Archive for the ‘Tularemia’ Category

Of Birds and Ticks

http://mainepublic.org/post/battle-against-ticks-and-lyme-disease-scientists-look-skies#stream/0

In the Battle Against Ticks and Lyme Disease, Scientists Look to the Skies

  JUL 3, 2017

As we head into the Maine outdoors this summer, the all-too-familiar warnings about how to avoid ticks reverberate in many of our heads.

Stay on the trail. Steer clear of wooded and brushy areas where ticks congregate.

But while most of us take pains to dodge the eight-legged pests, Chuck Lubelczyk heads straight for them.

As a field biologist at the Maine Medical Center Research Institute’s Lyme and Vector-Borne Disease Laboratory, he studies the spread of diseases carried by ticks, as well as by mosquitoes. That means venturing out into the fields, forests and coastlines of Maine to collect the bugs and evaluate where they pose the most risk to humans.

On a recent June day, Lubelczyk trudged into the greenery of the Wells Reserve, a 2,250-acre spread in York County headquartered at a restored saltwater farm. He partnered with researchers from the Biodiversity Research Institute in Portland to collect ticks from creatures less often associated with them: birds.

The team, assisted by several interns, set up wide nets to ensnare the birds as they flew through the area. They then delicately extricated them, tucked the birds into breathable collection bags, and toted them to a shady picnic table for easier handling. Using tweezers, the team plucked off each tick — typically feasting around the birds’ eyes, bills, and throats — and preserved the bugs for later testing at the lab.

Lubelczyk held up a vial containing at least 50 tiny nymphal deer ticks swirling in a preservative solution. They’d been tweezed off a single bird, a towhee, that morning.

Once free of ticks, the birds were then safely released to continue on their way.

https://bangordailynews.com/video/ticks-on-migratory-birds/ (Video here)

While mice, chipmunks and deer get most of the attention as hosts for ticks, “Not a lot of people talk about the bird issue,” he said. “They’re understudied in a big way, I think. They do have a real role to play.”

Ticks are an annoyance to birds, but they don’t transmit disease to them or slowly and lethally drain them of blood, as researchers have seen among moose calves in Maine. But birds facilitate the spread of ticks, picking them up in Maryland, Connecticut and other eastern states as they fly north in the spring, Lubelczyk explained.

“As they’re migrating, they’re either dropping the ticks off as they fly or when they land. They’re kind of seeding them along migration patterns.”

Emerging diseases

By tracking the birds and the ticks they carry, researchers hope to predict where Lyme and other tick-borne diseases are most likely to accelerate. Lyme is now present in every county in the state, after hitting a record of 1,488 cases in 2016, but ticks are just getting established in areas such as Aroostook and Washington counties, Lubelczyk said.

Along with Lyme, Lubelczyk tested the ticks for other two other emerging diseases, anaplasmosis and the rare but potentially devastating Powassan virus. Powassan, carried by both the deer tick and the groundhog or woodchuck tick, recently sickened two people in midcoast Maine, following the death in 2013 of a Rockland-area woman.

A recent survey Lubelczyk led found the virus in ticks crawling around southern Maine, Augusta and on Swan’s Island in Hancock County.

In the modest Scarborough lab, medical entomologist Rebecca Robich furthered the findings of that survey. Clad in a white coat and blue gloves, she cloned a tiny band of the Powassan virus’ inactivated RNA, using a sample derived from the ticks that tested positive in the survey. Robich began the work, designed to confirm the earlier test results, last winter.

She expects to know conclusively within the next month what percentage of the sampled ticks were infected with Powassan, she said.

“We’re this close to finishing,” Robich said.

Growing exposure

Ticks have become so prevalent in Maine that Lubelcyzk and his colleagues are increasingly called upon to educate the public about the health risks the arachnids pose. That includes speaking at community forums, town meetings, garden clubs and even to groups of employees.

“They’re widespread enough now that DOT, CMP, people like that are bumping into them on a regular basis,” he said. “Even people like law enforcement. The warden service, regular police with police dogs, they’re exposed.”

