not picked up by the test (we also have Borrelia miyamotoi in the province, which can cause a Lyme-like illness and doesn’t generally present with a rash)
Antibiotic use. If you were put on antibiotics for something between the bite and the test, or only received a one-day prophylactic treatment upon the bite, you could always test false-negative.
According to Conquering Lyme Disease, a book by doctors at the Columbia University Medical Center, “false negative rates on the ELISA have been reported as high as 67 per cent in early Lyme disease and 21 per cent in early neurologic Lyme disease.” The potential for people to not form enough antibodies to be picked up by the test is also possible.
If your test is negative, it doesn’t mean you do not have Lyme!
Also very important to note is that Lyme is supposed to be a clinical diagnosis, with testing supplementary. Unfortunately, doctors may recognize the better-known bull’s-eye rash, but that is only seen in 20-30 per cent of cases (if that). Other types of erythema migrans rashes are more common. About 20 per cent do not get any rash (Borrelia miyamotoi, perhaps?), while many that do don’t see it because it is tucked away somewhere not easily visible, just like the ticks like to be.
Symptoms can vary from person to person, with some not showing any outward, visible signs (such as an erythema migrans rash, Bell’s palsy, or swollen, hot knees), so medical professionals need to listen to their patients and start to put two and two together. That includes changes in mental health, new digestive issues, new sensitivities to scents, sounds, light and food, migrating pain, more frequent headaches, changes to heartbeats, and so much more that can be suggestive of Lyme and tick-borne diseases.
Rather than immediately dismissing Lyme and tick-borne diseases, as many doctors are still doing to this day, they need to realize that this issue is not rare, hard to get or easy to treat.
In other words, it is very hard to get a diagnosis if you do not see the tick, get the bull’s eye rash version of the erythema migrans rash, and/or test positive on both the ELISA and confirmatory Western Blot.
How many are we missing?
Donna Lugar is Nova Scotia representative of the Canadian Lyme Disease Foundation and founder of the N.S. Lyme Support Group. She lives in Bedford.
A vet has been left suffering with extreme fatigue for almost a decade, after she caught an infection from a cat scratch which caused symptoms so severe she thought she was going blind or had a brain tumor.
A flea-infested cat scratched Victoria Altoft, 41, from the county of Somerset in south west England, while she was at work in the fall of 2010, PA Real Life reported.
Weeks later, Altoft’s muscles and joints were in pain and she was hit by night sweats, leading her to assume she had the flu. She was “utterly exhausted” and took the uncharacteristic decision to take two weeks off work.
“I just couldn’t get out of bed,” she told PA Real Life. As time passed, her joints swelled up, which her doctor put down to post-viral inflammation.
But Altoft became worried when her vision started to blur. She went for an emergency eye appointment, and medics thought her symptoms could be caused by a brain tumor or the condition multiple sclerosis, which affects the central nervous system.
Tests revealed she was suffering a rare Bartonella infection, and doctors prescribed her with antibiotics: the treatment given to serious cases of the condition.
The bacteria is carried by infected fleas which live on animals like cats or dogs. Lice and sandflies are also vectors of the Bartonella group of bacteria which can cause cat scratch disease, as well as Carrion’s disease (only found in the Andes Mountains), and trench fever (most often present in people who live in areas of poverty with poor sanitation).
In most people, cat scratch disease doesn’t require treatment and fades by itself in between two to four months. But severe cases require antibiotic treatment.
Symptoms materialize several days or weeks after the bacteria invades the body. After three to 10 days, a painless raised red spot might appear on the skin where the infection passed through the skin. Over time this may become filled with fluid, with a crust forming before it heals. The lymph nodes near the site of infection might become swollen, red and hot to the touch, and puss-filled. Other symptoms include a general feeling of illness, headache, fatigue, and fever and—less often—sore throat and weight loss.
