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.
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.
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.
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.
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.
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?
DHHS: Kingston Man Tests Positive for Rare Viruses Carried By Ticks, Mosquitoes
ByDHHS 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.
…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…..
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:
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….
The Asian longhorned tick, first found in the U.S. in 2010, is now established in 11 states along the East Coast. The female is capable of laying 2,000 eggs without mating and an infestation may kill livestock from the blood loss
While ticks are known vectors of disease, thus far this species has not transmitted disease in the U.S. It is known to carry thrombocytopenia syndrome virus triggering human hemorrhagic fever, responsible for killing 15% of those the tick bites in Asia
The number of ticks and range in which they live have been expanding dramatically. Tickborne illnesses include Lyme disease, infecting 300,000 each year in the U.S., Rocky Mountain spotted fever, babesiosis, Powassan virus and Bourbon virus
As Lyme disease rates skyrocket, it’s important to do a quick check each time you come back inside after being in a grassy area or near trees and bushes; Lyme disease may be successfully treated when caught early. Your risk of infection is lower if you effectively remove the tick as soon as possible
While you might have thought a tick is an insect, it really belongs to the arachnid family, along with spiders, scorpions and mites.1 A tick survives by feeding on the blood of a host, growing from the size of an apple seed before food and swelling to more than double their size after feeding.2
Ticks are more active during the summer months, between March and November in the northern hemisphere. Most enjoy living in warm moist places, such as bushes, tall grasses and shrubs. Animals and humans get ticks while walking through these areas.3
Of the 899 species of ticks found throughout the world, only 90 reside in the U.S.,4 and just a select few are known to bite humans.5 After a tick gets on you, it doesn’t usually bite right away but will crawl around to find an acceptable place to latch on and feed. They look for soft, moist areas, including near your ears, hair, underarms and groin. They also like to settle under the waistband of your pants.6
After piercing your skin with its mouth, the tick inserts a tube to feed on your blood until it’s full. This may take up to two weeks.7Tick bites are often painless so it may be difficult to tell if you’ve been bitten.
First new tick species in US in 50 years
In the past decade the U.S. has become home to a new species, the Asian longhorn. Dr. Gregory Poland from the Mayo Clinic says this tick represents the first time in 50 years a new species has made its way to the U.S.8 Because it is an emerging threat in the U.S. the CDC recommends that surveillance should include testing for pathogens.9
Ticks are associated with diseases in humans and animals. The Asian longhorn tick is known to carry human hemorrhagic fever caused by thrombocytopenia syndrome virus10 in Asia.11 This species has been found in 11 states, including:12
Arkansas
Connecticut
Kentucky
Maryland
North Carolina
New Jersey
New York
Pennsylvania
Tennessee
Virginia
West Virginia
However, while it appears to be spreading across the eastern U.S., the CDC has reported there is currently no evidence these ticks have transmitted disease to humans or animals.13 Asian longhorned ticks in Asia carry a virus responsible for killing 15% of those they bite.14
In recent years, this population has spread to several Pacific Islands, Australia and New Zealand. Although some experts warn against extrapolating information to the Asian longhorn tick carrying serious viruses in the U.S.,15 this species also represents additional dangers to livestock and other animals.16
North Carolina State veterinarian Dr. Doug Meckes sent out information17 reminding farmers and pet owners to be vigilant with preventive measures to avoid ticks in their animals. Five cows in Surry County, North Carolina, recently died due to acute anemia triggered by a tick infestation.18
Asian tick sounds like something from a horror film
Samples from the cows confirmed the ticks were Asian longhorn. According to Meckes, this was the fourth confirmed case since 2018 and the first in 2019.19 One young bull presented to the diagnostic lab for necropsy had 1,000 ticks. As described in this short video, the ticks are aggressive biters, feeding on both animals and humans.
The first identified case, in 2010, involved a white-tailed deer from West Virginia.20 In other reports the tick was found in New Jersey in 201721 when a woman discovered them on her sheep.22
The first recorded human bite was reported by a 66-year-old man from Yonkers, New York, in June 2018. He removed the tick from his leg and subsequently took it to the Lyme Disease Diagnostic Center in Westchester County for testing.23 After confirmation that it was the Asian longhorned tick, sampling was done near his home and nearby park, finding 90 ticks.24
A unique characteristic of this species is its ability to reproduce quickly and prolifically without mating.25 The female does not need a male to lay as many as 2,000 eggs at a time.26 The threat to livestock may be significant. A dairy cow may experience a 25% drop in milk production after becoming a host.27
As the species continues to multiply and spread, it is conceivable millions of animals could be exposed.28 A study published in the Journal of Medical Entomology29 developed a model demonstrating the wide area of North America where favorable conditions for the Asian longhorned tick may exist.30
Study author Ilia Rochlin, Ph.D., is a professor at Rutgers University. She believes the adaptability of this species means it has the potential to spread across the U.S. and southern Canada.31 The ability of the tick to reproduce without mating may make it extremely hard to control. Rochlin said,32 “In practice, it’s impossible to eradicate this species.”
