< Back to Research Top Published Date 14/04/2018 Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease Journal Healthcare (Basel, Switzerland) Citation Healthcare (Basel). 2018 Apr 14;6(2). pii: E33 DOI 10.3390/healthcare6020033 Authors Middelveen MJ, Sapi E, Burke J, Filush KR, Franco A, Fesler MC, Stricker RB Abstract Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. Methods: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Results: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borreliaburgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023324 No Review Needed? Next

< Back to Research Top Published Date 01/02/2021 A murine model of Lyme disease demonstrates that Borrelia burgdorferi colonizes the dura mater and induces inflammation in the central nervous system Journal PLoS Pathogen Citation 17(2):e1009256 DOI 10.1371/journal.ppat.1009256 Authors Casselli T, Divan A, Vomhof-DeKrey EE, Tourand Y, Pecoraro HL, Brissette CA Abstract Lyme disease, which is caused by infection with Borrelia burgdorferi and related species, can lead to inflammatory pathologies affecting the joints, heart, and nervous systems including the central nervous system (CNS). Inbred laboratory mice have been used to define the kinetics of B. burgdorferi infection and host immune responses in joints and heart, however similar studies are lacking in the CNS of these animals. A tractable animal model for investigating host-Borrelia interactions in the CNS is key to understanding the mechanisms of CNS pathogenesis. Therefore, we characterized the kinetics of B. burgdorferi colonization and associated immune responses in the CNS of mice during early and subacute infection. Using fluorescence-immunohistochemistry, intravital microscopy, bacterial culture, and quantitative PCR, we found B. burgdorferi routinely colonized the dura mater of C3H mice, with peak spirochete burden at day 7 post-infection. Dura mater colonization was observed for several Lyme disease agents including B. burgdorferi, B. garinii, and B. mayonii. RNA-sequencing and quantitative RT-PCR showed that B. burgdorferi infection was associated with increased expression of inflammatory cytokines and a robust interferon (IFN) response in the dura mater. Histopathologic changes including leukocytic infiltrates and vascular changes were also observed in the meninges of infected animals. In contrast to the meninges, we did not detect B. burgdorferi, infiltrating leukocytes, or large-scale changes in cytokine profiles in the cerebral cortex or hippocampus during infection; however, both brain regions demonstrated similar changes in expression of IFN-stimulated genes as observed in peripheral tissues and meninges. Taken together, B. burgdorferi is capable of colonizing the meninges in laboratory mice, and induces localized inflammation similar to peripheral tissues. A sterile IFN response in the absence of B. burgdorferi or inflammatory cytokines is unique to the brain parenchyma, and provides insight into the potential mechanisms of CNS pathology associated with this important pathogen. URL Previous https://pubmed.ncbi.nlm.nih.gov/33524035/ No Review Needed? Next

< Back to Research Top Published Date 08/08/2018 The Persistent Lyme Disease: "True Chronic Lyme Disease" rather than "Post-treatment Lyme Disease Syndrome" Journal Journal of Global Infectious Diseases Citation J Glob Infect Dis. 2018 Jul-Sep;10(3):170-171 DOI 10.4103/jgid.jgid_152_17 Authors Lacout A, El Hajjam M, Marcy PY, Perronne C Abstract A controversy continues regarding the reality of a chronic form of Lyme disease. Chronic Lyme disease can present as a "post-Lyme syndrome" explained by inflammatory and immunological phenomena, or as a genuine "chronic form" attributable to the persistence of the bacteria despite proper antibiotic therapy as per the current guidelines. The current guidelines however may not be so appropriate in the latter case. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6100330 No Review Needed? Next

< Back to Research Top Published Date 24/06/2019 Molecular Testing of Serial Blood Specimens from Patients with Early Lyme Disease during Treatment Reveals Changing Coinfection with Mixtures of Borrelia burgdorferi Genotypes Journal Antimicrobial Agents and Chemotherapy Citation Antimicrob Agents Chemother. 2019; 63 (7) DOI 10.1128/AAC.00237-19 Authors Mosel MR, Carolan HE, Rebman AW, Castro S, Massire C, Ecker DJ, Soloski MJ, Aucott JN, Eshoo MW Abstract Borrelia burgdorferi is the etiological agent of Lyme disease. In the current study, we used direct-detection PCR and electrospray ionization mass spectrometry to monitor and genotype B. burgdorferi isolates from serially collected whole-blood specimens from patients clinically diagnosed with early Lyme disease before and during 21 days of antibiotic therapy. B. burgdorferi isolates were detected up to 3 weeks after the initiation of antibiotic treatment, with ratios of coinfecting B. burgdorferi genotypes changing over time. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/31036693 No Review Needed? Next