Their outreach also includes plenty of phone calls to the lab, fielded by its small staff of four, not counting summer interns.

“If somebody calls, we never really turn them down,” he said.

Many people don’t realize that the lab no longer identifies ticks for the public, Lubelczyk said. Now located in Scarborough along with MMC’s medical and psychiatric research centers, the lab formerly operated in South Portland, where it identified a tick’s species for anyone who walked in the door or mailed a sample. The University of Maine Cooperative Extension in Orono has since taken over that service (it does not test ticks for disease).

“It’s very hard to say no to someone when they’re really frantic because they found a tick on themselves, or their child, or even their pet,” he said. “And they’re sitting out in the parking lot.”

So far this season, the lab has fielded numerous calls from worried residents only to discover after viewing a photograph that the tick in question is a dog tick, not a deer tick. Maine is home to 15 species of ticks, and the dog tick is not among those that transmit disease to humans, at least in this region.

Through its outreach work, the lab has also found itself at the center of debates about how to manage ticks. Lubelczyk recalled a town forum on Long Island a couple of years ago that grew tense as residents discussed the use of pesticides.

“As soon as the topic of any kind of spray was brought up, not even by us, by somebody else, the fishing community was dead set against it,” he said. “Understandably, they’re worried about the stock. It really makes that difficult because you start to have divisions in how to control the ticks.”

The lab’s research on the role of birds in spreading tick-borne disease is similarly delicate, because many birds are under threat ecologically, Lubelczyk said.

“No one really cares if you try to target mice. Birds are federally protected in a lot of cases,” he said.

That other biting pest

Educating the public represents a large part of the lab’s mission but only a small part of its budget. Its outreach work is funded largely through small grants from foundations, Lubelczyk said.

Most of its research funding is targeted toward mosquitoes rather than ticks, boosted by the federal government’s initiative to combat the Zika virus, he said. While Zika hasn’t appeared in Maine, warming temperatures due to future climate change could make the state habitable for one of the mosquito species that carries it.

Lubelczyk explained this as he stood in the lab’s testing area, next to a large freezer storing petri dishes packed with frozen mosquitoes. A piece of yellow tape affixed to the door warned, “Not for food.”

While Lyme is far more prevalent, diseases carried by mosquitoes, such as West Nile virus and Eastern Equine Encephalitis, can lead to more acute illness. Both can cause inflammation of the brain and other serious complications.

Funding for tick research is generally less reliable, Lubelczyk said. The recent Powassan survey, for example, was funded by the Maine Outdoor Heritage Fund, which collects money through the sale of instant scratch lottery tickets.

A continuing threat

The lab’s role in helping to prevent tick-borne diseases has only grown as the tick population and the diseases they carry spread. The incidence of Lyme in Maine is among the highest rates in the country, averaging 82.5 cases per 100,000 people between 2013 and 2015.

Anaplasmosis and babesiosis are less common but becoming increasingly worrisome.

Lubelczyk understands the illnesses on both a professional and personal level. He contracted Lyme several years ago, after a deer tick latched onto him while he made a pitstop on the way home from work one steamy July day, he said. He had just changed into shorts and sandals and jumped out of his car for 30 seconds to hang a mosquito trap in Wells, he recalled.

A day and a half later, he spotted the tick bite. After a round of antibiotics, he recovered, Lubelczyk said.

His usual garb for field work includes long sleeves and pants treated with permethrin, along with gaiters over his boots.

“It’s embarrassing,” he said, wincing. “We always talk about wearing appropriate clothing.”

 

**Comment**

I’m thankful someone is dealing with the bird issue in relation to tick propagation as I believe it will be found to be much more of an issue than previously thought.  It would help explain why folks insist they’ve been infected while near trees as birds would drop them onto trees (as well as various rodents).  Like deer, birds serve primarily as transits that can spread ticks far and wide.

