Archive for the ‘Tularemia’ Category

Serendipitous Treatment of Tularemia in Pregnancy

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6804751/

Serendipitous Treatment of Tularemia in Pregnancy

Published online 2019 Sep 24. doi: 10.1093/ofid/ofz413

Abstract

We present a young pregnant woman who developed ulceroglandular tularaemia following a bite wound from a kitten. She grew Francisella tularensis from the ulcer. While awaiting bacterial culture results and serology for Bartonella, she was treated with azithromycin, with resolution of fever and axillary tenderness. Treatment recommendations for tularemia are either gentamicin or doxycycline, both of which can be perilous to the fetus. A Centers for Disease Control and Prevention report on the macrolide susceptibility of North American isolates of this organism has been underappreciated. The unanticipated result from this patient may give another potential option for treatment of tularemia in pregnancy.

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Please know ticks transmit Tularemia:  https://madisonarealymesupportgroup.com/2019/02/18/tularemia-in-minnesotan-ticks/

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

It also kills: https://madisonarealymesupportgroup.com/2018/09/28/after-tularemia-death-experts-stress-education/

Now, Dr. Brown said an increasing number of cases of tularemia that were transmitted by a tick bite are being seen. Tularemia is transmitted by dog ticks, which also can transmit Rocky Mountain spotted fever. Lyme disease, babesiosis and erlichiosis, which are transmitted by tiny deer ticks, also occur on the Vineyard.

And with the relatively recent spread on the Island of lone star ticks, a new species, Dr. Brown said there is added concern about the potential for more disease transmission.

Sweden Reports Surge in Tularemia Cases

http://outbreaknewstoday.com/sweden-reports-surge-in-tularemia-cases-29406/

Sweden reports surge in tularemia cases

August 12, 2019

By NewsDesk  @infectiousdiseasenews

The number of reported cases of human tularemia has increased significantly in Sweden during the end of July and the beginning of August, according to the Public Health Agency of Sweden, or Folkhälsomyndigheten (computer translated).

Image/Folkhälsomyndigheten

A total of 212 confirmed cases have been reported, significantly more than reported during an average year, officials note.

Most cases of illness have been reported from Dalarna, Gävleborg and Örebro counties, but the last week also saw an increase in the counties of Västerbotten and Norrbotten. Since the number of illness cases is usually highest in September, the outbreak is expected to grow further in the coming weeks.

The animals most likely to carry the disease are wild hares, hence the name rabbit fever, aka tularemia and rodents, but it can also be transferred to humans via mosquito bites and occasionally tick bites.

Tularemia can be transmitted to people, such as hunters, who have handled infected animals. Infection can also arise from the bite of infected insects (most commonly ticks and deer flies); by exposure to contaminated food, water, or soil; by eating, drinking, putting hands to eyes, nose, or mouth before washing after outdoor activities; by direct contact with breaks in the skin; or by inhaling particles carrying the bacteria (through mowing or blowing vegetation and excavating soil).

Typical signs of infection in humans may include fever, chills, headache, swollen and painful lymph glands, and fatigue. If tularemia is caused by the bite of an infected insect or from bacteria entering a cut or scratch, it usually causes a skin ulcer or pustule and swollen glands. Eating or drinking food or water containing the bacteria may produce a throat infection, mouth ulcers, stomach pain, diarrhea and vomiting. Inhaling the bacteria may cause an infection of the lungs with chest pain and coughing.

Tularemia can be effectively treated with antibiotics. Untreated tularemia can lead to hospitalization and may be fatal if not diagnosed and treated appropriately.

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

https://madisonarealymesupportgroup.com/2019/02/18/tularemia-in-minnesotan-ticks/

https://madisonarealymesupportgroup.com/2019/08/23/ticks-are-one-way-tularemia-can-be-spread-rabbits-are-another/

https://madisonarealymesupportgroup.com/2018/09/28/after-tularemia-death-experts-stress-education/

https://madisonarealymesupportgroup.com/2018/02/27/tularemia-infected-ticks-found-on-sorrento-valley-trail-in-ca

https://madisonarealymesupportgroup.com/2018/09/19/glandular-tularemia/

 

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.