< Back to Research Top Published Date 01/07/2014 Pathogenicity and treatment of Bartonella infections Journal The International Journal of Antimicrobial Agents Citation Int J Antimicrob Agents. 2014 Jul;44(1):16-25 DOI 10.1016/j.ijantimicag.2014.04.006 Authors Angelakis E, Raoult D Abstract Bartonella spp. are responsible for emerging and re-emerging diseases around the world. The majority of human infections are caused by Bartonella henselae, Bartonella quintana and Bartonella bacilliformis, although other Bartonella spp. have also been associated with clinical manifestations in humans. The severity of Bartonella infection correlates with the patient's immune status. Clinical manifestations can range from benign and self-limited to severe and life-threatening disease. Clinical conditions associated with Bartonella spp. include local lymphadenopathy, bacteraemia, endocarditis, and tissue colonisation resulting in bacillary angiomatosis and peliosis hepatis. Without treatment, Bartonella infection can cause high mortality. To date, no single treatment is effective for all Bartonella-associated diseases. In the absence of systematic reviews, treatment decisions for Bartonella infections are based on case reports that test a limited number of patients. Antibiotics do not significantly affect the cure rate in patients with Bartonella lymphadenopathy. Patients with Bartonella spp. bacteraemia should be treated with gentamicin and doxycycline, but chloramphenicol has been proposed for the treatment of B. bacilliformis bacteraemia. Gentamicin in combination with doxycycline is considered the best treatment regimen for endocarditis, and erythromycin is the first-line antibiotic therapy for the treatment of angioproliferative lesions. Rifampicin or streptomycin can be used to treat verruga peruana. In this review, we present recent data and recommendations related to the treatment of Bartonella infections based on the pathogenicity of Bartonella spp. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/24933445 No Review Needed? Next

< Back to Research Top Published Date 20/03/2019 Presence of Babesia odocoilei and Borrelia burgdorferi Sensu Stricto in a Tick and Dual Parasitism of Amblyomma inornatum and Ixodes scapularis on a Bird in Canada Journal Healthcare (Basel, Switzerland) Citation Healthcare (Basel). 2019 Mar 20;7(1). pii: E46 DOI 10.3390/healthcare7010046 Authors Scott JD, Clark KL, Durden LA Abstract Wild birds transport ticks into Canada that harbor a diversity of zoonotic pathogens. However, medical practitioners often question how these zoonotic pathogens are present in their locality. In this study, we provide the first report of an Amblyomma inornatum tick cofeeding with a blacklegged tick, Ixodes scapularis, which parasitized a Veery, Catharus fuscescens-a neotropical songbird. Using the flagellin (flaB) gene of the Lyme disease bacterium, Borrelia burgdorferi sensu lato, and the 18S rRNA gene of the Babesia piroplasm, a malaria-like microorganism, we detected Borrelia burgdorferi sensu stricto and Babesia odocoilei, respectively, in an I. scapularis nymph. After the molt, these ticks can bite humans. Furthermore, this is the first-ever documentation of B. odocoilei in a tick parasitizing a bird. Our findings substantiate the fact that migratory songbirds transport neotropical ticks long distances, and import them into Canada during northward spring migration. Health care practitioners need to be aware that migratory songbirds transport pathogen-laden ticks into Canada annually, and pose an unforeseen health risk to Canadians. URL Previous https://www.mdpi.com/2227-9032/7/1/46 No Review Needed? Next