While Lubelczyk doesn’t feel dog ticks are important carriers (at least in his area) – he’s mistaken.  Every tick should be suspect until proven otherwise.  Think about it:  they all exchange bodily fluids with their hosts.  Dog ticks are known to carry Tularemia, https://www.cdc.gov/ticks/diseases/index.html Rocky Mountain Spotted Fever, Ehrlichia, Mediterranean Spotted Fever, Babesia in dogs (which should also make it suspect for humans), and potentially Bartonella.  http://labs.russell.wisc.edu/wisconsin-ticks/rhipicephalus-sangineus/  No, it would not be wise to think of the Dog Tick in friendly terms.  Remember that ticks are moving all over the place defying commonly held beliefs about geography.  And while folks fighting for research grants want to promote and blame the supposed “global warming” mentioned in this article, there are many who disagree for good reasons:  https://madisonarealymesupportgroup.com/2017/07/08/global-warming-numbers-fudged/

https://madisonarealymesupportgroup.com/2017/08/14/canadian-tick-expert-climate-change-is-not-behind-lyme-disease/  John explains, “The climate change range expansion model is what the authorities have been using to rationalize how they have done nothing for more than thirty years. It’s a huge cover-up scheme that goes back to the 1980’s. The grandiose scheme was a nefarious plot to let doctors off the hook from having to deal with this debilitating disease. I caught onto it very quickly. Most people have been victims of it ever since.”
“This climate change ‘theory’ is all part of a well-planned scheme. Even the ticks are smarter than the people who’ve concocted this thing,” he says.
“Climate change has nothing to do with tick movement. Blacklegged ticks are ecoadaptive, and tolerate wide temperature fluctuations. On hot summer days, these ticks descend into the cool, moist leaf litter and rehydrate. In winter, they descend into the leaf litter, and are comfortable under an insulating blanket of snow. Ticks have antifreeze-like compounds in their bodies, and can tolerate a wide range of temperatures. For instance, at Kenora, Ontario, the air temperature peaks at 36°C and dips to –44°C, and blacklegged ticks survive successfully.

Also, please note that although there has only been one Zika death in an elderly man with a preexisting health condition the continental U.S., all the funding is going to it and mosquito research.  This is causing untold harm here where Lyme is causing around 400,000 new cases per year.  There is no official tally on all the other coinfections they often come with Lyme as they aren’t even reportable in many states but are a crucial detail in understanding the complexity of Lyme/MSIDS.  People are often infected with numerous pathogens.  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

To treat this complex as a one organism/one disease would be folly.  

Also, he claims that West Nile virus and Eastern Equine Encephalitis, can lead to more acute illness, I would disagree again.  Lyme (borrelia), Babesia, Bartonella, Mycoplasma, and numerous other viruses, and funguses have killed people outright.  Heart block, encephalitis, meningitis, and other serious illnesses are caused by TBI’s. Powassan can be transmitted in under 15 minutes and can kill. Rocky Mountain Spotted Fever is another killer.  There is much to show that if the non-cell wall and biofilm formation of borrelia isn’t successfully dealt with, it could lead to dementia or Alzheimer’s in the future:  https://madisonarealymesupportgroup.com/2017/06/10/the-coming-pandemic-of-lyme-dementia/https://madisonarealymesupportgroup.com/2016/06/03/borrelia-hiding-in-worms-causing-chronic-brain-diseases/https://madisonarealymesupportgroup.com/2016/08/09/dr-paul-duray-research-fellowship-foundation-some-great-research-being-done-on-lyme-disease/https://madisonarealymesupportgroup.com/2016/06/09/alzheimers-byproduct-of-infection/https://madisonarealymesupportgroup.com/2017/01/18/a-bug-for-alzheimers/

And of course, while many cases of Lyme (borrelia) don’t kill immediately, it can make you want to die and disrupt life in such a way people commit suicide.  https://madisonarealymesupportgroup.com/2017/06/20/suicide-lyme-and-associated-diseases/https://madisonarealymesupportgroup.com/2017/07/26/can-lyme-steal-your-mind/

If that isn’t serious, I don’t know what is.

