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Article by Natasha Metcalf, of patient support group Lyme Disease UK
In addition to Lyme disease, ticks also carry numerous other infections and these vectors are often referred to as ‘dirty needles’. According to one study, ‘ticks transmit more pathogens than any other arthropod’ (Moutallier et al, 2016).
The NHS don’t always test for Lyme disease, let alone other tick-borne infections but it is important to be aware of their existence as, for some patients, they can be a significant complicating factor in the clinical picture. Patients suffering from Lyme disease are usually immunosuppressed and so opportunistic infections are often able to get a stronghold. A patient survey conducted by Caudwell Lyme Disease, involving 500 patients, revealed that 95% of Lyme sufferers participating have at least one co-infection.
‘The ticks that carry the pathogen of Lyme disease can harbor many other organisms, some known to cause serious human disease…for patients who suffer these infections in combination with Lyme, illness can be especially severe. These infections don’t respond to all antibiotics used against Lyme disease’
– Pamela Weintraub
‘Coinfection rates in people have been found to be between 39% and 60% in some Lyme-endemic areas’
– Stephen Harrod Buhner’
Some of the tick-borne co-infections and their symptoms are outlined below:
Anaplasma and Ehrlichia are gram-negative bacterial infections from the rickettsiales genus which affect white blood cells. Both can be transmitted through the bite of an infected tick, through blood transfusions or organ transplants and they can also be fatal in immunosuppressed patients.
Symptoms and complications: confusion, exhaustion, headaches, abnormal gait, ulcers, anorexia, abdominal pain, muscle pain (in particular shoulders and hips), fever, rashes, flu-like symptoms, jaundice, nausea, sweats, photophobia, conjunctivitis, enlarged liver, enlarged spleen, elevated liver enzymes, low white blood cell count, low platelet count, anemia, myocarditis, renal failure, respiratory issues.
Regions of danger include Britain, Europe and the US.
Babesia is a malaria-like protozoal parasite which attacks red blood cells. The infected red blood cells are eventually destroyed and cell fragments can then lead to blocked capillaries and also put a strain on the liver and spleen. Over 20 species of Babesia carried by ticks have been identified but only a few are known to cause disease in humans. In 2006, The American Red Cross expressed concerns about the infection being spread via the blood supply and it can also be transmitted from mother to foetus. Babesia can be fatal for anyone with a compromised immune system.
Symptoms and complications: night sweats, fevers, chills, lethargy, headaches (around the front of the head), cough, air hunger/shortness of breath, insomnia, fatigue, depression, anxiety, chest pain, hip pain, intolerance to heat and cold, agitation and suicidal ideation, encephalopathy, low blood pressure, low platelet count, jaundice,disseminated intravascular coagulation, hemolytic anemia, renal failure, respiratory failure, congestive heart failure.
Regions of danger include Britain, Europe and the US.
‘About 80% of people who are coinfected at the time of the tick bite have been found to have babesia in addition to Lyme’
– Stephen Harrod Buhner
Bartonella is a gram-negative, intracellular bacteria which takes up residence in the endothelial cells and from there, attacks the red blood cells. Bartonella affects the central nervous system and the brain and it is also believed to infect bone marrow. Inflammation of the vascular system can occur and effects of Bartonella have even shown up on SPEC scans as changes in the white matter of the brain. There are over 28 sub-species of Bartonella and at least 4 cause disease in humans. Bartonella can be transmitted by ticks, mosquitoes, fleas, lice, biting flies as well as from the scratch of an infected cat (Cat scratch fever). It is also possible that the infection can be passed from mother to foetus.
Symptoms and complications: raised papule and/or pustule on skin, stretch-mark type skin manifestations, neuropsychiatric issues, neuropathy, depression, anxiety, rage, sudden changes in mood, cognitive impairment, bone pain (shins, neck and back), subcutaneous nodules on extremeties, low-grade fever, tremors, muscle twitching, fatigue, abdominal pain, seizures, burning or numbness on the soles of the feet, tingling and numbness, visual disturbances and other opthalmological symptoms, balance problems, ataxia, irritable bladder, severe joint pain , swollen glands, headaches around the back of the head, conjunctivitis raised liver enzymes, endocarditis, gastritis, anemia, bacillary angiomatosis and bacillary peliosis.
Regions of dangers include Britain, Europe and the US.
