Archive for the ‘Transmission’ Category

Review of PSI Joint Infections in Pediatrics – All With Negative Blood Cultures: Bartonella & Brucella, Among Others

https://www.ncbi.nlm.nih.gov/pubmed/31130517

2019 May 23. pii: S1695-4033(18)30548-4. doi: 10.1016/j.anpedi.2018.07.017. [Epub ahead of print]

[Pyogenic sacroiliitis: Lessons learned from an atypical case series].

[Article in Spanish]

Abstract

INTRODUCTION:

Pyogenic sacroiliitis (PSI) is a rare condition that amounts to 1% to 2% of all joint infections in the paediatric age group. Its diagnosis is often difficult and delayed due to its nonspecific signs, symptoms and physical findings. Also, the identification of the causative microorganism is frequently challenging due to a high proportion of negative blood cultures and the risks involved in joint aspiration in this site.

PATIENTS AND METHODS:

We performed a retrospective review of the health records of all patients aged less than 18 years admitted to a tertiary children’s hospital due to PSI between 2008 and 2016.

RESULTS:

We identified 6 cases of paediatric PSI. The blood cultures were negative, and the identification of the causative agent required joint fluid aspiration in one patient with infection by Aggregatibacter aphrophilus, and specific screening tests for less frequent agents in the other patients: Kingella kingae (n=2), Brucella melitensis (n=1) and Bartonella henselae (n=1). The patients were treated with specific antimicrobial regimens, and all had favourable clinical outcomes and were free from sequelae during the follow-up.

CONCLUSIONS:

Despite the small sample size, our study evinced the low effectiveness of blood cultures for diagnosis of paediatric PSI. It also highlights the need for a high level of suspicion for atypical agents and the early use of adequate diagnostic methods, including imaging and serological testing or polymerase chain-reaction (PCR) analysis of blood samples, as well as prescription of effective antimicrobial therapy.

____________________

**Comment**

Pyogenic sacroiliitis = puss forming joint infection in the sacroiliac joint.

iu-16

Brucella melitensisa gram negative rod-shaped bacteria, is a human pathogen (Malta fever), B.abortus (Bang’s disease), and in rare cases, B. suis and B. canis. Transmission occurs through animal contact (birth) or animal products, inhalation of infected particles, STD, breastfeeding, bone marrow transplants, blood products, and yes, ticks.  Pathogens are found in macrophages which are transported to lymph nodes, then spread throughout the body.  Treatment consists of doxycycline, rifampicin, & gentamicin.  Also, Ciprofloxin 500mg twice a day for 7-14 days.  http://brucellamelitensis.com

http://drsusanmarra.com/patient-resources/lyme-disease/brucella/ It has been found in eggs, larvae and engorged females of Dermacentor marginatus ticks (that bite humans)  https://www.sciencedirect.com/science/article/pii/S1877959X17303990

Hosts are most mammals including humans.  http://www.bristoluniversitytickid.uk/page/Dermacentor+marginatus/13/#.XPgbgS2ZPSc

Symptoms are very non-specific:  https://www.cdc.gov/brucellosis/symptoms/index.html

http://www.cfsph.iastate.edu/Factsheets/pdfs/brucellosis_melitensis.pdf  Actually the best information is found here.

And…according to the CDC:  https://www.cdc.gov/brucellosis/clinicians/brucella-species.html

*Three types of the bacteria that cause brucellosis – Brucella abortusBrucella melitensis and Brucella suis – are designated as select agents. This means that they have the potential to be developed as bioterrorism agents due to their ability to undergo aerosolization.

Oh goody, another potential bioweaponized agent spread by ticks.

For more on the history of brucella as a bioweapon:  https://www.globalsecurity.org/wmd/intro/bio_brucellosis.htm

https://www.ncbi.nlm.nih.gov/pubmed/8425348?dopt=Abstract  Acute Lyme arthritis in the hip mimicking acute pyogenic arthritis in 5-year old girl.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358077/  Bartonella & all sorts of rheumatic symptoms in patients from Lyme endemic regions with histories of cat, dog, mosquitoes, ticks, fleas, and biting fly exposure.

Staph is usually the culprit, but this case report highlights that Lyme, Bartonella, Brucella, and mycoplasma should be tested for as well.  Things to watch for in children/babies – pain with diaper changes, limping, fever, irritability, decreased range of motion in the pelvic area.  This review stated the highest incidence was in adolescents:  https://link.springer.com/article/10.1007/s00431-019-03333-8, but that it’s an under recognized entity in infants with an unidentified bacterial source.  Could this be a manifestation of congenital Lyme/MSIDS that’s flying under the radar?

