Bartonellosis, One Health and all creatures great and small

Dr Breitschwerdt’s recently published paper:- Bartonellosis, One Health and all creatures great and small https://www.ncbi.nlm.nih.gov/pubmed/28133871 Dr Breitscherdt reviews Bartonellosis, zoonotic infections which are found Worldwide, caused by an expanding number of recently discovered Bartonella species.  RESULTS: Of comparative medical importance, Bartonella spp. are transmitted by several arthropod vectors, including fleas, keds, lice, sand flies, ticks and, potentially, mites and spiders. Prior to 1990, there was only one named Bartonella species (B. bacilliformis), whereas there are now over 36, of which 17 have been associated with an expanding spectrum of animal and human diseases. Recent advances in diagnostic techniques have facilitated documentation of chronic bloodstream and dermatological infections with Bartonella spp. in healthy and sick animals, in human blood donors, and in immunocompetent and immunocompromised human patients. The field of Bartonella research remains in its infancy and is rich in questions, for which patient relevant answers are badly needed. Directed Bartonella research could substantially reduce a spectrum of chronic and debilitating animal and human diseases, and thereby reduce suffering throughout the world.  CONCLUSION: A One Health approach to this emerging infectious disease is clearly needed to define disease manifestations, to establish the comparative infectious disease pathogenesis of this stealth pathogen, to validate effective treatment regimens and to prevent zoonotic disease transmission.   Earlier posts on this emerging infectious disease can be found:-   Understanding Bartonella   Bartonellosis: One health perspectives on an emerging infectious disease   Through the search feature on the web version of this blog- Breitschwerdt Vector Infection Symposiums Also of interest –  Dr. Robert Mozayeni is a rheumatologist with graduate and post-graduate physician-scientist training from Albany Medical College, Yale University,...

Ticks in UK – ticks found to carry Borrelia s.l and Borrelia Miyamotoi in peri-urban and urban areas.

Ticks and Borrelia in urban and peri-urban green space habitats in a city in southern England Abstract Ticks are becoming increasingly recognised as important vectors of pathogens in urban and peri-urban areas, including green space used for recreational activities. In the UK, the risk posed by ticks in such areas is largely unknown. In order to begin to assess the risk of ticks in urban/peri-urban areas in southern England, questing ticks were collected from five different habitat types (grassland, hedge, park, woodland and woodland edge) in a city during the spring, summer and autumn of 2013/2014 and screened for Borrelia burgdorferi sensu lato. In addition, seasonal differences in B. burgdorferi s.l. prevalence were also investigated at a single site during 2015. Ixodes ricinus presence and activity were significantly higher in woodland edge habitat and during spring surveys. DNA of Borrelia burgdorferi s.l. was detected in 18.1% of nymphs collected across the 25 sites during 2013 and 2014 and two nymphs also tested positive for the newly emerging tick-borne pathogen B. miyamotoi. Borrelia burgdorferi s.l. prevalence at a single site surveyed in 2015 were found to be significantly higher during spring and summer than in autumn, with B. garinii and B. valaisiana most commonly detected. These data indicate that a range of habitats within an urban area in southern England support ticks and that urban Borrelia transmission cycles may exist in some of the urban green spaces included in this study. Sites surveyed were frequently used by humans for recreational activities, providing opportunity for exposure to Borrelia infected ticks in an urban/peri-urban space that might not be typically associated with...

INFORMATION BIAS – LYME DISEASE

‘Sin Lee, a pathologist and scientist, believes the deck is stacked in the quest to air new ideas on Lyme disease. Too many science journals telling him to take his research elsewhere. Too many deftly worded rejections. Too little inclination to engage in a fair fight over the facts and fiction of Lyme disease.’   “I’ve tried to publish in many journals,” Christian Perronne, a physician on the infectious diseases faculty at the University of Versailles-St Quentin, France, told a conference in Norway in 2014 and repeated those assertions when I spoke with him. “If you try to publish a little bit different from the guidelines, it’s anti-science.”   The above extracts are from:- Flunk the Lyme test? Just wait and get sicker   An article in the Huffington post written by Investigitive jourmalist Mary Beth Pfeiffer, read the full article here:-  http://www.huffingtonpost.com/entry/flunk-the-lyme-test-just-wait-and-get-sicker_us_5873ef2fe4b08052400ee537?    Mary Beth Pfeiffer has had many articles published related to Lyme Disease, perhaps one of her more well known ones was that over a five year delay of responding to FOIA request to CDC, discussed in this article:-  http://www.poughkeepsiejournal.com/story/news/health/lyme-disease/2014/03/25/lyme-emails/6881349/    The detailed interactive map of the Ad Hoc group that was exposed, no longer seems available but more information can be read here :- http://ire.org/blog/transparency-watch/2013/05/20/foia-request-cdc-took-five-years-fulfill/   Mary Beth Pfeiffer is writing a book  “The First Epidemic” on the global spread of ticks and the diseases they carry, due to be published in...

