A new tick-borne bacterium infecting humans with ehrlichiosis has been discovered in Wisconsin and Minnesota. It was identified as a new strain of bacteria through DNA testing conducted at Mayo Clinic. The findings appear in the Aug. 4 edition of the New England Journal of Medicine.
Doctors at Mayo Clinic, the Centers for Disease Control and Prevention (CDC), the University of Minnesota, the University of Wisconsin, and state and local health departments say the new species from the Ehrlichia genus can cause a feverish illness in humans. The new bacterium, not yet named, has been identified in more than 25 people and found in black-legged ticks, also known as deer ticks (Ixodes scapularis), in Minnesota and Wisconsin. Researchers used culture and genetic analyses.
“Before this report, human ehrlichiosis was thought to be very rare or absent in Minnesota and Wisconsin,” says Bobbi Pritt, M.D., a Mayo Clinic microbiologist and director of the Clinical Parasitology and Virology Laboratories who helped coordinate the multi-agency team. “Therefore, physicians might not know to look for Ehrlichia infections at all.”
Ehrlichia infect and kill white blood cells and may cause fever, body aches, headache and fatigue. More severe disease may involve multiple organs such as the lungs, kidneys and brain and require hospitalization. Ehrliochosis rarely results in death.
All four patients described in the New England Journal of Medicine article suffered fever and fatigue. One patient, who had already received a bilateral lung transplant, was hospitalized briefly for his illness. All four patients recovered following antibiotic treatment with doxycycline, the drug of choice for treating ehrlichiosis. Although more than 25 cases have been identified, many more have likely been missed or unreported, Dr. Pritt says.
The investigation began after Carol Werner, then a technologist at Mayo Clinic Health System’s Eau Claire hospital, noted an abnormal Ehrlichia Polymerace Chain Reaction (PCR) result in 2009 and raised the first red flag. Mayo Clinic then began investigating with the CDC, the universities and several public health departments. The Minnesota Department of Health last year put out a health advisory alerting people that it and its Wisconsin counterpart were seeing increasing reports of ehrlichiosis in humans.
“As the deer tick population continues to spread and increase across Wisconsin, we are likely to see increasing incidence of this new infection, just as we have seen with Lyme disease and anaplasmosis which are transmitted by the same tick species,’’ says co-author Susan Paskewitz, Ph.D, an entomologist at the University of Wisconsin-Madison.
To date, thousands of blood samples from across the United States have been screened by Mayo Clinic laboratory technologists, and the bacterium has been detected only in specimens collected from Wisconsin and Minnesota. Thousands of ticks across the country have also been analyzed, and only those from the two states have been carriers.
Because the bacterium is likely transmitted through the bite of an infected tick, Dr. Pritt cautions that people should apply insect repellent and wear pants and long-sleeved shirts when active outdoors.
Doctors need to know to test for ehrlichiosis in the two states so the diagnosis is not missed. However, traditional blood antibody tests may offer misleading results and fail to accurately identify the new species. A specific antibody test for the new bacterium has been developed by the CDC but isn’t widely available. Instead, a molecular blood test that detects DNA from the new Ehrlichia species is the preferred method for detecting this disease in symptomatic patients.
When testing for this new Ehrlichia species, physicians should also consider testing for other tick-borne diseases, such as Lyme disease, babesiosis and anaplasmosis, all prevalent in Minnesota and Wisconsin, Dr. Pritt says.
Genetically, the new bacterium bears closest similarity to another species of Ehrlichia — E. muris — that infects small rodents and deer in Eastern Europe and Asia. E. muris rarely infects humans, and no cases have been reported in North America.
Below is a link to an edited youtube video with Dr. Pritt.
Please have awareness that chronic lyme disease with co-infections is quite prevalent. Doxy does not always get rid of bacterial lyme as written in your article. Please read articles and studies in the Lyme Times Magazines presented by CALDA – can be looked up on the web. Lyme disease can cause death – as documented in these studies. They have on autopsy found lyme spyrochetes in the brain, and different organs of people very sick and dead from lyme. It is very disconcerting for us who are suffering from chronic lyme to read articles such as yours who trivialize the recovery of lyme and the co-infections of lyme. This is one heck of a disease to get well from. This is my third time being diagnosed with lyme plus 3 co-infections. Getting well seems an impossibility. I already took a round of doxy. Now my sero tests have a much more difficult time coming out positive due to the doxy. Please get your facts right. You need to do more research before publishing articles like this on the internet that do not include enough information to the general public. It is misleading and not fair to someone who has an initial dx of lyme or lyme with a co-infection.