 

 

 

Start Treatment if TBI’s are Suspected

http://www.mdedge.com/ccjm/article/141387/dermatology/tickborne-diseases-other-lyme-united-states  Cleveland Clinic Journal of Medicine. 2017 July;84(7):555-567

KEY POINTS

  • Tickborne illnesses should be considered in patients with known or potential tick exposure presenting with fever or vague constitutional symptoms in tick-endemic regions.
  • Given that tick-bite history is commonly unknown, absence of a known tick bite does not exclude the diagnosis of a tick-borne illness.
  • Starting empiric treatment is usually warranted before the diagnosis of tickborne illness is confirmed.
  • Tick avoidance is the most effective measure for preventing tickborne infections.

____________________________________________________________________________

The article delineates symptoms, transmission, reservoirs, testing, and treatment of the following TBI’s:  Rocky Mountain Spotted Fever, Rickettsiosis, Ehrlichioses, Babesiosis, Tickborne relapsing fever, Borrelia miyamotoi, Southern Tick-associated Rash illness, Tularemia, and Tickborne viral infections.

101_emrash316x316

47_rash316x316

I need to address the following statements at the end of the article:

“Knowledge of the geographic locations of potential exposure is paramount to determining which tickborne infections to consider, and the absence of a tick bite history should not exclude the diagnosis in the correct clinical presentation.

Clinicians need to tread carefully here.  Many patients have been denied testing and treatment due to a map.  These maps should be viewed with the same suspicion as the testing.  

25_antibody316x316

01_test_petri316x316

38_sensitive316x316

Until you tell the fox, squirrel, bird, deer, lizards, and hundreds of other reservoirs to stay put, ticks will be traveling everywhere along with the pathogens they carry.  Since Lyme Disease (borrelia) has been found in every continent except for Antarctia (it will be found there too), you can assume that means ticks are there too.  

I’m glad the authors stated this:

In addition, it is important to recognize the limitations of diagnostic testing for many tickborne infections; empiric treatment is most often warranted before confirming the diagnosis.”132_fail316x316

For those of us in this war, this “empiric treatment” by mainstream medicine is new.  Patient after patient has had to wait for test results before doctors will treat them.  Often, since the testing is so poor, it comes back negative and the patient is sent packing, even if the patient has every symptom in the book.  The next step is for authorities to admit and acknowledge that diagnosis of Tick borne infections is a clinical one.  This means doctors need to learn a whole lot more.  For docs willing to learn, please see:  https://www.lymecme.info

Even the CDC is stating to treat empirically:  https://madisonarealymesupportgroup.com/2017/07/01/good-morning-america-cdc-advises-multiple-lyme-tests-due-to-false-negative-results/ CDC spokesperson at end of video.

Another very important point needs to be made.  The CDC has pushed this one pathogen for one tick mantra for too long.  Many patients are co-infected making cases infinitely more complex and challenging to treat.  Lyme literate doctors trained by ILADS understand this and treat accordingly.  Until mainstream medicine realizes and admits people can have numerous pathogens, and treat for them, people will not get better.

32_co316x316

One last point is that mycoplasma, Bartonella, and other pathogens are not included here but are quite common in patients.  Both of these pathogens are persistent and adept at surviving.  More research needs to be done on these co-infections.

Please see:

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/  If ticks are co-infected, so are patients.

https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

https://madisonarealymesupportgroup.com/2016/03/20/why-we-cant-get-better/

 

 

One Tick Bite Could Put You at Risk For at Least 6 Different Diseases

http://www.businessinsider.com/deer-tick-can-carry-lyme-disease-powassan-virus-babesiosis-and-more-2017-6 by Kevin Loria, June 28,2017

The deer tick, also known as the blacklegged tick, is a fascinating but nasty little creature, and it’s spreading.

The tiny arthropods carry Lyme disease — the serious illness that we most associate them with — but that’s not the only pathogen they spread.

“One thing that people really need to be aware of is that Lyme disease is not the only pathogen that’s out there — there’s quite a few of them, [including] probably quite a few that we haven’t discovered yet,” says Rafal Tokarz, an associate research scientist at Columbia University’s Mailman School of Public Health.

