Lyme Disease And Co Infections

My Experience With Antibiotic Treatment For Lyme

When I was first diagnosed with Lyme disease, my first response was standard: Try antibiotics. But every time I started a new round, I was absolutely miserable by the second week.

Nausea, abdominal discomfort, and feeling generally terrible all over increased until I was forced to stop the drug. Probiotics didnt help, and I had the same response to different types of antibiotics. While some people tolerate antibiotic therapy better than others, it became obvious that I would have to find a different solution.

I later discovered that my experience was not unique many people seem to have the same response to oral antibiotics. I also met numerous people who had undergone 6-9 months of intravenous antibiotic therapy, only to be right back where they started within a couple of months of finishing.

Though there may be some logic in using antibiotics for 2-4 weeks during acute infection, many people develop symptoms despite initial use of antibiotics. And as I came to know the microbe better, I began to understand why antibiotics are not necessarily a good treatment for chronic Lyme disease. Though some people do overcome Lyme disease with antibiotics, those results arent consistent enough to be considered reliable. To date, no clinical studies have shown benefit from long-term antibiotic therapy for chronic Lyme disease.

Human Lyme Disease Infections Linked To Ecological Factors Across California

Date:

University of California – Santa Barbara

Summary:

Tick bites can transmit Lyme disease. But even knowing where these ticks live doesn’t necessarily mean you can predict the disease in humans. It’s only one part of a broader picture which includes human behavior and the habits of the parasite’s carriers.

Tick bites transmit Lyme disease. But even knowing where these ticks live doesn’t necessarily mean you can predict the disease in humans. It’s only one part of a broader picture which includes human behavior and the habits of the parasite’s carriers.

Researchers at UC Santa Barbara have discovered that the ecology of the small mammals upon which ticks feed can explain rates of human Lyme disease, at least in California. As a result, scientists and health officials may be able to predict future disease risk by studying the response of these animals, and their tick parasites, to changing climate and land use. The findings appear in the journal Environmental Research Letters.

“This study is unique because it tries to quantify the links connecting climate to mammals to ticks to humans, which requires different types of data, research techniques and academic backgrounds,” said co-author Sam Sambado, a doctoral student in the Department of Ecology, Evolution, and Marine Biology.

The researchers had two questions in mind. First, what environmental factors affect the infection rate in tick populations? Second, can this knowledge be used to predict human infections?

Diagnosis Testing And Treatment

You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.

Several weeks after infection, FDA cleared tests have very good sensitivity.

It is possible for someone who was infected with Lyme disease to test negative because:

If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.

* Silver HM. Lyme disease during pregnancy. Infect Dis Clin North Am. 1997 Mar 11:93-7.

The most common co-infections that occur with Lyme disease are anaplasmosis and babesiosis. In general:

References:

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Priority #: Improving The Detection And Diagnosis Of Other Tick

Note: References for the in-text citations can be found at the end of the document under Key Theme 1: Improving the detection and diagnosis of other tick-borne diseases and co-infections

The diagnosis of other tick-borne diseases & co-infections is dependent on the clinical context, which includes taking a proper history , reviewing symptomatology, performing a physical examination, and establishing a differential diagnosis augmented by laboratory diagnosis and detection. The following issues are essential to the accurate detection and proper diagnosis of other tick-borne illnesses and their coinfections.

Target groups: health care providers clinical testing laboratories patients and the general public.

What You Need To Know About Borrelia

Borrelia is an ancient microbe dating back 15-20 million years, and possibly even longer. Its an extremely adaptable microbe that can infect most anything with blood today, it commonly infects mammals, birds, and even some reptiles.

Infection is imperative for borrelias survival. To complete its life cycle, it must infect a new host via a tick-bite, reproduce within that host , and then reboard a new tick when the host is bitten again.