THE EYE AND TICK-BORNE DISEASE

The eye and tick-borne disease in the United States Sathiamoorthi, Saraniya; Smith, Wendy M.   Abstract   Purpose of review:Tick-borne diseases are increasing in incidence and geographic distribution. Several diseases endemic to the United States have ophthalmic manifestations, including the most common tick-borne disease, Lyme borreliosis. As ocular complaints may lead a patient to seek medical evaluation, it is important to be aware of the systemic and ophthalmic manifestations of tick-borne diseases in order to make the correct diagnosis. Recent findings:Vision-threatening ophthalmic manifestations are relatively common in Lyme disease and Rocky Mountain spotted fever. Ocular involvement is rare in babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever.There are clear guidelines for diagnosis and treatment of Lyme disease; however, confusion and misinformation among the general public as well as controversy about chronic or late-stage Lyme disease can impact the evaluation of ophthalmic disease. Furthermore, there are many gaps in our knowledge regarding the pathophysiology of ocular borreliosis although it seems likely that Lyme uveitis is rare in the United States. Summary: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. http://journals.lww.com/co-ophthalmology/Abstract/2016/11000/The_eye_and_tick_borne_disease_in_the_United.10.aspx Interesting observations have been made by Dr Daniel Cameron in his all things Lyme blog http://danielcameronmd.com/growing-list-eye-problems-lyme-disease/   The authors described patients with tick-transmitted diseases presenting with the following ophthalmologic findings:   Follicular conjunctivitis Periorbital edema and mild photophobia Bell’s palsy, cranial nerve palsies and Horner syndrome Argyll Robertson pupil Keratitis Optic neuritis, papilledema, papillitis and neuroretinitis Myositis of extraocular muscles and dacryoadenitis Episcleritis, anterior and posterior scleritis Anterior, intermediate, posterior and panuveitis...

TICK-BORNE DISEASES SYMPOSIUM 2016

        I know one or two of you will be interested to hear how the Vis-a-vis symposium went om Saturday 01.10.16. Brilliant, is probably the best way I would describe it – by far one of the best conferences/symposiums I have been to on Lyme Disease in the UK. Perhaps the best bit was knowing there were Doctors, Consultants, Researchers and Veterinarians all listening attentively (and some taking copious notes) to the excellent presentations. Prof Hany Elsheikha, Veterinary Parasitology/Human/animal/Public Health from UK, gave an informative presentation, encouraging the audience to understand the clear and abundant presence of Ticks and the complexity of the numbers of pathogens they are able to transmit. The problems over testing and difficulties with diagnosis. Dr Jack Lambert Infectious and Tropical Diseases doctor from Ireland gave an outstanding presentation telling the audience the situation – how in other infectious diseases they acknowledged the limitations of testing and often treated empirically which is what he has been doing with considerable success with his suspected Lyme Disease patients. He talked about a study of 100 patients and how many had a good response to treatment in the just over 60% patients who chose to have the antibiotics or combination antibiotics he recommends (not everyone will opt for antibiotics, the patient has choices to make). It was so refreshing to hear so many positive comments about supporting this patient section. He also discussed a long list of suggested testing for a number of tick associated infections and immune markers plus the usual blood tests. Dr Carsten Nicolaus, Internal Medicine and Tick Borne Diseases from Germany, gave...

CDC study on Cat Scratch Disease – Bartonella Henselae – finds a substantial burden of disease

New research from CDC on Cat scratch disease has just been published in the journal Emerging Infectious Disease.  Cat-Scratch Disease in the United States, 2005–2013 Abstract Cat-scratch disease (CSD) is mostly preventable. More information about the epidemiology and extent of CSD would help direct prevention efforts to those at highest risk. To gain such information, we reviewed the 2005–2013 MarketScan national health insurance claims databases and identified patients <65 years of age with an inpatient admission or outpatient visit that included a CSD code from the International Classification of Diseases, Ninth Revision, Clinical Modification. Incidence of CSD was highest among those who lived in the southern United States (6.4 cases/100,000 population) and among children 5–9 years of age (9.4 cases/100,000 population). Inpatients were significantly more likely than outpatients to be male and 50–64 years of age. We estimate that each year, 12,000 outpatients are given a CSD diagnosis and 500 inpatients are hospitalized for CSD. Prevention measures (e.g., flea control for cats) are particularly helpful in southern states and in households with children. and – “CSD causes a substantial burden of disease nationwide and disproportionately affects children. Because CSD is a zoonotic infection that is maintained and spread among cats by fleas, comprehensive flea control for cats can help reduce the risk for human infection. Risk may also be reduced by washing hands after contact with cats, to remove potentially infectious flea feces that could enter breaks in the skin. Furthermore, because cats that hunt outdoors are at substantially greater risk for B. henselae bacteremia (17), limiting hunting activity of cats may reduce risk for human infection. Educational efforts...