 

 

 

 

Can I Catch Lyme Disease Without A Tick Bite? Three Alternative Ways of Transmission

https://www.bca-clinic.de/en/can-i-catch-lyme-disease-without-a-tick-bite-3-alternative-ways-of-transmission/

Can I Catch Lyme Disease Without A Tick Bite? 3 Alternative Ways Of Transmission

As awareness of Lyme disease as a public health threat increases, so does the concern around its transmission and treatment. People are starting to realise the very real danger of Lyme infection, and they have a lot of questions, especially around alternative ways Lyme disease is transmitted.

Understanding the basics of Lyme transmission, diagnosis and treatment can go a long way in helping allay fears around this increasingly common disease. Let’s break down some of the most popular questions people have about Lyme disease.

How do you catch Lyme disease?

Lyme disease is a bacterial infection caused by a corkscrew-shaped bacterium known as Borrelia burgdorferi. It is typically transmitted to humans by Ixodes ticks, also known as black-legged or deer ticks. When ticks feed on rodents, other small mammals or certain birds that are infected with Borrelia burgdorferi, the ticks themselves become infected. When a tick carrying Borrelia burgdorferi bites a human, the bacterium spreads from the tick to the bitten human, leading to Lyme disease.

Can you catch Lyme disease without a tick bite?

Although far less common than tick bites, there are some additional ways that Lyme is transmitted. Here are three alternative ways of transmission:

  1. During pregnancy

There is some evidence that Lyme disease can spread from a woman who is pregnant to her placenta, leading to potential complications. However, it appears that these problems can be avoided when the Lyme-infected mother receives antibiotic treatment for her Lyme disease. Lyme disease has not been found to be transmitted through breast milk.

  1. Through a blood transfusion

Scientists have determined that the bacteria responsible for Lyme disease can live in the blood of an actively infected person even after it has been drawn and placed in storage. Although there are no known cases of Lyme infection through a blood transfusion, a person with Lyme disease who is receiving treatment should not give blood. After antibiotic treatment has been completed, however, Lyme patients may be eligible blood donors.

  1. During sex

Scientists are very much at odds over whether Lyme disease can be transmitted sexually. While some research indicates that Lyme bacteria may be passed from person to person during sex, the Centers for Disease Control (CDC) states that there is no credible evidence supporting the claim that Lyme disease can be transmitted through sexual contact.

People being treated for Lyme disease may not be eligible for blood donation.

What should you do if you’ve been bitten by a tick?

Because tick bites are the main way that Lyme disease is transmitted, taking precautions to avoid being bitten can be your first line of defence. Some of the ways to protect yourself from ticks are:

  • Avoid wooded areas, long grass, fallen logs and other tick habitats.
  • If you’re going to be in an area where you may be exposed to ticks, dress protectively. Wear a hat, long-sleeved shirt and long trousers tucked into your socks. If you have long hair, pull it back.
  • Use tick repellent. Active ingredients that have been shown to repel ticks include DEET, picaridin and lemon eucalyptus.
  • Check for ticks periodically while outdoors, and take a shower as soon as you get home.

If you’ve been bitten by a tick, do your best to remain calm. Avoid methods like smearing Vaseline on the tick or burning it with a match, as neither of these works to remove the tick. Instead, follow these steps:

  • Take care to avoid squeezing or squashing the tick.
  • Using a tweezers with a fine point or a special tool designed to remove ticks, grasp the tick as close to your skin as possible.
  • Steadily and firmly pull the tick straight out.
  • Once the tick is out, disinfect the bite area and wash your hands thoroughly.
  • Place the tick in a small bottle or plastic bag. If it’s still alive (which is preferable for identification purposes), add a small green leaf or damp tissue to the container.
  • Explore your options for having the tick tested.
Dress protectively to avoid exposure to ticks.

 

How do you know if you have Lyme disease?

After you’ve been bitten for a tick, it’s important to watch for symptoms of Lyme disease so you can seek treatment as soon as possible. Symptoms of early Lyme disease include:

  • An expanding red rash that sometimes resembles a bullseye or target
  • Headaches and neck stiffness
  • Fever
  • Fatigue
  • Joint pain and swelling
  • Weakness or paralysis of facial muscles
  • Lightheadedness or fainting
  • Heart palpitations or chest pain

Seek medical attention immediately if you experience any or all of these symptoms of Lyme disease. The sooner the disease is diagnosed and treated, the better the chances of treating it successfully.

Knowing you’re at risk for Lyme disease can be scary, especially when the disease seems to be spreading so rapidly. But arming yourself with knowledge about Lyme disease and the different ways it’s transmitted can help you be more aware of what you need to do to protect yourself.