That last step reboarding a new tick is crucial. If the host is never bitten by another tick, the microbe reaches a dead end. It cant spread to new hosts. Here are some either key facts you should know about borrelia:

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Why Isnt A Test Result Enough To Tell Me If I Have Lyme

Common tests for Lyme disease include ELISAs and Western blots. Both tests work by detecting the patients antibodies reacting to the Borrelia burgdorferi bacteria. Many factors affect that response and the tests ability to measure it, and can produce both false positive and false negative results. Although the CDC recommends a two-step testing process, consisting of an ELISA as a first test, followed by a Western Blot only if the ELISA is positive or uncertain, i.e. no further testing if the first step is negative, this testing scheme is insensitive. Additionally, positive results might reflect an old, rather than current infection. This is why testing is only one part of the information that contributes to making the diagnosis.

What Are Some Of These Co

According to LymeDisease.org, the most common Lyme disease co-infections are reported in the following order from most to least common:

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Background: Why Other Tick

Co-infection of ticks with human and animal pathogens is more widespread than is commonly recognized by both medical professionals and the public. Ticks contain multiple tick-borne pathogens, which can be transmitted with a single tick bite. Some tick-borne pathogens can be transmitted within a short period of time after a tick bite , although other tick-borne pathogens such as Anaplasma, Ehrlichia, Babesia,Rickettsia and other borrelia species take longer. Transmission for some tick-borne diseases is also possible by blood transfusion , solid organ transplantation , and through maternal-fetal transmission . Increased awareness with appropriate testing and treatment is therefore important to help decrease morbidity and mortality from other tick-borne diseases and co-infections.

Table 1: Members of the Other Tick-borne Diseases and Co-infections

Table 3: Presenters to the Other Tick-borne Diseases and Co-infections

Table 4: Votes Taken by the Other Tick-borne Diseases and Co-infections subcommittee

Priority #1 Improving The Detection And Diagnosis Of Other Tick

Aguero-Rosenfeld, M., Nowakowski, J., Bittker, S., Cooper, D., B Nadelman, R., & P Wormser, G. . Evolution of the serologic response to Borrelia burgdorferi in treated patients with culture-confirmed erythema migrans. Journal of Clinical Microbiology, 34, 19.

Akoolo, L., Schlachter, S., Khan, R., Alter, L., Rojtman, A. D., Gedroic, K., Parveen, N. . A novel quantitative PCR detects Babesia infection in patients not identified by currently available non-nucleic acid amplification tests. BMC Microbiology, 17. https://doi.org/10.1186/s12866-017-0929-2

Allred, D. R. . Babesiosis: persistence in the face of adversity. Trends in Parasitology, 19, 5155. https://doi.org/10.1016/S1471-492200065-X

Beaman, M. H. . Lyme disease: why the controversy? Internal Medicine Journal, 46, 13701375. https://doi.org/10.1111/imj.13278

Bloch, E. M., Herwaldt, B. L., Leiby, D. A., Shaieb, A., Herron, R. M., Chervenak, M., Kjemtrup, A. M. . The third described case of transfusion-transmitted Babesia duncani. Transfusion, 52, 15171522. https://doi.org/10.1111/j.1537-2995.2011.03467.x

Branda, J. A., Body, B. A., :, J., Branson, B. M., Dattwyler, R. J., Fikrig, E., Schutzer, S. E. . Advances in Serodiagnostic Testing for Lyme Disease Are at Hand. Clinical Infectious Diseases, 66, 11331139. https://doi.org/10.1093/cid/cix943

Brownson, R. C., Colditz, G. A., & Proctor, E. K. . . Dissemination and implementation research in health: translating science to practice. Oxford University Press.

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Real Solutions For Chronic Immune Dysfunction

I divide options for overcoming illnesses associated with Chronic Immune Dysfunction and stealth microbes into two categories: Heroic Therapies and Restorative Therapies.

A third category of solutions, Symptomatic Therapies, is best reserved for acute relief. Specifically directed at controlling symptoms, Symptomatic Therapies come mostly in the form of prescription drugs and contribute only minimally to healing and wellness.