And the deer tick, which as far as we know carries more illnesses than any other tick, “has been expanding its range enormously in the last 30 years,” says Durland Fish, professor emeritus of epidemiology at the Yale School of Public Health. Before the early 70s, it was largely unknown outside the Northeast, but now it has spread north, south, and west.

The diseases that we know deer ticks spread are all serious:

1. Lyme disease, which is transmitted by ticks infected with the bacterium Borrelia burgdorferi, infects roughly 300,000 Americans every year. It can be treated with antibiotics if caught early, but can cause severe inflammation, nerve, and joint pain, among other symptoms, if left untreated.

2. When people are infected with babesiosis, parasites infect and destroy red blood cells. Not everyone shows symptoms but it can be life-threatening for some at-risk patients. It’s “like tick-borne malaria,” says Fish, and is the most important contaminant of the blood bank right now, he says.

3. Anaplasmosis is spread by another bacteria carried by deer ticks. It usually shows up a week or two after a bite and can cause fever, headaches, nausea, and general malaise, among other symptoms. If untreated it can be severe, leading to hemorrhage, renal failure, and for a small fraction of even healthy patients, potentially can be fatal.

4. Deer ticks can also spread the Borrelia miyamotoi bacteria, which Fish says is similar to the one that causes Lyme. Symptoms include joint pain, fatigue, fever, chills, and headache.

5. A relatively recently discovered disease that’s spread by deer ticks as well as dog and Lone Star ticks is ehrlichiosis, caused by a bacteria in the same family as the one responsible for Rocky Mountain spotted fever. Symptoms often present like the flu.

6. Powassan virus has been around for a while but has received more attention recently, especially since the deer tick (which frequently bites humans) started spreading it — the ticks that transmitted the first reported cases in the 1950s rarely bite people. Unlike Lyme, which often takes many hours or even a couple days before it’s transmitted, Powassan infection can occur in as little as 15 minutes. Not everyone who gets bitten by an infected tick gets sick, but if they do, it’s a serious problem since there’s no treatment. In those (still rare) cases, Fish says that there’s about a 50% chance of permanent neurological damage and a 10% chance of death.

The broad range of potential conditions means that doctors don’t even necessarily know what to look for. Even worse, “ticks can frequently be co-infected with more than one pathogen,” says Tokarz. That’s especially true in certain locations, like on Long Island. One bite could transmit both Lyme disease and babesiosis, conditions that would normally be treated quite differently.

It’s also possible that having two or more illnesses could change the way the disease manifests. “We still don’t know whether co-infection exacerbates a disease or doesn’t make a difference,” says Tokarz.”Studies have shown both.”

Unfortunately, we don’t have any good way to control ticks and to stop the ongoing expansion, which will lead to more people getting sick.

In the places where people are at risk of picking up a tick “it is a very important, very severe problem, but the only thing that can be done is to educate people on the dangers of coming into contact with ticks,” says Tokarz.

If you get one on you, pull it off right away — don’t bother with urban legends about needing to burn it off. And protect yourself if you are going to be hiking or spending time in a place where ticks are common. Use permethrin-treated clothing for outdoors work and use insect repellent that contains DEET.

________________________________________________________________________________________

**My letter to the author**

Dear Mr. Loria,

Thank you for your piece on ticks and the pathogens they carry. I just wanted to add to your list; however, as there are many more pathogens carried by ticks. Also, they are discovering a variety of ticks carry pathogens, and if you think about it logically for a moment, ticks have similar habits and mouth parts, and require blood meals to survive, which technically makes every tick suspect. Unfortunately, geographical maps and entomology information (which ticks spread what) have been used to deny patients diagnosis and treatment. A doctor will look at the CDC map and claim, unequivocally, that since such and such isn’t supposed to be in that state, it isn’t TBI’s (tick borne infections). https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/ and then eventually they have to admit they are wrong: https://madisonarealymesupportgroup.com/2017/03/02/hold-the-press-arkansas-has-lyme/

How many went undiagnosed through the years?