____________________

**Comment**

Much, much work remains to be done regarding transmission. This is one of the most honest articles I’ve read for a long time; however, due to the lack of work in this area we truly haven’t a clue on transmission prevalence regarding sexual, congenital, blood, or via other means, including other insects.  I know numerous experienced practitioners who disagree about the stance this article takes that it can’t be spread via breast milk.  Again, until more transparent work is done, all we have are clinical case studies.

For far too long authorities have dismissed these possibilities with a wave of the hand, while experienced researchers have stated since the 80’s that the black legged tick is not the sole perp:  https://madisonarealymesupportgroup.com/2019/05/24/microbiology-professor-im-convinced-lyme-disease-is-transmittable-from-person-to-person/

“I AM CONVINCED THAT LYME DISEASE IS TRANSMITTABLE FROM PERSON TO PERSON.” Lida Mattman, PhD.

Well, it doesn’t get any clearer than that.

When you consider the insidious conflicts of interest within the CDC and the fact there has been biowarfare experimentation done on ticks for decades, one begins to understand why the CDC has dismissed anything that might bring them under the Eye of Mordor.  

https://madisonarealymesupportgroup.com/2019/05/17/where-lyme-disease-came-from-and-why-it-eludes-treatment/

ConflictReport copy

Czechs Record Most Tick-borne Encephalitis Cases in Entire EU

https://www.radio.cz/en/section/news/czechs-record-most-tick-borne-encephalitis-tbe-cases-in-entire-eu

CZECHS RECORD MOST TICK-BORNE ENCEPHALITIS (TBE) CASES IN ENTIRE EU

24-05-2019

The Czech Republic recorded the highest number of tick-borne encephalitis (TBE) cases in the EU last year. In the whole of Europe, only Russia recorded more cases of the potentially deadly disease.

There were 712 recorded TBE cases in the country last year, the highest number since 2011, a Czech member of the International Scientific Working Group on TBE (ISW-TBE) said in a press release on Thursday.

Only about one quarter of inhabitants of the Czech Republic are vaccinated against TBE, a low percentage compared to other EU countries. Within the bloc, the second-highest number of TBE cases was recorded in Germany, which has a population eight times larger.

Encephalitis patients suffer from fever, headache, aching joints and muscles. It can develop into meningitis.

____________________

For more:  https://madisonarealymesupportgroup.com/2017/10/30/tick-borne-encephalitis-found-in-serbian-dogs-horses-wild-boar-and-roe-deer/

In the USA and Russia, another tick-borne flavivirus, Powassan virus, is responsible of encephalitis in humans.

More on Powassan (which can be transmitted within 15 min.):  https://madisonarealymesupportgroup.com/2018/06/13/half-of-powassan-cases-from-wisconsin-and-minnesota/

https://madisonarealymesupportgroup.com/2016/02/21/powassan-virus/

https://madisonarealymesupportgroup.com/2017/06/28/powassan-can-kill/

https://madisonarealymesupportgroup.com/2018/01/25/new-powassan-test-89-sensitive/

https://madisonarealymesupportgroup.com/2017/05/05/powassan-another-reason-to-avoid-ticks/

https://madisonarealymesupportgroup.com/2017/05/18/powassan-and-bb-infection-in-wisconsin-and-u-s-tick-populations/

https://madisonarealymesupportgroup.com/2019/03/04/powassan-virus-on-the-up-tick/

https://madisonarealymesupportgroup.com/2019/05/04/tick-borne-powassan-virus-confirmed-in-6-minnesota-counties/

 

Septic Shock Caused by RMSF in Suburban Texas Patient With Pet Dog Exposure: A Case Report

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091339/

. 2018; 19: 917–919.
Published online 2018 Aug 4. doi: 10.12659/AJCR.909636
PMCID: PMC6091339
PMID: 30076285

Septic Shock Caused by Rocky Mountain Spotted Fever in a Suburban Texas Patient with Pet Dog Exposure: A Case Report

Abstract

Patient: Female, 45

Final Diagnosis: Rocky mountain spotted fever

Symptoms: Altered mental state • ataxia • dyspnea • fever • headache

Objective:

Unusual clinical course

Background:

Rocky Mountain spotted fever (RMSF) is associated with high mortality and requires prompt identification and treatment to ensure better outcomes.

Case Report:

We describe an advanced case of RMSF in a 45-year-old female patient with pet dog exposure who presented with altered mental status, dyspnea, and ataxia progressing to septic shock and acute hypoxic respiratory failure requiring intubation and mechanical ventilation.

Conclusions:

This case illustrates the importance of keeping RMSF in the differential diagnosis in patient populations outside of the usual geographic areas of incidence in the appropriate clinical setting.

___________________

**Comment**

This is what can happen when diagnosis is delayed.

This woman that lived in the suburbs had a 7-day history of fevers associated with headache, arthralgias, nausea, fatigue, and neck pain, but did NOT have the tell-tale blotchy RMSF rash.