What Are Lyme Disease Co

When Lyme disease was first discovered in 1975, it was the only known tick-borne illness recognized by clinicians. The disease, which is caused by an infection with the bacterium Borrelia burgdorferi, is transmitted through the bite of a black-legged tick.

Today, ticks harbor multiple infectious pathogens that can be transmitted to humans through a tick bite or tainted blood transfusion. The Centers for Disease Control and Prevention now reports that a single tick can transmit multiple pathogens, including bacteria, viruses, and parasites. This can result in patients developing what is referred to as Lyme disease co-infections.

In fact, between 2004 and 2016, the CDC identified 7 new tick-borne microbes capable of infecting humans.

While most Lyme disease co-infections are acquired through the bite of an infected tick, several can be transmitted through contaminated blood transfusions. One investigation concluded, Aside from a Babesia infection, Anaplasma is the most frequent transfusion-transmitted with rapidly increasing clinical cases.

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Mapping Lyme Disease Out West

UC Santa Barbara Researchers connect human Lyme disease infections with ecological factors across California

Dusky-footed woodrats make their homes in the thick underbrush of Californias chaparral, woodlands and forests, much like the western blacklegged tick that transmits the bacterium responsible for Lyme disease.

The Most Common Lyme Disease Co

According to LDo, the most common Lyme disease co-infections are reported in the following order from most to least common:

It is also possible to be co-infected with the potentially fatal Powassan virus. Finally, while more data is needed, it should be noted that there is one species of Borrelia that causes Tick-Borne Relapsing Fever Borrelia miyamotoi that is spread by blacklegged ticks, the same ticks that spread Lyme disease. As such, doctors who suspect a patient may be infected with Lyme disease should also consider testing for Tick-Borne Relapsing Fever.

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What Should A Medical Professional Consider In Diagnosing Lyme

• Tick bite and exposure risk. A patient who recalls a tick bite should tell their medical provider. However, just because a you dont recall a tick bite doesnt mean you dont have Lyme. Many patients with Lyme disease do not recall a tick bite. Tell your doctor about your activities, and where you live and have traveled.
• Rash. A classic indicator of Lyme disease is the presence of a rash — erythema migrans , which is often called a bulls-eye rash. However, most erythema migrans do not have a bulls-eye appearance, and many patients do not recall any rash at all. It is important to consider Lyme as a diagnosis if other factors warrant it, even if a rash does not appear or is not recalled.
• Other infections sometimes cause a rash. Borrelia miyamotoi and B. mayonii also cause an EM-like rash. Anaplasma and Ehrlichia occasionally cause a diffuse pink to red, spotty rash. Bartonella has been associated with vasculitic rashes that can resemble stretch marks or scattered red lesions on various parts of the body. Other tick borne infectors, like spotted fever rickettsiae, also cause rashes, but are transmitted by different ticks.

Issue 2 Improve Diagnostic Methods For Clinical Diagnosis

Questions: Under what circumstances do we need to improve clinical diagnosis?

In order for a health care provider to consider a diagnosis and therefore pick a test, a clinical suspicion of the illness is required. The suspicion is generated by the clinical symptoms and course of development of illness described by the patient or patient representative. Multiple simultaneous infection is a fact in tickborne disease in ticks and in humans. The infections are often tick borne, and other vector borne or opportunistic infections have been documented at times to be coinfecting a single individual patient. There are a few case reports and fewer series documenting some symptoms in some simultaneous infections. Severity of symptoms is noted to be increased in coinfection with Babesia and Borrelia, and infectious potential, particularly into the central nervous system, may be augmented by Ehrlichia . This would suggest a possible worse neurological picture with Borellia–Ehrlichia coinfection.

