posted
When I was at the Paramus forum a couple weeks ago, Dr. B made a statement regarding the prevalence of Bartonella in ticks in NJ being greater than that of lyme. I believe the study he was referring to is this one:
which states, "PCR analysis of Ixodes scapularis ticks collected in New Jersey identified infections with Borrelia burgdorferi (33.6%)... and Bartonella spp. (34.5%)."
I did see two past posts during a search on this board that mentioned this study (which was conducted in 2004), but there was very little discussion in regards to it. I'm just starting to significantly spend more time researching co-infections lately, and I'm sure some of the following has been discussed here previously, but I'd think the results of this study would be a pretty big concern for those of us in NJ (as well as elsewhere if the prevalence of bartonella is indicated to be similarly high). Especially for those who don't resolve with lyme treatment.
First off, I don't know what the mechanism for transmission of bartonella from tick to human is and if this transmission is as likely (or not significantly less likely) than the transmission of lyme upon a tick bite. Does the bartonella bacteria similarly detect that a tick is feeding on a host and consequently migrate to the salivary glands? If so, is this process as likely to occur as the corresponding lyme spirochetes process or is the bartonella say, less likely to detect and/or respond to an environmental change in the tick upon the tick feeding? Or is the transmission completely incidental and not at all a response to detection that the tick is attached to a host?
Assuming the stipulation that bart transmission is as likely (or at least not substantially less likely) than lyme transmission is true, then it leads me to believe that bartonella is highly under-diagnosed in NJ, both in the general public and within those of us being treated for lyme and TBI. I don't know where to get data for reported bartonella cases in NJ offhand to get some gauge of this, but for one thing, I'd be surprised if the number of people in NJ treated for bartonella and not lyme comes anywhere near approaching the number treated for lyme and not bartonella. Even if transmission of bart doesn't happen as frequently as lyme during a bite from an infected tick, there could still be credence for a large under-diagnosis, of course depending in part on how much less likely the transmission is to occur.
Granted, this study was just a single study conducted in a localized area, primarily in one county in Northern New Jersey. And I don't know how many ticks were collected and analyzed in the study and didn't see the information after skimming through the study again. However, unless the study had an asburdly low sample size (which I don't think was the case), I think it raises substantial concerns about the prevalence of Bartonella, at least in Northern Jersey and surrounding areas.
With all this being said, I realize I may be overlooking other variables in play, which is part of the reason I'm posting this. I suppose, for example, that it's possible an average human immune system is able to better eradicate bartonella than lyme upon infection without any supporting treatment. It could also be the case that lyme is transmitted through other vectors/ticks and transmission methods (like congenitally or through sex) at a higher rate than bartonella although the deer tick analyzed in this study is recognized as the primary vector of lyme so I would think that wouldn't factor in too much.
One last aspect to consider is that this study was based on detection of Bartonella spp. and not strictly B. henselae, which I believe is the species being referenced when typically discussing bartonella infection though I don't know for sure. Upon a cursory look into things, it seems that there are at least several species of bartonella, and I don't know if they are all pathogenic in humans. If they aren't, then naturally the findings of this study would have to be further analyzed to determine the prevalence of the pathogenic bartonella species in deer ticks.
Anyway, I'm probably a bit all over the place with this post, but I wanted to throw this up for discussion and get some feedback and different perspectives on the prevalence and infection rates for bartonella.
Posts: 43 | From NJ | Registered: May 2007
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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CD57
Frequent Contributor (1K+ posts)
Member # 11749
posted
Those two numbers don't seem to be much of a difference (33 vs 34%)? But I've heard my LLMD say that bart is ubiquitous (everyone who has Lyme has bart) but not everyone who has bart has Lyme. Bart can be transmitted by other vectors besides ticks too..fleas, etc. B. henselae is a flea and tick vector, and recently I think it's been supposed that b. quintana may be too.
Posts: 3528 | From US | Registered: Apr 2007
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posted
Thanks for the reply. Interesting to hear your LLMD says that as I've seen a number of people mention that their LLMDs don't seem to really believe or at least pay enough attention to the possibilities of co-infections.
As for the 33% vs. 34% having no real difference, I agree. I think you may have been referring to the statement I included from Dr. B about bart being more prevalent than lyme, but I think he was just using this study to suggest the same line of thinking as my post: that bart is being significantly under-diagnosed. Even if the study showed say, 30% of ticks infected with lyme and 15% infected with bart, it would still be suggestive of a large under-diagnosis as I think the rate of diagnoses in NJ of lyme to bart is substantially higher than 2:1.
Of course, as I mentioned in my post, there are still many other variables in play which could potentially influence human infection rates so that they don't correspond too directly to the prevalence of bart and lyme in deer ticks. I'm trying to make myself more knowledgeable in this regard to further assess the likely incidence of bart around where I live and elsewhere for that matter.
Posts: 43 | From NJ | Registered: May 2007
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