Archive for the ‘Transmission’ Category

Babesia Subverts Adaptive Immunity and Enhances Lyme Disease Severity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635642/

. 2019; 10: 1596.
Published online 2019 Jul 10. doi: 10.3389/fmicb.2019.01596
PMCID: PMC6635642
PMID: 31354683

Protozoan Parasite Babesia microti Subverts Adaptive Immunity and Enhances Lyme Disease Severity

Vitomir Djokic,1,† Lavoisier Akoolo,1,† Shekerah Primus,1 Samantha Schlachter,1,‡ Kathleen Kelly,2 Purnima Bhanot,1and Nikhat Parveen1,

Abstract

Lyme disease is the most prominent tick-borne disease in the United States. Co-infections with the tick-transmitted pathogens Babesia microti and Borrelia burgdorferi sensu stricto are becoming a serious health problem. B. burgdorferi is an extracellular spirochete that causes Lyme disease while B. microti is a protozoan that infects erythrocytes and causes babesiosis. Testing of donated blood for Babesia species is not currently mandatory due to unavailability of an FDA approved test. Transmission of this protozoan by blood transfusion often results in high morbidity and mortality in recipients.

Infection of C3H/HeJ mice with B. burgdorferi and B. microti individually results in inflammatory Lyme disease and display of human babesiosis-like symptoms, respectively.

Here we use this mouse model to provide a detailed investigation of the reciprocal influence of the two pathogens on each other during co-infection.

We show that

  • burgdorferi infection attenuates parasitemia in mice while
  • B. microti subverts the splenic immune response, such that a marked decrease in splenic B and T cells, reduction in antibody levels and diminished functional humoral immunity, as determined by spirochete opsonophagocytosis, are observed in co-infected mice compared to only B. burgdorferi infected mice

Furthermore

  • immunosuppression by B. microti in co-infected mice showed an association with enhanced Lyme disease manifestations.

This study demonstrates the effect of only simultaneous infection by B. burgdorferi and B. microti on each pathogen, immune response and on disease manifestations with respect to infection by the spirochete and the parasite. In our future studies, we will examine the overall effects of sequential infection by these pathogens on host immune responses and disease outcomes.

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**Comment**

Two of the authors recently completed a review of literature on concurrent Babesia and Lyme infections:   https://madisonarealymesupportgroup.com/2019/08/25/babesia-microti-borrelia-burgdorferi-coinfection/

Due to the high prevalence of infection and the issues of congenital transmission and transmission through blood transfusion, the issue of concurrent infection and what it does to animal and human health is of paramount importance.

For more on Babesia:   https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/ Symptom checklist within this link as well as treatment options.

https://madisonarealymesupportgroup.com/2018/10/11/babesia-found-in-patient-with-persistent-symptoms-following-lyme-treatment/

While a current article downplays Babesia in Canada, another article shows it’s much more of a problem than suspected:  https://madisonarealymesupportgroup.com/2019/08/21/prevalence-of-babesia-in-canadian-blood-donors-june-october-2018/

https://madisonarealymesupportgroup.com/2019/07/11/characteristics-of-transfusion-transmitted-babesia-microti-american-red-cross-2010-2017/  This clearly shows there were more than 200 Babesia transfusion-transmissions reported. It also shows you don’t have to reside in an endemic area or travel to an endemic area to get it. The article also clearly points out that the geographic range of ticks is expanding, which means the pathogens they carry will as well.

Category:

Babesia, Lyme, research, Ticks, Transmission

Ticks Are One Way Tularemia Can Be Spread. Rabbits Are Another

https://www.lymedisease.org/tularemia/

Ticks are one way tularemia can be spread. Rabbits are another.

Briana-Zellner, tularemia

By Briana Zellner

Ticks can be hosts to many different infectious diseases including Lyme disease and Rocky Mountain spotted fever. However, you may not be familiar with another important tick-borne disease called tularemia.

Tularemia, or rabbit fever, is caused by the bacterium Francisella tularensis (F. tularensis). F. tularensis can cause life-threatening infections that often are misdiagnosed as the flu.

If antibiotic treatment is not started early, tularemia can be fatal or can result in life-long health problems, including kidney and liver damage.