https://www.lymediseaseassociation.org/about-lyme/other-tick-borne-diseases

Babesiosis
Bartonellosis
Borrelia miyamotoi
Bourbon Virus
Colorado Tick Fever
Ehrlichiosis/Anaplasmosis
Heartland Virus
Meat Allergy/Alpha Gal
Pacific Coast Tick Fever: Richettsia philipii
Powassan Encephalitis
Q Fever
Rickettsia parkeri Richettsiosis
Rocky Mountain Spotted Fever
STARI: Southern Tick-Associated Rash Illness
Rick Paralysis
Tularemia

I run a physical support group here in Wisconsin, 6th in the nation for TBI’s, and nearly all of us are co-infected, and while Tokarz states he doesn’t know whether coinfection exacerbates a disease, we all do. http://danielcameronmd.com/babesia-and-lyme-its-worse-than-you-think/

Babesia can increase the severity of Lyme disease. Coinfected patients were more likely to have experienced fatigue, headache, sweats, chills, anorexia, emotional lability, nausea, conjunctivitis, and splenomegaly more frequently than those with Lyme disease alone. [7]
Babesia can also increase the duration of illness with Lyme disease. Babesia patients can remain symptomatic for years with constitutional, musculoskeletal, or neurological symptoms. One study found that 50% of coinfected patients were symptomatic for 3 months or longer, compared to only 4% of patients who had Lyme disease alone. [7] Meanwhile, one-third of patients with a history of both Babesia and Lyme disease remained symptomatic an average of 6 years. [2]

“The clinical pictures for 3 out of our 4 coinfected patients included a large number of symptoms, and 1 coinfected patient had persistent fatigue after treatment,” according to a study by Steere and colleagues. [8]”

https://madisonarealymesupportgroup.com/2016/03/20/why-we-cant-get-better/

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

https://madisonarealymesupportgroup.com/2014/11/14/studies-show-why-its-tough-to-treat-lyme-and-co/

https://madisonarealymesupportgroup.com/2015/05/08/interview-with-dr-horowitz/

For a fantastic book on all of this and more, read science journalist and past Executive Editor of Discover Magazine, Pam Weintraub’s work, Cure Unknown: Inside the Lyme Epidemic. http://www.astralgia.com/pamelaweintraubresume18.pdf

Sincerely,
Alicia Cashman
Madison Lyme Support Group
https://about.me/lymecoordinator56
lymecoordinator56@gmail.com
https://madisonarealymesupportgroup.com

 

 

 

Review of Tick Attachment Time For Different Pathogens

http://dx.doi.org/10.3390/environments4020037

Stephanie L. Richards, Ricky Langley, Charles S. Apperson and Elizabeth Watson 

Abstract

Improvements to risk assessments are needed to enhance our understanding of tick-borne disease epidemiology.

We review tick vectors and duration of tick attachment required for pathogen transmission for the following pathogens/toxins and diseases: (1) Anaplasma phagocytophilum (anaplasmosis); (2) Babesia microti (babesiosis); (3) Borrelia burgdorferi (Lyme disease); (4) Southern tick-associated rash illness; (5) Borrelia hermsii (tick-borne relapsing fever); (6) Borrelia parkeri (tick-borne relapsing fever); (7) Borrelia turicatae (tick-borne relapsing fever); (8) Borrelia mayonii; (9) Borrelia miyamotoi; (10) Coxiella burnetii (Query fever); (11) Ehrlichia chaffeensis (ehrlichiosis); (12) Ehrlichia ewingii (ehrlichiosis); (13) Ehrlichia muris; (14) Francisella tularensis (tularemia); (15) Rickettsia 364D; (16) Rickettsia montanensis; (17) Rickettsia parkeri (American boutonneuse fever, American tick bite fever); (18) Rickettsia ricketsii (Rocky Mountain spotted fever); (19) Colorado tick fever virus (Colorado tick fever); (20) Heartland virus; (21) Powassan virus (Powassan disease); (22) tick paralysis neurotoxin; and (23) Galactose-α-1,3-galactose (Mammalian Meat Allergy-alpha-gal syndrome).