It took a year for her sight to return to normal. Altoft told PA Real Life she still suffers from fatigue despite being scratched in 2010.
“To this day, it’s difficult to know exactly what the long-lasting effects of contracting Bartonella are, as there is so little research, but I know I’m not the same now as I was before it happened,” she said.
Altoft is working with the Big Flea project run by the University of Bristol and the pharmaceutical company MSD Animal Health, who are researching the parasites which affect dogs and cats in the U.K.
The vet urged pet owners to take flea infestations seriously as they can pose a serious threat to human health.
First off, Bartonella is NOT RARE.
Second, someone PLEASE cut the nails on that cat!
For many, many people Bartonella is NOT something that, “fades by itself in between two to four months.”
Bartonella is a particularly tenacious infection that can cause so many symptoms it boggles the mind. Couple it with Lyme disease and you are one sick dog. Throw in Babesia, and you are in bed for a long, long time.
Regarding vectors, it’s far more than fleas, lice, and sandflies:
Bartonella spp. are zoonotic pathogens transmitted from mammals to humans through a variety of insect vectors including the sand fly, cat fleas, and human body louse [4,5]. New evidence suggests that ticks, red ants, and spiders can also transmit Bartonella[15,16,17,18]. Bed bugs have been implicated in the transmission cycle of B. quintanaand have been artificially infected . B. quintana was found in bed bug feces for up to 18 days postinfection . The diversity of newly discovered Bartonella species, the large number and ecologically diverse animal reservoir hosts, and the large spectrum of arthropod vectors that can transmit these bacteria among animals and humans are major causes for public health concern.
3.3 Arachnids (Spiders &Ticks)
Over the last 10 years, the topic of ticks transmitting Bartonella species has been widely debated. Evidence exists to support the transmission of Bartonella through many different species of ticks.
Ixodid ticks, also known as hard ticks, appear to be the main type of tick associated with these bacteria. Tick cell lines have been used to show that Bartonella can replicate and survive within:
were collected when in the adult and nymphal stages and tested for Bartonella by PCR for the citrate synthase gene. . All types of ticks were found to contain Bartonella DNA, although in varying percentages and locations.These data alone do not prove that ticks can transmit Bartonella spp. Bacteria; however, the results do show Bartonella DNA occurring naturally in these wild ticks.
Kelly Oggenfuss is walking into the woods. Leading her team of four young researchers through a thicket of slender oak trees, she doles out assignments by letters corresponding to a grid. As early morning light filters through the canopy, Oggenfuss and her colleagues pull on latex gloves then disperse to gather surveillance data.
For 20 years, this has been a post-dawn ritual for Oggenfuss, a senior research specialist at the Cary Institute of Ecosystem Studies in Millbrook, New York, a bucolic town in the state’s Hudson Valley region. Four times a week from April to November — traditionally the most active tick season in the Northeast — she leads a platoon of field researchers as they don white coveralls, drive a pair of old Chevy Tracker SUVs down an overgrown dirt road, and hike to a five-acre tract designated “Henry Control” on the grounds of the institute. Their mission is to seek out and study ticks in one of the most tick-infested areas in America.
Oggenfuss and the others work methodically across a grid of 242 spring-loaded box traps, checking for rodents lured overnight by whole-oat seeds. Sharing updates via walkie-talkie, the team gathers after a squirrel is found in one of the traps. The new researchers transfer the animal to a plastic mesh sleeve and take turns examining it. A similar process unfolds with chipmunks.
Most often, the traps capture mice, which Oggenfuss and her team carry with them, still in the trap, until the grid check is complete. Then the group convenes around a collapsible table. As one researcher records data (grid location, gender, tag number, etc.), the others apply tags to the mice and collect blood, urine, and stool samples. Finally, Oggenfuss and her team meticulously comb the mice with tweezers and blow on their fur, pushing it aside in search of ticks.
