Focus on the Co-Infections Richard I. Horowitz, a doctor specializing in internal medicine, is the author of the forthcoming "Why Can’t I Get Better?: Solving the Mystery of Lyme and Chronic Disease." UPDATED AUGUST 12, 2013, 11:38 AM Over the last few months the news media has begun covering what many doctors already knew: there are two newly discovered pathogens transmitted by ticks that endanger our health. One, Borrelia miyamotoi, is a strain of bacteria that resembles the organism that causes Lyme disease. It causes relapsing fevers as well as a Lyme-like illness, complete with fatigue, joint and muscle pain, headaches and severe neurological symptoms. There is no widely available blood test for this bacterium, and it is transmitted by the same ticks that carry Lyme. The existence of these co-infections explain why some people with Lyme remain chronically ill even after treatment. The other pathogen, a virus known as Powassan encephalitis, can be transmitted in as little as 15 minutes, and may be deadly in up to 30 percent of cases. Again, it is transmitted by the same tick that carries Lyme disease. These pathogens join a rapidly expanding list of other bacteria, viruses and parasites that are transmitted by tick bites, including ehrlichia, anaplasma and babesia (a malaria-like parasite that creates day and night sweats and chills). There is also bartonella (cat scratch disease), mycoplasma, Rocky Mountain spotted fever, Q fever, typhus, and tularemia. The existence of these co-infections — so-called because they are often transmitted along with Lyme disease — explain why some people with Lyme remain chronically ill even after treatment: while the Lyme is identified and treated, these other infections are not. In addition, testing for co-infections is often unreliable, as it is for Lyme disease, so co-infections often go undiagnosed. They were not adequately accounted for in four major scientific trials that attempted to explain why Lyme symptoms persist even after antibiotic treatment. The trial conclusions — that antibiotics are not effective in eliminating chronic Lyme disease — are not surprising given that the antibiotics tested do not address all of the infecting organisms now frequently found in ticks. But there is hope. When co-infections are properly diagnosed and treated, patients significantly improve. For example, one of my patients was disabled in a wheelchair for six years, and was able to walk again once babesia was diagnosed and treated with antimalarial medication. We must improve the testing and treatment of tick-borne co-infections if we expect to see those individuals, suffering from Lyme disease and other unexplained illnesses, finally get better.
Posted on: Wed, 14 Aug 2013 15:18:22 +0000
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