< Back to Research Top Published Date 16/06/2020 Interrupted Blood Feeding in Ticks: Causes and Consequences Journal Microorganisms Citation 8(6):910 DOI 10.3390/microorganisms8060910 Authors Tahir D, Meyer L, Fourie J, Jongejan F, Mather T, Choumet V, Blagburn B, Straubinger RK, Varloud M Abstract Ticks are obligate hematophagous arthropods and act as vectors for a great variety of pathogens, including viruses, bacteria, protozoa, and helminths. Some tick-borne viruses, such as Powassan virus and tick-borne encephalitis virus, are transmissible within 15-60 min after tick attachment. However, a minimum of 3-24 h of tick attachment is necessary to effectively transmit bacterial agents such as Ehrlichia spp., Anaplasma spp., and Rickettsia spp. to a new host. Longer transmission periods were reported for Borrelia spp. and protozoans such as Babesia spp., which require a minimum duration of 24-48 h of tick attachment for maturation and migration of the pathogen. Laboratory observations indicate that the probability of transmission of tick-borne pathogens increases with the duration an infected tick is allowed to remain attached to the host. However, the transmission time may be shortened when partially fed infected ticks detach from their initial host and reattach to a new host, on which they complete their engorgement. For example, early transmission of tick-borne pathogens (e.g., Rickettsia rickettsii, Borrelia burgdorferi, and Brucella canis) and a significantly shorter transmission time were demonstrated in laboratory experiments by interrupted blood feeding. The relevance of such situations under field conditions remains poorly documented. In this review, we explore parameters of, and causes leading to, spontaneous interrupted feeding in nature, as well as the effects of this behavior on the minimum time required for transmission of tick-borne pathogens. Keywords: interrupted blood feeding; ixodid ticks; pathogens; transmission time. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355616/ No Review Needed? Next

< Back to Research Top Published Date 30/08/2012 A new phlebovirus associated with severe febrile illness in Missouri Journal The New England Journal of Medicine Citation N Engl J Med. 2012 Aug 30;367(9):834-41 DOI 10.1056/NEJMoa1203378 Authors McMullan LK, Folk SM, Kelly AJ, MacNeil A, Goldsmith CS, Metcalfe MG, Batten BC, Zaki SR, Rollin PE, Nicholson WL, Nichol ST, Albarino CG Abstract Two men from northwestern Missouri independently presented to a medical facility with fever, fatigue, diarrhea, thrombocytopenia, and leukopenia, and both had been bitten by ticks 5 to 7 days before the onset of illness. Ehrlichia chaffeensis was suspected as the causal agent but was not found on serologic analysis, polymerase-chain-reaction (PCR) assay, or cell culture. Electron microscopy revealed viruses consistent with members of the Bunyaviridae family. Next-generation sequencing and phylogenetic analysis identified the viruses as novel members of the phlebovirus genus. Although Koch's postulates have not been completely fulfilled, we believe that this phlebovirus, which is novel in the Americas, is the cause of this clinical syndrome. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/22931317 No Review Needed? Next

< Back to Research Top Published Date 11/06/2021 Examining prevalence and diversity of tick-borne pathogens in questing Ixodes pacificus ticks in California Journal Applied Environmental Microbiology Citation AEM.00319-21 DOI 10.1128/AEM.00319-21 Authors Salkeld DJ, Lagana DM, Wachara J, Porter WT, Nieto NC Abstract Tick-borne diseases in California include Lyme disease (caused by Borrelia burgdorferi), infections with Borrelia miyamotoi, and human granulocytic anaplasmosis (caused by Anaplasma phagocytophilum). We surveyed multiple sites and habitats (woodland, grassland, coastal chaparral) in California to describe spatial patterns of tick-borne pathogen prevalence in western black-legged ticks (Ixodes pacificus). We found that several species of Borrelia - B. burgdorferi , B. americana and B. bissettiae - were observed in habitats such as coastal chaparral that does not harbor obvious reservoir host candidates. Describing tick-borne pathogen prevalence is strongly influenced by the scale of surveillance: aggregating data from individual sites to match jurisdictional boundaries (e.g., county or state) can lower the reported infection prevalence. Considering multiple pathogen species in the same habitat allows a more cohesive interpretation of local pathogen occurrence.ImportanceUnderstanding the local host ecology and prevalence of zoonotic diseases is vital for public health. Using tick-borne diseases in California, we show that there is often a bias to our understanding and that studies tend to focus on particular habitats e.g., Lyme disease in oak woodlands. Other habitats may harbor a surprising diversity of tick-borne pathogens but have been neglected, e.g., coastal chaparral. Explaining pathogen prevalence requires descriptions of data at a local scale; otherwise, aggregating the data can misrepresent the local dynamics of tick-borne diseases. URL Previous https://aem.asm.org/content/early/2021/04/15/AEM.00319-21.long No Review Needed? Next

