Archive for the ‘Tularemia’ Category

One Tick Bite Could Put You at Risk For at Least 19 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
  • Crimean-Congo hemorrhagic 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 (RMSF)
  • SFTS: Severe Fever with Thrombocytopenia Syndrome 
  • STARI: Southern Tick-Associated Rash Illness
  • Tickborne meningoencephalitis
  • Tick Paralysis
  • Tularemia

I run a physical support group here in Wisconsin, 4th 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/.  Each pathogen necessitates different medications so the CDC mono therapy of doxycycline won’t do a thing against many of the other pathogens.

“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

Category:

Activism, Anaplasmosis, Babesia, Bartonella, Lyme, Mycoplasma, Ticks, Tularemia

Review of Tick Attachment Time For Different Pathogens

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

Environments 2017, 4(2), 37; https://doi.org/10.3390/environments4020037

Do Tick Attachment Times Vary between Different Tick-Pathogen Systems?

Stephanie L. Richards 1,* , Ricky Langley 2, Charles S. Apperson 3and Elizabeth Watson 4

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/

 

 

Category:

Anaplasmosis, Babesia, Lyme, research, Rickettsia, Ticks, Transmission, Tularemia, Viruses

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.

Category:

Ticks, Treatment, Tularemia