During the Great Depression era (1930s), there were over 10,000 cases of tularemia per year in the U.S., linked to either rabbit hunting or tick bites. Today, about 250 tularemia cases are reported each year in the U.S. Worldwide, there are thousands of tularemia cases each year. F. tularensis can be carried or cause disease in over 3,000 different animals.

Tularemia transmission

In addition to ticks, humans can become infected by eating or drinking contaminated food or water, being bitten by infected mosquitoes or flies, handling infected animal carcasses, or even inhaling air contaminated with the bacteria (mowing over an infected rabbit burrow/nest). These different infection routes can cause different disease symptoms, making tularemia extremely difficult to diagnose.

If quickly diagnosed, tularemia can be treated with antibiotics. However, there is no vaccine to prevent tularemia disease.

As a researcher in Dr. Jason Huntley’s lab at the University of Toledo College of Medicine and Life Sciences, I study how F. tularensis infects and causes disease. Using this information, our lab also works to develop new therapeutics and vaccines to prevent tularemia.

Every day we are exposed to millions of bacteria on our skin, in our lungs, and in our digestive tract. Luckily, we have specialized immune cells in our body that recognize invading bacteria, engulf, and kill them. These immune cells signal to other cells to alert them that the body is under attack so that infections can be quickly cleared.

Unfortunatley, F. tularensis is very good at avoiding these immune cells. In fact, F. tularensis actually can invade and replicate inside immune cells and many other cell types.

The bacteria have specialized proteins on their surface that allow them to invade and survive inside human cells. The bacteria also have a unique protective barrier, called the cell wall, which prevents them from being killed by our immune system.

The cell wall is a very important component of these bacteria. Think of it like a suit of armor or a bullet-proof vest designed to protect these bacterial invaders. If the armor is damaged or missing, the invaders are much more vulnerable to attack.

When immune cells encounter F. tularensis, they try to attack the bacteria and cause chinks in the armor. However, F. tularensis is very good at quickly repairing these chinks, infecting other cells, and reproducing to extremely high numbers – causing life-threatening disease.

Tularemia’s bacterial armor

Our lab has identified over 50 bacterial armor genes that allow F. tularensis to infect human cells and cause disease. Although these genes work together to protect the bacteria from our immune attack system, I have been able to use genetic tools to precisely delete only one armor gene to study.

I have found that these modified bacteria cannot replicate inside immune cells or cause disease in animals. When I examine these modified bacteria by electron microscopy, I have shown that they have abnormal cells walls – chinks in their armor.

Most importantly, I have recently shown that these modified bacteria can be used as a vaccine to protect animals from tularemia, similar to the modified chickenpox and measles, mumps, rubella (MMR) vaccines that are currently used.

Although I am a long way from testing this vaccine in humans, the potential to prevent human tularemia is exciting. In addition, because very little is known about the cell wall of F. tularensis, my project has provided new information about how we can develop new drugs to attack F. tularensis and potentially other bacteria.

Briana Zellner is a Ph.D. student in the Department of Medical Microbiology and Immunology in The University of Toledo College of Medicine and Life Sciences Biomedical Science Program. For more information, contact Briana.Zellner@rockets.utoledo.edu or go to utoledo.edu/med/grad/biomedical. This article was originally published in The Toledo Blade. 

Click here to see our Lyme and co-infections chart.

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For more:  https://www.lymedisease.org/516/  Tick-borne Mystery in Folsom, CA. Can You Say “Tularemia”?

https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/  Excerpt:  

Tularemia, in aerosol form, is considered a possible bioterrorist agent that if inhaled would cause severe respiratory illness. It was studied in Japan through 1945, the USA through the 60’s, and Russia is believed to have strains resistant to antibiotics and vaccines. An aerosol release in a high population would result in febrile illness in 3-5 days followed by pleuropneumonitis and systemic infection with illness persisting for weeks with relapses. The WHO estimates that an aerosol dispersal of 50 kg of F. tularensis over an area with 5 million people would result in 25,000 incapacitating casualties including 19,000 deaths.