“Look there’s a nymph,” says Oggenfuss. “And I’ve got one, two, three larvae. Can you see them?” She pulls a patch of the mouse’s fur back to reveal a blacklegged tick no bigger than a poppy seed burrowed into its head. The larvae are barely perceptible.
A researcher named Agi holds up another mouse. “Look,” she announces. “That’s a larva on top of that nymph. We have a co-feeding situation here.” The theory is that their feeding sites are so close that pathogens move between them easily, Oggenfuss explains. The potential result is one tick sharing infectious material directly with another through the host mouse as if it were a straw, speeding the spread of disease. “That could have an effect on infection prevalence,” Oggenfuss adds. “It’s one of the things we’re studying.”
Since 1992, the Cary Institute has been compiling a record of tick ecology that they believe to be the longest continuous study of this kind in the U.S. and possibly the world. Mostly its researchers encounter the blacklegged, or deer, tick (Ixodes scapularis), but in recent years, they’ve also been seeing increasing numbers of lone star ticks (Amblyomma americanum), which are native to the American Southeast but now range from northern Mexico to Canada. Over the years, an alarming number of ticks in the surrounding area have been revealed to carry Borrelia burgdorferi, the bacteria that causes Lyme disease, while others have tested positive for the pathogens that cause other tick-borne illnesses, including the potentially fatal Powassan virus.
Because ticks acquire pathogens from hosts, understanding tick-borne diseases means understanding ticks’ so-called disease reservoir, especially mice. If the urban rat was the primary carrier of bubonic plague, the country mouse is it for Lyme disease. And just as the fleas that fed on infected rats spread the plague, ticks that feed on infected mice transmit Lyme.
On this early May morning, the team’s trap yield is relatively modest — four mice, two squirrels, and a chipmunk. “It’s early days still,” says Oggenfuss. In August, during the so-called larval peak, the researchers sometimes catch as many as 220 mice and can find 150 or even 200 tick larvae crawling on a single mouse. It can be an unnerving moment. “When the ticks are looking for a feeding site,” Oggenfuss says, “the mouse fur just seems to move on its own.”
The process for counting ticks not affixed to hosts is called a drag — the researchers pull a one-square-meter sheet of fabric along the ground for 30 meters then tally the number of ticks affixed to it. Oggenfuss holds the Cary Institute record for ticks collected in a single drag: 1,700. As horrifying as that haul was — and it would, by extrapolation, put the tick population on the Cary Institute’s 2,000-acre campus at 2 billion — Oggenfuss is quick to note it was exceptional, and tick density is irregular. Her more conservative calculations of average tick populations, based on drags done during the same time of year (August, the larval peak), are only reassuring by comparison: upward of 20,000 ticks per acre, more than 100,000 on the Henry Control grid, and more than 40 million on the Cary Institute grounds.
The scary thing is, that’s nothing. Experts say the worldwide tick population is exploding,triggering a dramatic spike in the incidence of Lyme disease and a rise in other tick-borne illnesses, some of which, like Powassan, are far more dangerous than Lyme.
First identified in 1975 in the leafy New England town of Old Lyme, Connecticut, Lyme disease has now reached what experts consider pandemic proportions. According to the Centers for Disease Control and Prevention (CDC), the number of confirmed cases of Lyme disease in the U.S. has more than doubled in the two decades leading up to 2017 (the most recent year for which final figures are available) and increased 17% from 2016 to 2017 alone. More than half the counties in the U.S. are considered high-risk areas for Lyme, according to the CDC, and in some areas, as many as six out of 10 ticks carry the infection.
“It’s been a relentless expansion since the 1980s,” says John Aucott, director of the Lyme Disease Clinical Research Center at Johns Hopkins University School of Medicine. “There may be down years and up years, but the trends are in place, and there’s no indication that they’re going to reverse.”