< Back to Research Top Published Date 03/04/2019 Detection of tick-borne pathogens in questing Ixodes ricinus in the French Pyrenees and first identification of Rickettsia monacensis in France Journal Parasite Citation Parasite. 2019;26:20 DOI 10.1051/parasite/2019019 Authors Akl T, Burggoin G, Soug ML, Appolinaire J, Poirel MT, Gibert P, Abi Rizk G, Garel M, Zenner L Abstract Ticks are important vectors of several human and animal pathogens. In this study, we estimated the prevalence of important tick-borne infections in questing ticks from an area in Southwestern France (Hautes-Pyr?n?es) inhabited by Pyrenean chamois (Rupicapra pyrenaica pyrenaica) experiencing high tick burden. We examined adult and nymph ticks collected by the flag dragging method from 8 to 15 sites in the Pic de Baz?s during the years 2009, 2011, 2013 and 2015. PCR assays were conducted on selected ticks for the detection of Borrelia burgdorferi s.l., Babesia spp., Rickettsia spp., spotted fever group (SFG) Rickettsia and Anaplasma phagocytophilum. Randomly selected positive samples were submitted for sequence analysis. A total of 1971 questing ticks were collected including 95 males, 101 females and 1775 nymphs. All collected ticks were identified as Ixodes ricinus. Among them, 696 ticks were selected for pathogen detection and overall prevalence was 8.4% for B. burgdorferi s.l.; 0.4% for Babesia spp.; 6.1% for A. phagocytophilum; 17.6% for Rickettsia spp.; and 8.1% for SFG Rickettsia. Among the sequenced pathogens, we detected in this population of ticks the presence of Babesia sp. EU1 and Rickettsia helvetica, as well as Rickettsia monacensis for the first time in France. The detection of these pathogens in the Pic de Baz?s highlights the potential infection risks for visitors to this area and the Pyrenean chamois population. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447091 No Review Needed? Next

< Back to Research Top Published Date 01/02/2012 Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here? Journal Quality of Life Research Citation Qual Life Res. 2013 Feb;22(1):75-84 DOI 10.1007/s11136-012-0126-6 Authors Aucott JN, Rebman AW, Crowder LA, Kortte KB Abstract PURPOSE: A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatmentLyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time. METHODS: Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months. RESULTS: Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than "minimal" depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months. CONCLUSIONS: Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms. URL Previous https://link.springer.com/article/10.1007%2Fs11136-012-0126-6 No Review Needed? Next

< Back to Research Top Published Date 16/04/2021 One man, three tick-borne illnesses Journal BMJ Case Reports Citation 14(4):e241004 DOI 10.1136/bcr-2020-241004 Authors Grant L, Mohamedy I, Loertscher L Abstract A 70-year-old man presented to the emergency department with fevers, ankle edema and nausea following a presumed insect bite on his ankle 1 month prior. On examination, he was febrile and had left leg pain with passive range of motion. Laboratory studies revealed anemia, thrombocytopenia, acute kidney injury and elevated aminotransaminases. Due to his recent travel to the Northeastern United States, he was suspected of having a possible tick-borne illness. Serologies were positive for Borrelia burgdorferi, Anaplasma phagocytophilum and Babesia microti, and the patient was diagnosed with Lyme disease, babesiosis and anaplasmosis. He was treated with doxycyline, atovaquone and azithromycin, leading to resolution of symptoms. While co-infection with Lyme disease is common, infection with three tickborne illnesses at one time is relatively rare. Keywords: disease and health outcomes; drugs: infectious diseases; infectious diseases; medical management. URL Previous https://pubmed.ncbi.nlm.nih.gov/33863772/ No Review Needed? Next