Category:

Testing, Ticks, Transmission, Tularemia

Avid Hiker Meets Bad Bug, Ends Up With Babesiosis

https://www.stltoday.com/lifestyles/health-med-fit/health/to-your-good-health/avid-hiker-meets-bad-bug-ends-up-with-babesiosis/article_

Avid hiker meets bad bug, ends up with babesiosis

Dear Dr. Roach • I am an avid hiker, and I live in an area with lots of Lyme disease. I recently developed some fever, headache, shaking chills and dark urine, and just felt awful. My doctor did some blood tests and said I had Babesia and/or Anaplasma. Are these related to Lyme disease? — I.J.M.

 

Answer • Like Lyme disease, babesiosis (caused usually by Babesia microti) and anaplasmosis (caused by Anaplasma phagocytophilium) can be spread by the bite of the deer tick, Ixodes scapularis, but neither bacteria species is related to Borrelia burgdorferi, the cause of Lyme disease. These diseases are not well-known by most people, nor even by many general doctors outside the areas where they are common, such as Wisconsin and Connecticut.

Babesiosis causes fever as high as 105.6 F, fatigue and feeling unwell. Dark urine is occasionally present. There are nonspecific lab findings, such as anemia and low platelet counts, but the diagnosis is confirmed by seeing the bacteria inside the red blood cells or by sophisticated blood testing (PCR). Treatment is with azithromycin and atovaquone.

Anaplasmosis has a generally lower fever, muscle aches, headache, chills and the same feeling of being unwell (called “malaise” in medical literature). Blood counts frequently show low white blood cell counts. The diagnosis is made by antibody or PCR testing, but treatment is usually started in the appropriate setting even before positive results. Treatment is with doxycycline.

Tickborne diseases may exist at the same time, so consideration must be given to people having both anaplasmosis and babesiosis, with or without Lyme disease.Doxycycline treatment for anaplasmosis also treats early Lyme disease, but does not treat babesiosis.

Both anaplasmosis and babesiosis can be very severe in people with immune system disease, such as HIV or an organ transplant. Older people are also at higher risk for severe disease.

Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

________________

**Comment**

This article reminds us of issues that demand answers:

  1. Why does mainstream medicine STILL know so little about tick-borne diseases after 40 years? https://madisonarealymesupportgroup.com/2019/08/22/early-diagnosis-necessitates-lyme-savvy-doctors/
  2. Why is testing STILL being used that is so unreliable after 40 years?  https://madisonarealymesupportgroup.com/2019/08/05/controversies-challenges-in-treating-lyme-other-tick-borne-diseases/
  3. Please notice the doctor’s wise usage of “usually caused by?” This is wise because it could be one of a number of strains of Babesia.
  4. Please notice the the doctor’s wise explanation that a tick bite can transmit a whole host of pathogens – not just Lyme and sometimes not Lyme at all.  This issue is what is completely being neglected in mainstream medicine because doctors aren’t looking at all for any of these coinfections that can come with or without Lyme. Since testing is abysmal for ALL of them, they should be educated in symptomology since diagnosis has always been and still is a clinical diagnosis. Testing is not accurate and should not be the sole means of diagnosis.
  5. Little research has been done on concurrent infection & what it does to the body and how it affects testing:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  But this recent study shows by Garg et al. shows a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.  Mainstream medicine isn’t touching this with a ten foot pole.
  6. The good doctor points out that anaplasmosis and babesiosis can be very severe in people with compromised immune systems. I believe tick borne illness compromises the immune system greatly and it’s only logical to conclude that concurrent infection with numerous pathogens do so even more. Add a few opportunistic infections like Chlamydia and EBV, and you have a patient as sick as a dog:  https://madisonarealymesupportgroup.com/2016/10/07/chlamydia-like-organisms-found-in-ticks/, https://madisonarealymesupportgroup.com/2017/04/11/diagnosed-with-ebv-had-lyme/  This is why patients are so sick and why standard mono therapy often doesn’t work.
Taking into account the totality of these issues presents an entirely different picture than what authorities such as the IDSA and CDC present.

This is often a complex illness with many moving parts which necessitates various drugs of longer duration than currently being used.

The CDC/IDSA “One size fits all” approach just doesn’t work. Until authorities take into account these variables and allow doctors to treat patients accordingly, it’s a losing battle – and make no mistake about it – it’s the patients who loose.