A tick bite frequently results in two or more infections. Community health care providers need a method of reporting patients who are chronically ill. This can allow us to create case definitions and clinical descriptions of the different multiple infections thus guiding our choice of testing as well as testing developmentcreating a cohort to study.

Background

What needs to be done

Possible opportunities

Development of new and more inclusive clinical diagnosis algorithms.

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Several Species Of Bartonella

Scientists have identified several species of bartonella. Sand flies in the Andes Mountains in Peru, Colombia, and Ecuador carry one type. Human body lice worldwide carry another. European sheep ticks carry Bartonella and scientists have detected five different Bartonella strains in 19.2% of Ixodes pacificus ticks collected in California.

Potential Actions For The Working Group To Consider

Potential Action One: Increase education and awareness pre-diagnosis, and counseling after diagnosis.

Potential Action Two: Increase research and educational efforts regarding food or food-based products that contain meat allergens that pose a risk to the public following a tick bite.

Potential Action Three: Increase resources for surveillance of alpha-gal allergy in human populations within the expanding range of Amblyomma americanum.

Potential Action Four: Dedicate additional resources for surveillance and control of Amblyomma americanum across its expanding range.

Potential Action Five: Increase resources for immunologic and animal model research to identify and better understand the tick allergens that cause alpha-gal meat allergy.

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Priority #: Treatment Of Other Tick

References by Topic

Gabbys Story: The Importance of Properly Diagnosing and Treating Other Tick-borne Diseases

Zientek, Jillian, F. Scott Dahlgren, Jennifer H. McQuiston, and Joanna Regan. Self-Reported Treatment Practices by Healthcare Providers Could Lead to Death from Rocky Mountain Spotted Fever. The Journal of Pediatrics, 2, 2014): 41618. https://doi.org/10.1016/j.jpeds.2013.10.008.

Background: Why other tick-borne diseases and co-infections are important

Aliota, M. T., Dupuis, A. P., Wilczek, M. P., Peters, R. J., Ostfeld, R. S., & Kramer, L. D. . The prevalence of zoonotic tick-borne pathogens in Ixodes scapularis collected in the Hudson Valley, New York State. Vector Borne and Zoonotic Diseases, 14, 245250. https://doi.org/10.1089/vbz.2013.1475

Egizi A., Fefferman N. H., & Jordan R. A. . Relative risk for ehrlichiosis and Lyme disease in an area where vectors for both are sympatric, New Jersey, U.S.A. Emerging Infectious Diseases, 23:939945. doi:10.3201/eid2306.160528

Swanson, S. J., Neitzel, D., Reed, K. D., & Belongia, E. A. . Coinfections acquired from ixodes ticks. Clinical Microbiology Reviews, 19, 708727. https://doi.org/10.1128/CMR.00011-06

Cost to Society

Adrion, E. R., Aucott, J., Lemke, K. W., & Weiner, J. P. . Health care costs, utilization and patterns of care following Lyme disease. PLOS ONE, 10, e0116767. https://doi.org/10.1371/journal.pone.0116767

Vanderhoof I. T., Vanderhoof-Forschner K. . Lyme disease: Cost to society. Contingencies, 4248.

Table : Improving Issues Related To Pathogenesis Transmission And Treatment Of Other Tick

Prioritized List of Issues that Will be Addressed in the First Report to Congress

Key Issues 1.

Key Issue 2.

• Alpha gal allergy: How can we improve the awareness, diagnosis and treatment of alpha gal allergy? What is the pathogenesis underlying delayed anaphylaxis several hours after eating meat, and/or after being exposed to certain medical products, nutritional supplements and/or animal-based products?
• Alpha gal allergy gap: What practical steps can we take to improve the awareness, diagnosis, cause -association), pathogenicity, and treatment of this newly identified tick-borne disease?

Key Issue 3.

• Priority gap: How do co-infections compare in priority to single non-Lyme tick-borne infections in prevalence, severity, and their role in acute, chronic and persistent infections?

Appendum A:

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