North Central Integrated Pest Alert

https://www.ncipmc.org/projects/pest-alerts1/

image.png

They have the following for ticks and specific diseases:

https://www.ncipmc.org/projects/pest-alerts1/brown-dog-tick-vector-for-rocky-mountain-spotted-fever/

https://www.ncipmc.org/projects/pest-alerts1/rocky-mountain-spotted-fever-rickettsia-rickettsii/

https://www.ncipmc.org/projects/pest-alerts1/ticks-and-tick-borne-diseases/

 

Other Arthropod-Borne Bacteria Causing Nonmalarial Fever in Ethiopia

https://www.ncbi.nlm.nih.gov/pubmed/31184993/

2019 Jun 10. doi: 10.1089/vbz.2018.2396. [Epub ahead of print]

Arthropod-Borne Bacteria Cause Nonmalarial Fever in Rural Ethiopia: A Cross-Sectional Study in 394 Patients.

Abstract

Bacterial arthropod-borne pathogens are a common cause of fever in Africa, but their precise impact is unknown and usually underdiagnosed in the basic rural laboratories of low-resourced African countries. Our aim was to determine the prevalence of arthropod-borne bacterial diseases causing fever among malaria smear-negative patients in a rural hospital located in Ethiopia. The study population included patients aged 2 years or older; referred to Gambo Rural General Hospital (West Arsi, Ethiopia), between July and November 2013, for fever or report of fever in the previous 48 h; attending the outpatient department; and testing negative for malaria by Giemsa-stained thin blood smears. We extracted DNA from 394 whole blood samples, using reverse line blot assays of amplicons to look for bacteria from the genera: Anaplasma, Bartonella, Borrelia, Coxiella, Ehrlichia, Francisella, and Rickettsia.

Thirteen patients showed presence of DNA for these pathogens: three each by Borrelia spp., the Francisella group (F. tularensis tularensis, F. tularensis holartica, and F. novicia), Rickettsia bellii, and Rickettsia Felis, and one by Bartonella rochalimae. Thus, in this rural area of Africa, febrile symptoms could be due to bacteria transmitted by arthropods. Further studies are needed to evaluate the pathogenic role of R. bellii.

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**Comment**

What if some of this is mosquito-borne as well? We frankly don’t know because the transmission studies are screaming to be done.

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

https://madisonarealymesupportgroup.com/2018/02/12/wolbachia-laced-mosquitoes-being-released-why-lyme-msids-patients-might-be-negatively-affected/

 

 

 

 

Tick Data – 76% Infected With One Organism, 20% Have Three or More Pathogens

https://www.tickcheck.com/statistics?

Each tick submitted for testing contributes to the research being conducted at TickCheck. By keeping records of all the results generated, we have been able to gain valuable insights into disease prevalence and co-infection rates. The comprehensive testing panel has been especially helpful in contributing to this research by ensuring all diseases and coinfections are accounted for when examining a tick.

Our current research shows:
  • 76% of ticks tested have at least one disease causing organism
  • 49% are co-infected with two or more organisms
  • 20% carry three or more
  • 9% of the ticks tested carry four or more

Infection Visualization by Tick Species

All Ticks Tested
76% Positive for Infection
Negative (24%)
_____________________________
  • 93% Positive for Infection
  • Negative (7%)
  • 63% Positive for Infection
  • Negative (37%)
  • 48% Positive for Infection
  • Negative (52%)

Coinfection Visualization

  • 2+ coinfection 49%
  • No coinfection 51%

Pathogenic Prevalence

The information below shows the positive/negative prevalence ratio of selected pathogens we test for. These pathogens were observed in ticks from the United States and Canada. Data set includes tests performed since TickCheck’s founding in 2014 and is updated in real time. (

Go to link at beginning to filter by state.  I’ve added the 3 listed for Wisconsin next to the entire sample size.  Please note the small sample sizes of WI ticks. 