 

Category:

Anaplasmosis, Babesia, Ticks, Transmission, Treatment

Prevalence of Babesia in Canadian Blood Donors: June – October 2018

https://www.ncbi.nlm.nih.gov/pubmed/31385317

2019 Aug 5. doi: 10.1111/trf.15470. [Epub ahead of print]

Prevalence of Babesia in Canadian blood donors: June-October 2018.

Tonnetti L1,2, O’Brien SF3,4,5, Grégoire Y6, Proctor MC2, Drews SJ3,4,5, Delage G6, Fearon MA3,4,5, Brès V7, Linnen JM7, Stramer SL1,2.

Abstract

BACKGROUND:

The erythrocytic protozoan parasite Babesia microti, the cause of human babesiosis, is transmitted not only by tick bites but also via blood transfusion. B. microti is endemic in the northeastern/upper midwestern United States, where partial screening of blood donations has been implemented. In Canada, a 2013 study of approximately 14,000 donors found no B. microti antibody-positive samples, suggesting low risk at that time.

METHODS:

Between June and October 2018, 50,752 Canadian donations collected from sites near the US border were tested for Babesia nucleic acid by transcription-mediated amplification (TMA). Reactive donations were tested for B. microti by IgG immunofluorescence assay and polymerase chain reaction. A subset of 14,758 TMA nonreactive samples was also screened for B. microti antibody. Donors who tested reactive/positive were deferred, asked about risk factors, and were requested to provide a follow-up sample for supplemental testing.

RESULTS:

One sample from Winnipeg, Manitoba, was TMA and antibody reactive. Of the 14,758 TMA-nonreactive donations tested for antibody, four reactive donations were identified from southwestern Ontario near Lake Erie. None of the interviewed donors remembered any symptoms, likely tick exposure, or relevant travel within Canada or the United States.

CONCLUSIONS:

This is the largest B. microti prevalence study performed in Canada. The results indicate very low prevalence, with only one TMA-confirmed-positive donation of 50,752 tested. This donor was from the only region in Canada where autochthonous infection has been reported. Seropositive donations in southwestern Ontario suggest low prevalence; travel should not be ruled out given the proximity to the US border.

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For more: I would caution authorities in believing there is a low prevalence of Babesa. I’ve heard it takes a trained eye to see it and is rarely detected using only 1 diagnostic test. I think the word is out on the seriousness of tick-borne disease. Let’s not go back in time by adopting a carefree approach. We should be looking hard and using accurate testing methods.

 https://madisonarealymesupportgroup.com/2016/06/02/study-showing-results-testing-babesia-microti/

https://madisonarealymesupportgroup.com/2019/07/28/tick-borne-infection-risk-in-blood-transfusion/

https://madisonarealymesupportgroup.com/2017/09/27/premature-infants-develop-babesia-via-blood-transfusion/

https://madisonarealymesupportgroup.com/2019/07/11/characteristics-of-transfusion-transmitted-babesia-microti-american-red-cross-2010-2017/  This clearly shows there were more than 200 Babesia transfusion-transmissions reported. It also shows you don’t have to reside in an endemic area or travel to an endemic area to get it. The article also clearly points out that the geographic range of ticks is expanding, which means the pathogens they carry will as well.

According to Dr. Ken Singleton, Babesia is rarely detected using one diagnostic test alone.  http://www.lymebook.com/chronic-lyme-testing-and-diagnosis

Excerpts:

Lyme-aware physicians generally screen for 2 strains—Babesia microti and WA-1 (Babesia duncani)—by testing for antibodies (by IFA or ELISA testing) made by the body against those organisms.

Another very useful test for Babesia is known as the FISH (fluorescent in situ hybridization) test. The FISH test is performed on thin blood smears (tests used to detect germs in white blood cells) and is able to detect the RNA (genetic material) of Babesia. If this test is positive, it is very strong evidence of the presence of active Babesia. The advantage of the FISH test is that it will detect other subspecies of Babesia in addition to B. microti and B. duncani. (A direct thick and thin blood smear using a staining technique called “Giemsa” can also be done by one’s local or commercial labs to look for Babesia organisms in red blood cells; however, it is an insensitive test except during acute Babesia, particularly when fever is present.)