Tick population rising, along with the diseases they carry
The number of all ticks and the range in which they live have both increased. According to the CDC,33the lone star tick has expanded from the southeastern U.S. into the northern and Midwestern states. The range of the black-legged tick, responsible for many cases of Lyme disease, has more than doubled in the past 20 years. Between 1993 and 2012, the number of counties in the U.S. at high risk for Lyme disease rose by more than 300%.34
Although the Asian longhorned does not yet carry disease, many other ticks do. The CDC announced it will begin monitoring the population and diseases ticks carry as the number of people diagnosed with diseases carried by ticks has more than doubled. Anna Perea, from the CDC’s Division of Vector-Borne Diseases, commented on the new monitoring:35
“For the first time this year, the CDC is funding states to conduct widespread surveillance of ticks and the pathogens they can transmit, in addition to funding human disease surveillance and education and prevention. Taken together, the data can help define areas where ticks are spreading, the infectious pathogens that they carry, and where risk of tick-borne disease is increasing.”
Tick-borne diseases may include Lyme disease, suspected to affect nearly 300,000 people each year.36 Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis and babesiosis are also spread by ticks. New infections have also been detected, including the Bourbon virus, Heartland virus37 and Powassan virus.38 Ticks spread disease by virtue of the way they find nutrients.
In order to transition through life stages, ticks must have a blood meal to survive.39 Through the process of hatching from the egg, going through the larvae, nymph and adult stage, they may live up to three years. If unable to find a suitable host, they die.40 As they ingest blood, they also suck up any pathogens from the host and spread it to their next host.
Lyme disease rates skyrocketing
The rising number of ticks and their spreading habitat has meant an increase in the number diagnosed with tick-borne diseases. Lyme disease is the most prevalent of those conditions. CDC41data show that in 1997, there were 12,801 confirmed cases which more than doubled to 29,513 confirmed and 13,230 probable cases in 2017.
Data also show more males than females are affected, with the age group of 5 to 9 years having the greatest number affected. The disease is most frequently diagnosed in the months of June and July.42One study from researchers at Carnegie Mellon University43 called the rising epidemic of Lyme disease a “Ticking Bomb.”
These researchers found a relationship between rising temperatures and the incidence of Lyme disease, predicting the number of people diagnosed may rise by more than 20% by midcentury.44 In addition to temperature playing a role in the rising number of tickborne illnesses, researchers find smaller patches of forest may also increase the number of Lyme carrying ticks.
White-footed mice, also known to carry Lyme disease,45 are often the first blood meal for the larval tick.46 In smaller forest fragments measuring less than 5 acres, the mice are abundant because smaller areas of forest support fewer predators.47
Felicia Keesing from Bard College, New York, and other researchers have found an average of three times the number of ticks in a three-acre forest fragment than in larger areas. As many as 80% of the arachnids in the smallest patches were infected.48
Challenges of diagnosis and treatment for Lyme disease
Although the disease has been around for thousands of years, the medical community only began describing it in the 1970s. An autopsy of a 5,300-year-old mummy found the presence of the bacteria and a German physician first wrote about symptoms more than 130 years ago.49
Lyme disease is caused by a bacterium, which when left untreated may spread to the joints, heart and nervous system. The bacterium, Borrelia burgdorferi, may be treated successfully when found early.50 However, while commonly acknowledged now, Lyme disease has historically been a challenge to diagnose.
CNN reported51 on a U.S. Air Force enlisted man, Ruben Lee Sims, who was voted the “top enlisted management analyst of the year” in 1977. Only seven years later he was discharged and labeled a hypochondriac when the military was unable to diagnose Lyme disease. Misdiagnosed for more than three decades, he now shares his story to help others.