Published studies for 12 of the 23 pathogens/diseases showed tick attachment times. Reported tick attachment times varied (<1 h to seven days) between pathogen/toxin type and tick vector. Not all studies were designed to detect the duration of attachment required for transmission. Knowledge of this important aspect of vector competence is lacking and impairs risk assessment for some tick-borne pathogens.

**Highlights**

The researchers point out that unlike mosquitoes which rely on saliva for transmission, ticks can transmit via saliva, regurgitation of gut contents, and also via the cement-like secretion used to secure itself to the host (hard ticks).  Published data on transmission times relies upon rodent studies showing 15–30 min for Powassan, anywhere from 4-96 hours for bacteria, 7–18 days for the protozoan Babesia microti, and 5-7 days for neurotoxin (Tick Paralysis). For soft ticks, attachment time of 15 sec–30 min was required for transmission of Borrelia turicata (Tick Relapsing Fever).

The challenge with these studies, and there are many, is that most placed multiple ticks on multiple rodents.  Multiple ticks may be transmitting different pathogens.  It has also been shown that ticks feeding on mice coinfected with B. microti and B. burgdorferi were twice as likely to become infected with Bb compared to B. microti, suggesting that coinfection can amplify certain pathogens – which is another reason to only use one rodent and one pathogen to separate out multiplying factors to muddy the waters.  Also, rarely do studies record the titer of both tick and host – again, making it nearly impossible to determine what’s what.  It was also noted that transmission times are unknown for many pathogens.

**And as always:  if you are the ONE person who contracted Lyme Disease in 10 minutes, all these numbers are essentially meaningless.  The frightening truth is that these numbers, along with geographical information regarding tick habitats, are often used against patients.  It is beyond time for doctors to listen, educate themselves, and treat patients with the respect they deserve – not to mention it’s time for them to treat patients clinically and not based on tests that are wrong over half the time and with the knowledge that ticks are spreading everywhere and bringing the pathogens with them. (In other words, throw the maps away!)

The review essentially gives the following transmission times for various pathogens. Again, please know these numbers are not definitive and many, many cases have proven this fact.

Take each and every tick bite seriously and don’t mess around and take a “wait and see approach.”  There is too much at stake.

Transmission Times noted in review:

Anaplasmosis: 24 hours and increased dramatically after 48-50 hours.  It is possible for it to be transmitted transovarially (from mom to baby tick) and it inhabit’s the salivary glands more frequently than the mid-gut.

Babesiosis:  Greater than 36 hours, 17% after 48 hours, and 50% after 54 hours.  Can be transmitted transovarially and transstadially (pathogen stays with tick from one stage to the next).  Ticks feeding on mice coinfected with B. microti and B. burgdorferi were twice as likely to become infected with Bb compared to B. microti.

Lyme Disease (Borrelia burgdorferi):  24 hours; however, the researchers comment that there are questions regarding previous transmission studies.  They also commented that there may be a difference in attachment time between nymphs and adult females. Transovarian transmission is unknown.

Tick Relapsing Fever (Borrelia turnicatae, B. hermsii):  15 and 30 seconds respectively.  Transovarian transmission is unknown.

Borreliosis (Borrelia mayonii):  24 hours.  Transovarian transmission is unknown.

Borrelia myamotoi Disease:  24 hours.  Transovarial transmission occurs.

Tularemia (Francisella tularensis):  Not assessed.  Can be transmitted mechanically by deer flies, horse flies, mosquitoes, aerosol/ingestion when processing/eating infected animal tissues.  Can be transmitted transtadially and transovarially.

Rocky Mountain Spotted Fever (Rickettsia rickettsii):  10-20 hours.  Can be transmitted transovarially.

Heartland Virus:  Not assessed.  Can be transmitted transovarially and transstadially.

Powassan Virus:  15 Minutes; however, it is possible it was sooner since the first they checked for transmission was 15 minutes.  Can be transmitted transovarially.

Tick Paralysis (Neurotoxin):  2-6 days.