Two days later, she worsened with confusion, combativeness, dyspnea, and ataxia. She got multiple recent bug bites from her pet dogs sleeping in her bed. The dogs were not up to date on flea and tick medication but were healthy and showed no sign of illness.
  • Rule #1:  Do NOT sleep with pets.  The risk is too great.
  • Rule #2:  If you choose to have pets, make sure you treat them if they go outdoors.  The risk is too great.
  • Rule #3:  Doctors need to start treating this plague with the respect it deserves and frankly should keep it in the back of their minds AT ALL TIMES.
Positive findings were R. typhi IgM 1: 1024 (normal <1: 64), R. Rickettsii IgM 1: 1024 (normal <1: 64), IgG 1: 128 (normal <1: 64), and echovirus Ab 1: 80 titer (normal <1: 80). The Rickettsial titers were repeated for possible cross-reactivity and R. typhi antibodies were noted to be negative (<1: 64).
Although R.typhi was ruled out due to cross-reactivity, I believe we will start seeing more of this strain in the future.
The patient improved on doxycycline, the drug of choice for RMSF and was discharged.
Why isn’t there a full-out media blitz on this like there was on Zika?

Going Outside? Watch Out For Asian Longhorned Tick Now in Kentucky

https://www.wymt.com/content/news/Going-outside-Watch-out-for–510400381.html  News Story in Link

Going outside? Watch out for unusual tick found in Eastern Kentucky

By WYMT News Staff

MARTIN COUNTY, KY. (WAVE) – It’s Memorial Day weekend and more people will head outside as the summer season kicks off. While you’re out having fun, be sure to keep an eye out for a tick that is new to the area.

This year’s tick season is different in Kentucky because a new tick has popped up in our area.

The University of Kentucky College of Agriculture, Food and Environment has received more calls about seeing ticks, but reports that incidents of tick-borne diseases in the state are very low.

People still need to use precautions because ticks are out there. They’re looking to suck blood three times in their lives in order to reproduce. This year’s tick season is different in Kentucky because a new tick has popped up in our area.

“The most common ticks we have are the Lone Star Ticks and the American Dog Tick,” Spencer County Agriculture agent Bryce Roberts said. “The new one we found is the Asian Longhorned Tick.”

Roberts said the Asian Longhorned Tick was found in Eastern Kentucky, in Martin County.

It’s very concerning because of the diseases they do carry,” Roberts said.

New ticks bring new diseases. Before or when someone gets a tick disease, they see epidemiologist Dr. Paul Schulz.

“The two we encounter the most are Ehrlichia and Rocky Mountain Spotted Fever,” Schulz said.

Schulz said the infectious disease department at Norton Healthcare found its first tick-borne disease of the year in March, a sign that tick season could be starting early.

“(In) well over 50 percent of diagnosed infections, the patient didn’t know they had tick exposure,” Schulz said.

People often don’t see or feel when a tick is biting them. However, there are ways to protect yourself and your summer experience: Cover up as much of your skin as you can, use a spray with DEET, avoid overgrown wooded areas, check yourself and your children every night.

____________________

For more:  https://madisonarealymesupportgroup.com/2018/09/12/three-surprising-things-i-learned-about-asian-longhorned-ticks-the-tick-guy-tom-mather/

https://madisonarealymesupportgroup.com/2018/08/08/an-invasive-new-tick-is-spreading-in-the-u-s/

https://madisonarealymesupportgroup.com/2018/07/19/rutgers-racing-to-contain-asian-longhorned-tick/

https://madisonarealymesupportgroup.com/2019/01/14/multistate-infestation-with-the-exotic-disease-vector-tick-haemaphysalis-longhornis-u-s-aug-2017-sept-2018/Where this tick exists, it is an important vector of human and animal disease agents. In China and Japan, it transmits the severe fever with thrombocytopenia syndrome virus (SFTSV), which causes a human hemorrhagic fever (2), and Rickettsia japonica, which causes Japanese spotted fever (3). Studies in Asia identified ticks infected with various species of Anaplasma, Babesia, Borrelia, Ehrlichia, and Rickettsia, and all of these pathogen groups circulate zoonotically in the United States (4,5). In addition, parthenogenetic reproduction, a biologic characteristic of this species, allows a single introduced female tick to generate progeny without mating, thus resulting in massive host infestations.

 

Authorities have been relatively mum on what this tick transmits and I’ve had to dig to find it.  So far there are no noted human illnesses caused by this tick in the U.S., but the ones listed above have occurred other countries.  Do they really think this tick isn’t going to acquire disease and transmit here?  Maybe in an alternative reality, but then again, the CDC lives in an alternative reality.