Early symptoms resemble the flu and the bullseye rash is not always recognized.52 Within 30 days of being bitten, you may experience fever, chills, fatigue and muscle and joint aches. Up to 80% of those infected will have a rash resembling a bull’s-eye target at the site of the tick bite, which gradually reaches 12 inches or more across.53
Later on, signs of infection may include severe headache and neck stiffness, a spreading rash on other areas of your body, severe arthritis pain and swelling, facial palsy, heart palpitations and possibly an irregular heartbeat.54 If left untreated, you may develop inflammation of the brain and spinal cord. This can lead to pain, numbness and tingling in the hands and feet as well as problems with short-term memory.55
Some people have seen multiple physicians and undergone a plethora of tests before being given a correct diagnosis.56 Early tests may not detect antibodies to the bacteria as it may take several weeks to rise to detectable levels.
Since early treatment is most effective57 some physicians begin treatment before offering a definitive diagnosis.58 The Lyme antibody test looks for exposure to the bacteria, but it may take your immune system several weeks to produce measurable levels. This can result in a false negative test with early testing.59
You’ve found a tick — now what?
Anytime you’re out in grassy areas or around trees and bushes do a quick skin check when you get back inside. Look for small brown to black spots or crawling, eight-legged arachnids. If the tick is unattached to your skin and has not fed, slip a sheet of paper under it and seal it in a container with alcohol.
However, if it’s become attached to your skin, it’s important to remove it to lower your risk of infection. While there are several tools on the market you may want to consider, a set of fine-tipped tweezers will also do the job. According to the CDC you should:60
Grasp the tick close to the skin’s surface.
Using steady and even pressure, pull the tick upward. Twisting or jerking may cause the mouth parts to remain in the skin. If the mouth parts are left behind, try to remove them with clean tweezers. If you are unable to remove them easily, allow the skin to heal.
Clean the area and your hands thoroughly with rubbing alcohol or soap and water.
Do not crush the tick as this forces blood and pathogens into your body.61
Avoid using techniques such as painting the tick with nail polish or covering it with petroleum jelly. This will not suffocate it. Likewise, poking it or using heat to make it detach are not recommended.62
Once a tick has been safely removed drop it in a sealed container with alcohol and take it to your health department or Lyme disease center for identification. Keep an eye on the area for the next several weeks. If you develop a rash or flu-like symptoms, see a doctor who’s experienced in treating Lyme disease.
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**Comment**
A few points for consideration:
While human infection from the Asian Long-horned tick has not been documented in the U.S., it may still be happening. Remember, in Asia, it causes illness that KILLS 15% of those whom contract it. Don’t take this lightly.
Regarding what to do when you find an attached tick – again – insanity is doing the same thing over and over and expecting different results. Since everyone admits catching this early makes all the difference, why are people still telling people to “wait and see?” No, do NOT wait and see! By that point it will be TOO LATE! Treat this as seriously as a heart attack and treat it prophylactically if you are bitten by a tick. It’s not worth the risk, trust me. A month’s worth of cheap antibiotics are worth it. Take probiotics, avoid sugar, and live to see another day, or take your chances, spend $15K a year for potentially ever, and hope you can keep working to keep the lights on, as well as keep your family intact. People STILL are not “getting” the seriousness of this. Here’s better advice on what to do if you are bitten: https://madisonarealymesupportgroup.com/2019/05/25/help-ive-been-bitten-by-a-tick-now-what/ and go here for better info on prevention: https://madisonarealymesupportgroup.com/2019/04/12/tick-prevention-2019/
Tick Expert Admits to ‘Working on Ticks’ & Dropping Them Out of Airplanes
The following full-length interview with James H. Oliver, Jr. is an eye opener on the type of work that’s been done on ticks and mosquitoes.
He’s described by Pamela Weintraub in the book, Cure Unknown, as a “world-class entomologist” for figuring out that the southern U.S. had Lyme Disease by finding 300 southern genetic strains of Borrelia, 57 of which are nearly identical to the northern pathogen and are classified as Borrelia burgdorferi sensu stricto. He also discovered two new species, Borrelia americana and Borrelia carolinensis that could potentially help explain why many in the South suffer with Lyme yet are not testing positive on current tests.
Oliver was responsible for producing ticks and mosquitos, running distribution tests, and determining factors that would cause migration for the Army.
Oliver also worked in Australia where he found ticks on snakes there.
The Navy used Oliver in Uganda, where he stayed at the Rockefeller Institute, as their acarologist where he collected ticks.
James H. Oliver, Jr.: Ticks, Lyme Disease, and a Golden Gloves Champion
Source:
Marlin E. Rice & James H. Oliver, Jr. Ticks, Lyme Disease, and a Golden Gloves Champion. American Entomologist (2016) 62 (4): 206–213, doi:10.1093/ae/tmw073. Published by Oxford University Press/ on behalf of the Entomological Society of America.