We now live in a frightening new normal: It’s estimated that 300,000 people contract Lyme every year in the U.S., with victims found not just in traditionally tick-heavy areas like upstate New York and Maine, but also in all 50 states and Washington, D.C. While most people are cured quickly with antibiotics, some go on to experience lingering symptoms characteristic of Lyme, like headaches, fatigue, and joint and muscle pain, for months or longer after they’ve been treated, a condition known as post-treatment Lyme disease syndrome (PTLDS). According to a recent study led by experts at the Brown University School of Public Health, the number of people in the U.S. with PTLDS was estimated to be 1.5 million in 2016 and is predicted to rise to nearly 2 million by 2020.
“There is little doubt that [Lyme disease] is pandemic. It calls for a huge national and concerted international effort to bring it under control.”
Tick populations now exist on every continent, even Antarctica, and Lyme disease can be found throughout most of Europe, where it ranks as the most common vector-borne disease, and beyond. “To me, there is little doubt that it is pandemic,” says Mary Beth Pfeiffer, author of Lyme: The First Epidemic of Climate Change. “It’s in China, Russia, Japan, Australia. It’s moving fast into Canada. It is all across the U.S. It calls for a huge national and concerted international effort to bring it under control.”
The incidence of other tick-borne illnesses is also sharply rising. According to the CDC, the occurrence of those diseases in the U.S. has nearly tripled since 2004 and increased more than 22% from 2016 to 2017. In addition to Lyme, ticks transmit a slew of pathogens, including those that cause babesiosis, ehrlichiosis, anaplasmosis, southern tick-associated rash illness, tick-borne relapsing fever, tularemia, Colorado tick fever, Q fever, Rocky Mountain spotted fever, and Powassan encephalitis. Most of the bacterial diseases are treatable if diagnosed early. Others, like Rocky Mountain spotted fever, are potentially fatal, particularly in children, if not treated quickly. Incidences of spotted fever rickettsiosis, which includes Rocky Mountain spotted fever, increased more than 12-fold from 2000 to 2017 (up from 495 to 6,248). And while more rare still, cases of Powassan virus, which can kill one in 10 people who are infected and for which there is no treatment, are rising as well. In 2008, only two cases were reported. In 2016, that number jumped to 22 and again in 2017 to 33.
“Ticks account for more diseases than all other biting insects and arthropods in the United States,” says Ben Beard, deputy director for the Division of Vector-Borne Diseases at the CDC. “It’s hard to know what the maximum or the ceiling might be. All we can say is that the number of cases is growing every year.”
Alarms are going off all over the globe. South Africa, where tick-bite fever (a form of rickettsias) is common, has seen an increase in incidences of Crimean-Congo hemorrhagic fever (CCHF), which is deadly in 30% to 40% of cases. The tick that carries CCHF, a native of sub-Saharan Africa and eastern Europe, has been found in Spain, Portugal, Germany, and the United Kingdom, where it is believed to have been brought from Africa by migratory birds. Bites from the lone star tick have been shown to cause alpha-gal syndrome, which manifests in rapid-onset allergies to meat, typically beef and pork, that can result in unexplained anaphylactic reactions. There is no treatment, other than eschewing the consumption of red meat.
In North America, news reports in Maine and southern Canada this spring featured a shocking number of sightings of what are called ghost moose — skeletal-looking, malnourished, denuded animals that have rubbed off their fur in response to tick irritation after hosting up to 75,000 feeding ticks through the winter. Many emerged anemic after being the source of so many blood meals, and a number of calves died after losing too much blood to ticks — a vampire-like end to life known as exsanguination.
If Lyme disease has reached pandemic proportions, why haven’t we heard more about it? Because, experts say, Lyme doesn’t strike fear into people’s hearts the way some other illnesses, like Ebola or Zika, do. People respond to dramatic pictures or dramatic mortality, says Aucott.
“It’s hard for them to have a perspective on the real impact of Lyme disease because it doesn’t cause visible changes. People with Lyme disease don’t look sick.”