Alpha Gal/Mammalian Meat Allergy (Galactose-a-1,3-Galactose):  Not assessed.  Transovarian transmission is unknown.

For more on transmission times, please read:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/

 

 

Of Rabbits and Men

rabbit-meadow-1280x1024

Tularemia is known as a rabbit disease which is spread to those who handle them including hunters and cooks; however, at the recent Lyme Disease Association 17th Annual Conference on Lyme and Tick-Borne Diseases, Timothy Lepore, MD, FACS, surgeon at Nantucket Cottage Hospital, explained that it is also a disease of those who work with the land such as landscapers and farmers, as well as those who get bit by a tick. There are cases reported in every state but Hawaii, and many other wild and domestic animals can be infected. The highest rates of infection are in Arkansas.

Tularemia first appeared in the United States in Massachusetts in 1937 after importing 30,000 to 40,000 rabbits per year from Europe. Importing came to an end in 1947.

http://columbia-lyme.org/patients/tbd_tularemia.html
Francisella tularensis, a gram negative, aerobic, pleomorphic, highly persistent intracellular pathogen, spread via the lymphatic system can cause fever, chills, headache, myalgia, extreme fatigue, glandular (swollen glands), oropharyngeal (sore throat, nausea, vomiting and diarrhea, abdominal pain and intestinal ulcerations), conjunctivitis, pneumonic (dry cough, respiratory difficulty and chest pain), ulceroglandular (skin ulcer at infection site) and can be septic and lethal. Symptoms typically develop within three or four days of inoculation but can take up to 10 days.

Tests: Tests for Tularemia are not widely available but direct examination of biopsy specimens or secretions by fluorescent antibody or Gram or histochemical stains are often helpful. F. tularensis can also be demonstrated microscopically with fluorescent-labeled antibodies. Antibodies are not typically present in the first ten days after exposure. Patient samples should come from sputum or pharyngeal washings, as the organism is not present in large numbers in blood. Polymerase chain reaction (PCR) tests can also be utilized. It is imperative that lab personnel take strong precautions as it is quite easy to become infected.

Treatment: Antibiotic therapy with Gentamicin (5mg/kg/day, IM or IV) or streptomycin (1 gm twice daily, IM). The recommended treatment period is 10 days. In vitro susceptibility studies indicate that quinolones and fluoroquinolones are also effective against F. tularensis, thus providing an additional option for physicians. Tetracyclines and chloramphenicol can also be used, but a higher rate of relapse is associated with these agents, as they are bacteriostatic rather than bactericidal. Thus, it is recommended that treatment with these medications be extended to 2-3 weeks. If treatment is initiated quickly the mortality rate for tularemia is around 1-2%; however, one-third of untreated patients will die, usually from pneumonia, meningitis or peritonitis.

http://www.idph.state.il.us/public/hb/hbtulare.htm
Transmission: Transmission can occur through the skin or mucous membranes when handling infected animals as well as through tick bite, contact with fluids from infected deer flies, mosquitoes or ticks, handling or eating undercooked rabbit, drinking contaminated water, inhaling dust from contaminated soil, and handling contaminated pelts or paws of animals. It can also be inhaled from infected hay, grain, or soil. Dr. Lepore had patients who contracted it from their pet dog who shook rain water on them after chewing on a dead rabbit, as well as from folks eating road kill, a person who held sick animals, and a gentleman who slept with his pet bunny.
http://www.siumed.edu/medicine/id/tularemia.htm
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.

In a mass casualty situation – treat with oral agents for 14 days using Doxycycline (adults 100mg by mouth twice a day, children under 45kg 2.2 mg/kg by mouth twice daily) or Ciprofloxacin (adults 500mg, by mouth twice a day, children 15mg/kg by mouth twice a day).

Those performing autopsies should avoid bone sawing or any procedure likely to cause aerosolization and exposed people should wash with soap and water. In environmental contaminations use a 10% bleach solution for spraying and cleaning using alcohol 10 minutes after using bleach. There have been no reports of human to human transmission.