A final potentially useful test is the Babesia PCR (polymerase chain reaction). Unfortunately, in my experience it is also not a sensitive test and is the least useful of the three tests mentioned.

All three of these tests—Babesia IFA, FISH, PCR—are available through IgeneX, a laboratory specializing in Lyme disease and other tick-borne organisms. Medical Diagnostics Laboratory (MDL) has two of the tests—Babesia ELISA and PCR. Both labs are excellent and I utilize both regularly. (See the resources section for more information.) However, as mentioned, Babesia can frequently escape detection by diagnostic tests. Therefore, many times babesiois must be a clinical diagnosis made by physicians who are experienced in its detection and treatment.

How many Canadian people slipped through the cracks?

 

 

Category:

Babesia, research, Transmission

New Hampshire Man Tests Positive For Jamestown Canyon & Powassan Viruses

http://indepthnh.org/2019/08/08/dhhs-kingston-man-tests-positive-for-rare-viruses-carried-by-ticks-mosquitoes/

DHHS: Kingston Man Tests Positive for Rare Viruses Carried By Ticks, Mosquitoes

By DHHS news release

Public Domain photo

NH health officials say protect yourself from mosquito bites.
Concord, NH – The New Hampshire Department of Health and Human Services (DHHS) announced that an adult from Kingston, NH tested positive for both Jamestown Canyon virus (JCV) and Powassan virus (POW), the first time these vector-borne diseases have been identified in the State in 2019.JCV is transmitted by infected mosquitoes and POW is transmitted by infected ticks. There are no vaccines to prevent JCV or POW and treatment consists of supportive care.

“From spring until fall, New Hampshire residents and visitors are at risk for a number of different infections from the bite of mosquitoes and ticks, and this case highlights the risk from both,” said Dr. Benjamin Chan, State Epidemiologist.

“In addition to Jamestown Canyon virus and Powassan virus, there are a number of other viral and bacterial infections that can be transmitted by mosquitoes and ticks in New Hampshire, and we recommend that residents and visitors continue to take basic steps to prevent mosquito and tick bites in order to stay healthy.”

Jamestown Canyon virus is a mosquito-borne pathogen that circulates widely in North America primarily between deer and a variety of mosquito species, but it can also infect humans. First reported in the early 1970s, reports in humans are rare but have been increasing over the last several years. This is New Hampshire’s seventh case of JCV since the first report of the disease in 2013. Most reported illnesses caused by JCV have been mild, but moderate-to-severe central nervous system involvement has been reported.

Powassan virus infection is similar to mosquito-borne viruses like JCV, West Nile virus (WNV), and Eastern equine encephalitis (EEE), but is transmitted to people by infected ticks. POW was identified as a cause of human illness in the late 1950’s. In the last decade, 144 cases of POW have been detected in the United States. This is New Hampshire’s fourth case of POW, also since 2013. In New Hampshire, the blacklegged tick is the most likely to transmit this virus to people. A tick needs to be attached to a person for only 15 minutes to transmit POW. Some people who are infected may experience mild illness or no symptoms. Powassan virus can also infect the central nervous system causing brain inflammation, which may be disabling or fatal.

The Kingston resident had no recent history of travel outside our state and spent a great amount of time outdoors. Residents and visitors to New Hampshire should protect themselves and their family members by:

·         using an effective mosquito and tick repellant containing DEET (20-30%), Picaridin, or oil of lemon eucalyptus

·         wearing protective clothing, tucking shirts into pants and pants into socks

·         removing standing water from around your house so mosquitoes do not have a place to breed

·         being mindful of tick habitat keeping grass cut short, and

·         performing frequent and daily tick checks with immediate tick removal.

Vitamin B, ultrasonic devices, incense, and bug zappers have not been shown to be effective in preventing mosquito- or tick-borne diseases.

Other mosquito- and tick-borne illnesses that have been documented in New Hampshire include WNV and EEE from mosquitoes, and Lyme disease, anaplasmosis, babesiosis, and Borrelia miyamotoi from ticks. Biting mosquitoes will continue to be a disease concern until there are two, statewide, hard frosts. Risk of tick bites exists when temperatures are above freezing and ticks are not covered by snow.