Babesiosis is a tick-transmitted intraerythrocytic zoonosis. In Korea, the first mortalities were reported in 2005 due to Babesia sp. detection in sheep; herein we report epidemiological and genetic characteristics of a second case of babesiosis. Microscopic analysis of patient blood revealed polymorphic merozoites. To detect Babesia spp., PCR was performed using Babesia specific primers for β-tubulin, 18S rDNA, COB, and COX3 gene fragments. 18S rDNA analysis for Babesia sp., showed 98% homology with ovine Babesia sp. and with Babesia infections in Korea in 2005. Moreover, phylogenetic analysis of 18S rDNA, COB, and COX3 revealed close associations with B. motasi. For identifying the infectious agent, Haemaphysalis longicornis (296) and Haemaphysalis flava (301) were collected around the previous residence of the babesiosis patient.Babesia genes were identified in three H. longicornis: one sample was identified as B. microti and two samples were 98% homologous to B. motasi.
Our study is the first direct confirmation of the infectious agent for human babesiosis.This case most likely resulted from tick bites from ticks near the patient house of the babesiosis patient. H. longicornis has been implicated as a vector of B. microti and other Babesia sp. infections.
The full-length article tells the unfortunate story of an elderly men’s death 36 hours after hospitalization due to an emerging type of Babesia due to a tick bite.
A blood sample was obtained from the jugular vein in the patient that presented with dizziness and general weakness.
No microorganisms were isolated from the blood culture.
Microscopy revealed the following:
Upon light microscopic examination, variable intraerythrocytic parasites as ring forms, pear-shaped forms, paired pyriforms, pleomorphic ring forms, and multiple-infected parasites and clusters of extracellular rings were detected in Giemsa-stained blood smears. The percentage of parasitaemia was 1.8% (Figure 1). Maltese cross forms comprising four masses in an erythrocyte that are often described as a characteristic of B. microti infection were not detected in most blood smears (Figure 1).
Please note that the patient would have failed a simple blood test and even microscopy revealed atypical findings as well as the fact parasitemia was less than 2%.
Yet, 2% was enough to kill a man.
Tick collections were performed by dividing the area around the patient’s residence and the findings were:
A total of 597 ticks were collected around the patient’s residence, including 296 H. longicornis(186 adult, 41 nymphs, and 68 larvae) and 301 Haemaphysalis flava (1 adult and 300 larvae) (Table 2). Among these, 94% of the ticks were collected in both the front yard of patient’s residence (442 ticks) and associated hill III (124 ticks). Based on the results of the amplification of Babesia genes in each tick, 2 (0.3%) were positive for 18S rDNA of Babesia species, 1 (0.2%) for COB and COX3, and 1 (0.2%) for β-tubulin gene of B. microti. While the nymph of H. longicornis yielded a positive result for only 18S rDNA, one female tick of H. longicornis yielded positive results for 18S rDNA, COB, and COX3 gene fragments. Also, one female tick of H. longicornis only yielded positive results for β-tubulin gene of B. microti (Table 3).
Please note two things: the high amount of ticks found right in his yard and the low incidence of infected ticks – yet, it only took one to kill him.
The Discussion section reveals some interesting things:
Previously, seven different Babesia spp., B. microti, B. divergens, B. bovis, B. canis, B. duncani, B. venatorium, and a novel Babesia sp. similar to ovine babesias were reported to cause human babesiosis...Human babesiosis (KCDC-1) in 2017 was the second case identified in Korea and the sequence of Babesia sp. was very closely related to that of KO1 and Liaoning, China. These large Babesia are clearly distinct from other agents of human babesiosis based on their shape and phylogeny. These results suggest that the causative agent in their case of babesiosis is a novel large Babesia parasite infecting humans and may be highly fatal….
the identified Babesia parasites (in the patient) might be B. motasi, and this is the first study to detect B. motasi in human babesiosis and H. longicornis in Korea.