Borrelia burgdorferi (deer tick) associated with Lyme disease

Sample size of 3,280 ticks.           70 Wisconsin ticks
  • 30% postive                                           33% positive
  • 70% negative                                         67% negative

Borrelia burgdorferi (western blacklegged tick) associated with Lyme disease

Sample size of 279 ticks.
  • 4% positive
  • 96% negative

Borrelia burgdorferi (lone star tick) associated with Lyme disease

Sample size of 899 ticks.
  • 8% positive
  • 92% negative

Borrelia burgdorferi (American dog tick) associated with Lyme disease

Sample size of 901 ticks.
  • 2% positive
  • 98% negative

Anaplasma phagocytophilum associated with anaplasmosis

Sample size of 2,146 ticks.           36 Wisconsin ticks
  • 8% positive                                           11% positive in Wisconsin
  • 92% negative                                        89% negative in Wisconsin

Babesia microti associated with babesiosis

Sample size of 1,894 ticks.           32 Wisconsin ticks
  • 4% positive                                            6% positive
  • 96% negative                                        94% negative

Bartonella spp. associated with bartonellosis

Sample size of 1,060 ticks.
  • 47% positive
  • 53% negative

Ehrlichia chaffeensis associated with ehrlichiosis

Sample size of 857 ticks.
  • 2% positive
  • 98% negative

Rickettsia spp. associated with Rocky Mountain spotted fever

Sample size of 944 ticks.
  • 23% postive
  • 77% negative

Francisella tularensis associated with tularemia

Sample size of 1,028 ticks.
  • 1% positive
  • 99% negative

Borrelia miyamotoi associated with B. miyamotoi

Sample size of 1,091 ticks.
  • 6% postive
  • 94% negative

Borrelia lonestari associated with STARI

Sample size of 831 ticks.
  • 19% postitive
  • 81% negative

Babesia spp. associated with babesiosis

Sample size of 564 ticks.
  • 5% positive
  • 95% negative

Mycoplasma spp. associated with Mycoplasma spp.

Sample size of 948 ticks.
  • 8% positive
  • 92% negative

Borrelia spp. associated with Borrelia spp.

Sample size of 612 ticks.
  • 17% postive
  • 83% negative

Powassan virus Lineage II associated with Deer tick virus

Sample size of 102 ticks.
  • 24% positive
  • 76% negative

Borrelia mayonii associated with Lyme disease

Sample size of 376 ticks.
  • 100% negative

Ehrlichia ewingii associated with ehrlichiosis

Sample size of 283 ticks.
  • 100% negative

Rickettsia amblyommii associated with Rocky Mountain spotted fever

Sample size of 177 ticks.
  • 46% positive
  • 54% negative

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For more about Tickcheckhttps://www.tickcheck.com/about

You can request free tick identification by sending in a quality picture of your tick. Using real-time PCR (Polymerase Chain Reaction), Tickcheck can determine the presence of certain pathogens with an accuracy level of over 99.9%.  All information about how to send in your tick, costs of various tests, time for results, etc. is found here:  https://www.tickcheck.com/info/faq

Jonathan Weber is the founder and CEO of TickCheck and became acutely aware of the dangers of tick-borne diseases after his father caught Lyme during a family trip on the Appalachian Trail.

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**Comment**

This information supports current research showing many patients are infected with numerous pathogens causing more severe illness & requiring far more than the CDC’s mono therapy of doxycycline:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

It also supports previous work showing coinfections within ticks:  https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

What I want to know is WHY nothing’s being done about this?  Why are people STILL given 21 days of doxycycline when that particular med will not work on numerous pathogens?
Lastly, a word about statistics – this tick data should be used with caution & never to turn sick patients away due to a statistic. If you are the sorry sucker who gets bit by that ONE tick carrying a “statistically insignificant” pathogen, you still got bit and have to deal with it.  
Shame on doctors for turning sick people away due to statistics and maps.
There’s no such thing as an “insignificant” tick bite!