TICKS FOUND ON 1 in 3 DOGS IN THE UK

The results of The Big Tick Project were announced by the media at the start of September following a collaboration between MSD Animal Health and Bristol University, this was accompanied by the launch of a new Tick Awareness Month Campaign by TV presenter Chris Packham.   Ticks infesting domestic dogs in the UK: a large-scale surveillance programme Research published 7 July 2016 Parasites & Vectors   http://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-016-1673-4   The largest study of ticks found on dogs in the UK showed nearly one in three dogs were infested. The Big Tick Project analysed ticks collected by vet practices across the UK and found almost a third of dogs (31%) checked at random during a visit to a vet were carrying a tick. The Big Tick Project saw 1,094 veterinary practices from across the UK participate in the 16 week study. Over this period 12,092 dogs were chosen at random for a tick inspection. Scientists received 6,551 tick samples for analysis.   Prof Richard Wall  at the University of Bristol said  ” We were overwhelmed by the veterinary profession’s support for the Big Tick Project – the vast number of ticks collected and analysed make this a robust study the results of which can only help to further raise awareness of the risk to pets and people from ticks. In Great Britain the distribution of ticks is estimated to have expanded in the last 10 years by 17% and the abundance of ticks to have increased at 73% of locations surveyed.”    Surprisingly, dogs that were restricted to urban habitats were no less likely to have ticks than dogs exposed to more rural...

RESEARCH GRANT – Enhanced Testing for the Diagnosis of Bartonellosis in Dogs

The American Kennel Club Canine Health Foundation 07/25/2016 The AKC Canine Health Foundation (CHF), a nonprofit organization whose mission is to prevent, treat and cure diseases in all dogs, announces a second round of new grants awarded through its Tick-Borne Disease Initiative. This comprehensive Initiative addresses important health concerns that include Lyme disease, bartonellosis, and ehrlichiosis, through much-needed research in diagnostics, disease pathogenesis and prevalence. Edward B. Breitschwerdt, DVM, DACVIM, of North Carolina State University, will study “Enhanced Testing for the Diagnosis of Bartonellosis in Dogs.” Bartonellosis is a potentially life-threatening zoonotic disease distributed throughout the world by approximately ten different Bartonella bacteria species. Bartonella bacteria are transmitted to dogs and humans by ticks, fleas, lice, mites, and sand flies. Due to a lack of sensitive and reliable diagnostic tests, definitive diagnosis of bartonellosis in dogs remains a significant problem. Because these bacteria invade cells and infect tissues throughout the body, this chronic intracellular infection is difficult to cure with currently used antibiotic regimens. Dr. Breitschwerdt and his team aim to develop improved blood tests for bartonellosis in dogs that can also be used for world-wide sero-epidemiological prevalence studies, and to establish early and accurate diagnosis. Go to this link to read further on the various awards of grants :- http://www.akcchf.org/news-events/news/tick-borne-disease-initiative-second-round-funding.html  Research Program Area: Immunology and Infectious Disease Donate to Support this Grant   ABSTRACT Bartonellosis, a zoonotic disease of worldwide distribution, is caused by approximately 10 different Bartonella species. Bartonella are transmitted to canines and humans by ticks, fleas, lice, mites, and sand flies. Dr. Breitschwerdt’s laboratory demonstrated the first evidence for Bartonella infections in dogs in 1993....

Lyme Disease and Borrelia species spirochetes.

Michael J Cook Lyme disease was named by Alan Steere to cover an arthritic illness in juveniles in the townships of Lyme and Old Lyme in Connecticut. In 1984 Willy Burgdorfer determined the cause to be an infection with a species of borrelia spirochete subsequently named after him.  The U.S. Centers for Disease Control and Prevention has defined Lyme disease as being transmitted by Borrelia burgdorferi carried by Ixodes scapularis ticks. In Europe where the disease was first described by Afzelius in 1910, the definition includes other species of borrelia including B. afzelii and B. garinii, carried I. ricinus and I. persulcatus species of ticks.  In 1874 the first cases of Relapsing Fever were reported and the cause attributed to a borrelia species named B. recurrensis carried by the human louse.  Between 1874 and 1984 another 17 borrelia species were identified as causing Relapsing Fever. All were carried by soft bodied ticks of the genus Ornithodoros.  From 1984 until now 19 species of borrelia spirochetes have been assigned to the Lyme Borreliosis group, all are carried by hard bodied ticks. Based on disease symptoms and records of the presence of only one species in a patient, it is now demonstrated that more than B afzelii, B burgdorferi and B garinii are associated with Lyme disease and Lyme like illnesses. With evidence for 10 species definitively causing disease a more appropriate name is Lyme Borreliosis. The following 2 charts show the assigned date of discovery of 47 species borrelia, and the 19 species currently classed within the Lyme Borreliosis group including a species with the proposed name of B. mayonii...