People can be infected and not develop any symptoms, or only develop very mild symptoms. Early symptoms can include flu-like illness including fever, muscle aches, headaches, and fatigue. People infected with JCV, EEE, WNV, and Powassan can develop more serious central nervous system disease, including meningitis or encephalitis. If you or someone you know is experiencing flu-like symptoms, including fever and headache, contact your local medical provider.

Anyone with questions about vector-borne illnesses can call the DHHS Division of Public Health Services Bureau of Infectious Disease Control at (603) 271-4496 between 8 AM to 4:30 PM, Monday through Friday. More information can also be found online at www.dhhs.nh.gov and www.cdc.gov.

News story here:  https://www.wmur.com/article/new-hampshire-adult-infected-with-jamestown-canyon-virus-powassan-virus/28647142

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**Comment**

Pathogens have a certain proclivity for their vectors. It’s always interesting to me to entertain the possibility that perhaps there is cross over.

For instance, borrelia has been found in mosquitoes and many patients claim to have become infected with Lyme after a mosquito bite:

https://madisonarealymesupportgroup.com/2018/11/07/are-mosquitoes-transmitting-lyme-disease/

https://www.ncbi.nlm.nih.gov/m/pubmed/26631488/  Excerpt:

…results show that DNA of Borrelia afzelii, Borrelia bavariensis and Borrelia garinii could be detected in ten Culicidae species comprising four distinct genera (Aedes, Culiseta, Culex, and Ochlerotatus). Positive samples also include adult specimens raised in the laboratory from wild-caught larvae indicating that transstadial and/or transovarial transmission might occur within a given mosquito population.

BTW: THE LAST STUDY ON THE POTENTIAL OF OTHER BUGS TRANSMITTING LYME (MINUS THE GERMAN STUDY ON MOSQUITOS) WAS DONE OVER 30 YEARS AGO.  AND, WHILE NO SPIROCHETES WERE ISOLATED FROM THE HAMSTERS, ANTIBODIES WERE FOUND – EVEN BACK THEN.

Therein lies the hang up. The presence of antibodies does not prove infection. It’s interesting that the current CDC 2-tiered testing relies upon antibodies…..

The transmission of Bartonella from ticks is also still being quibbled about with some just stating emphatically that it is:  https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/ while others take a more conservative approach and say the science isn’t settled: https://madisonarealymesupportgroup.com/2019/07/13/suspected-insect-and-arthropod-vectors-for-bartonella-species-galaxy/

This issue of what is being transmitted by whom seems to me to be a very important and practical issue.  Why isn’t the science being done?

Also, while the media continues to inform us all of this is “rare,” please remember that many of these pathogens are not mandatorily reported, and we have no idea on prevalence. Coppe Lab out of Wisconsin emphatically states Powassan is NOT rare:

http://www.coppelabs.com/blog/why-is-powassan-virus-infection-still-described-as-rare-and-mysterious/  Please read the following excerpt by Coppe Lab here in Wisconsin,

For the last two years, Coppe Laboratories has dedicated a significant amount of time and resources to dispelling the myth that infection with Powassan virus, a virus transmitted by tick bite, is rare. The Centers for Disease Prevention and Control (CDC) reports only 100 cases of Powassan virus infection in the United States in the last 10 years. Indeed, that statistic gives the illusion that Powassan infection is rare. However, did you know that the only infections reported to CDC are those that are life-threatening, particularly cases causing severe inflammation of the brain like the case reported in LiveScience? Coppe has published three new papers in the last year that clearly show Powassan virus infection is not rare are at all,and until testing for this virus is included as part of tick-borne disease screening panels infections will continue to be underreported. Coppe’s Powassan Guide, which can be downloaded from the website, summarizes the findings from both tick and human Powassan prevalence studies, as well as defining the patient populations that would benefit most from Powassan testing.

To my knowledge, not only are there few current studies on what transmits what, but nothing has been done  on transmission time when multiple pathogens are being transmitted concurrently. Everyone’s stuck on climate change….

 

 

 

 

Category:

mosquitoes, Ticks, Transmission, Viruses