Brucella is a gram negative intracellular infection which can potentially be acquired from a tick bite as the bacteria has been detected in ticks. It is most commonly spread by consuming contaminated, unpasteurised milk or raw meat. The infection can also be caught by inhaling contaminated dust or through skin abrasion contact with infected animals or from handling contaminated blood samples. There have also been cases where Brucella has been spread from person to person sexually, in utero and via breast milk. Brucella can affect every organ of the body and initially, people can be be asymptomatic. However, the infection can persist and recur and complications can be fatal.
Symptoms and complications: cyclical fevers, foul smelling sweat, headaches, urinary tract infections, joint pain, cough, gastrointestinal issues, weight loss, swollen glands, depression, enlarged spleen and liver, optic neuritis, endocarditis, meningitis, liver abscesses, arthritis, spondylitis.
Regions of danger include mainlly southern Europe, and also the US.
Q fever is a gram negative intracellular infection caused by the bacteria Coxiella burnetii which can be transmitted by a tick bite. The bacteria has been found in over 40 species of tick and it can also be contracted by consuming contaminated animal products (unpasteurised milk) and by being exposed to infected animals’ wool, fur, hide, blood, urine, sexual fluids, amniotic fluids and placentas. It can also be transmitted by handling contaminated soil or animal bedding. Q fever can be transmitted sexually and from mother to foetus. People can have Q fever and be asymptomatic but it can also cause chronic disease often involving cardiac complications and can pose risks during pregnancy.
Symptoms and complications: fevers, weight loss, muscle pain, sweats, muscle pain, joint pain, headaches, chills, confusion, dry cough, respiratory issues, nausea, gastrointestinal disturbances, mengioencephalitis, pneumonia, granulomatous hepatitis, liver enlargement, endocarditis, retinal vasculitis.
Regions of danger include continental Europe in particular; there has recently been an epidemic of Q-fever in the Netherlands.
Tick-borne encephalitis is a viral infection transmitted by ticks belonging to the flavivirus genus. This infection affects the central nervous system. According to NHS Choices, this infection cannot be caught in the UK but it is found in some European and Asian countries. People can recover from the infection after a period of approximately a week but in some cases, more serious symptoms and complications can occur.
Symptoms/complications: flu-like symptoms, fever, headache, fatigue, muscle pain, meningitis, encephalitis, cognitive dysfunction, seizures, photophobia, paralysis.
Regions of danger include Africa and parts of southern Europe and Asia.
Toxoplasmosis is a parasitic disease found in infected meat, contaminated unwashed vegetables and cat feces but it can also be transmitted by a tick bite, from mother to foetus and by blood transfusion or organ transplant. Often, people do not experience symptoms when they contract toxoplasmosis but for people with weakened immune systems, symptoms and complications can manifest. Complications can also occur if a woman is infected with toxoplasmosis during pregnancy such as miscarriages, stillbirths and birth defects.
Symptoms and complications: flu-like symptoms, skin lesions, hives, swollen glands, muscle aches, fevers, cognitive dysfunction, poor coordination, lung issues, visual issues, seizures.
Regions of danger are worldwide.
Tularemia is an intracellular infection caused by the bacteria Francisella tularensis and it can be transmitted by biting flies as well as ticks. Those infected may notice a lesion at the site of the bite which then forms a papule/ulcer and which has a black base. Tularemia can cause very severe pneumonia.
Symptoms and complications: pneumonia, fatigue, signs of sepsis, skin ulcers, swollen glands, runny nose, chills, fever, headache, gastrointestinal issues, nausea, ulcers, conjunctivitis and other opthalmological symptoms.
Buhner, S.H. (2005). Healing Lyme: Naturally Healing and Prevention of Lyme Borreliosis and Its Coinfections. Silver City: Raven Press.
Horowitz, R.I. (2013). Why Can’t I Get Better? Solving the Mystery of Lyme and Chronic Disease. New York: St Martin’s Griffin
Moutallier et al. (2016). Co-infection of Ticks: The Rule Rather Than the Exception. PLoS Negl Trop Dis 10(3): doi:10.1371/journal.pntd.0004539
Weintraub, P. (2008). Cure Unknown. New York: St Martin’s Griffin
Williams, M. (2011). Nature’s Dirty Needle. San Francisco: Bush Street Press
Zheludko, M.M. (2013), Reservoirs of Brucella Infection. Biology Bulletin. December 2010, Volume 37, Issue 7, pp 709-715
Featured photograph by Michela Metcalf