But, Patients are STILL being turned away:  https://madisonarealymesupportgroup.com/2019/04/22/its-just-crazy-why-is-lyme-disease-treatment-so-difficult-to-find-in-mississippi/

https://madisonarealymesupportgroup.com/2019/03/19/jacksonville-family-shares-daughters-9-month-diagnosis-of-rare-disease-which-isnt-rare-lyme/

https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/

https://madisonarealymesupportgroup.com/2017/10/24/no-lyme-in-oklahoma-yeah-right/

https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/  “They had the classic symptoms, they had the bulls eye rash, they had the joint pain, they had fevers and had flu like symptoms, yet we were denied treatment for at least two of them and I don’t understand how this is legal,” said Bowerman.

According to Dr. Naveen Patil, Director of the Infectious Disease Program, ADH,

“We don’t have Lyme Disease in Arkansas, we have the ticks that transmit Lyme Disease but we don’t have any recorded cases of Lyme Disease.” 

Bowerman also received a letter from the clinic stating doctors would no longer treat her children because she consistently questioned their medical advice and recommendations.

This is getting to be way beyond ludicrous.

 

Eye Problems in Tick-borne Diseases Other Than Lyme

http://danielcameronmd.com/eye-problems-tick-borne-diseases-lyme/

EYE PROBLEMS IN TICK-BORNE DISEASES OTHER THAN LYME

“Why should an ophthalmologist have a good understanding of Lyme diagnosis and treatment?” asks Sathiamoorthi [1], from the Mayo Clinic, in an article published in the Current Opinion in Ophthalmology. “Vision-threatening ophthalmic manifestations are relatively common in Lyme disease (LD) and Rocky Mountain spotted fever.”

by Daniel J. Cameron, MD MPH

“Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases,” she explains.

While manifestations may be present with LD and Rocky Mountain spotted fever, ocular involvement is rare in other tick-borne diseases such as babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever, Sathiamoorthi points out.

However, the true prevalence of ocular involvement due to tick-borne illnesses is unknown. Limitations with testing can make it difficult to identify patients. “It is crucial to know who is appropriate to test in order to avoid false positive results.” If an individual has been symptomatic for only a short period of time, they “may not have detectable serum IgM antibodies to the causative organism because it takes time for this immune response to develop.”

It can also be difficult to determine the cause of the ocular complaints if there is evidence of more than one tick-borne illness.

“One case report [2] describes a patient with optic neuritis and orbital myositis who had serologic evidence of HME [Human Monocytic Ehrlichioisis], Borrelia burgdorferi, and Babesia,” cites Sathiamoorthi.

There are more than one species of ticks associated with ocular findings, as well. According to Sathiamoorthi, those include Ornithodoros genus, Dermacentor variabilis Ambylomma americanum, Ixodes scapularis, and Dermacentor andersonii.

Sathiamoorthi advises doctors to “carefully generate a reasonable differential based on clues in the medical and social history regarding exposures and risks.”

“Patients who are most likely to have ophthalmic Lyme disease,” explains Sathiamoorthi, “are those with ocular manifestations commonly associated with Lyme disease (i.e. Bells palsy, cranial nerve palsies and keratitis); tick exposure in Lyme endemic regions; other signs/symptoms of late Lyme disease (i.e. inflammatory arthritis, carditis, acrodermatitis chronica atrophicans rash, encephalopathy and meningitis); and negative syphilis testing.”

Read more on eye problems in tick-borne diseases in “A growing list of eye problems in Lyme disease.”

References:

1. Sathiamoorthi S, Smith WM. The eye and tick-borne disease in the United States. Curr Opin Ophthalmol. 2016;27(6):530-537.
2. Pendse S, Bilyk JR, Lee MS. The ticking time bomb. Surv Ophthalmol. 2006;51(3):274-279.