Amy, thank you for your comments on Lyme disease, which is one of several serious tick borne diseases confronting us today. Dr. Pritt encourages anyone who is tested for ehrlichiosis to also be tested for all other tick-related conditions, including Lyme disease. Some conditions have similar symptoms, but different mechanisms of action and different treatments. While this news story focused on a specific discovery of a new bacterium, more information on Lyme disease and treatment can be found at MayoClinic.com [http://www.mayoclinic.com/health/lyme-disease/DS00116]
My father was diagnosed with Ehrlichiosis at Mayo several years ago and nearly died from the disease, which was not identified by his local hospital and therefore delayed diagnosis by Mayo. My father’s organs shut down and he was delierous for days. His kidneys also shut down and he had to be on dialysis for approximately 6 months, never fully recovering from the damage. Understand, death from the disease may not occur frequently, but then neither do cases of Ehrlichiosis. In any event I think it is important to emphasize that this disease can be very difficult to recover from and can also result in DEATH, if not diagnosed quickly. My Father spent 4 days in the local hospital deteriorating every day before we insisted that they transfer him to Mayo. Doctors at Mayo told me if we had waited 12 hours more, he would not have survived.
Ron Petrovich; It’s time for Mayo Clinic to stop engaging in conflicts-of-interest at the expense of philanthrompic and public monies provided in the form of research grants, etc. How many physicians and researchers have made a 20-40 year career doing research that never sought to benefit those seeking healthcare? The information Mayo Clinic provides to the public on their website regarding Lyme and other tick infections is elementary, archaic, and shameful to say the least. Mayo Clinic had been doing years of research on such things as biofilm and the use of the antibiotic rifampicin for the neurological (versus infectious) condition of multiple system atrophy – not a far cry from the antibiotic rocephin’s ability to uptake glutamate from the nerve synapse to relieve patients of symptoms that caused them to be misdiagnosed with ALS when in fact they had Lyme. Yet where is the benefit to those seeking healthcare? As a healthcare professional and recent regular attendee at various Lyme support meetings, I’ve heard numerous accounts of patients who have received non-care at Mayo Clinic for blatant disabling objective and subjective neurological/cognitive/other chronic Lyme symptoms – one such patient suffering bells palsy, seizures, and weakness with frequent falls (in addition to cognitive and other disabling symptoms) spent a week at Mayo a year ago and was sent home with the diagnosis of “migraines” and told she would get well in six months with no treatment- a year later she still suffers the same symptoms, is unable to work, and can hardly be a mother and wife to her family. Due to the fragmented and inadequate mainstream healthcare of Lyme (IDSA vs ILADS based) the family is at risk of losing their home due to the patient’s medical expenses – despite the husband’s higher-than-average income and employer provided health insurance. I’m sure you are aware there are over 100 different strains of the Lyme bacteria in the U.S. and 300 strains worldwide – obviously the bacteria is highly adaptive and evolving, so it’s no suprise to anyone with basic science knowledge of Lyme and other tick-borne infections that strains of Erichliosis and the other tick infections are also evolving. IDSA Dr. Wormser recently proclaimed that Babesia has been “under-the-radar” and that’s why it’s recent high incidence caught everyone by surprise – when infact there is nothing “recent” about the high incidence. The lab communities regards Mayo Clinic’s announcement of a new strain of Erichliosis as some sort of “big news” discovery as a joke. Big news would be that Mayo Clinic begins to appropriately treat patients with chronic Lyme with and without the co-infections of Erichliosis, Babesia, Bartonella, Anaplasmosis, and/or Mycoplasma etc. Thank you for publishing my comment. .. Patricia Salazar
Outside the lab, in the lives of patients and physicians, knowledge is deficient with regards to tick-borne illness; especially if patients go years without a diagnosis or treatment. I know that State Government has had to pass laws to progress physician’s awareness on this topic i.e. Texas Senate Bill 1360 authored by Senator Chris Harris and signed by Governor Rick Perry in 2011. Surprisingly, there are only 3 responses to this story; are all responses posted or do patients & physicians not care? I was hoping to glean more information on how Medical Institutions, like Mayo Clinic, are bridging this knowledge gap.
Mayo Clinic has made every effort to work with and continues to work with public health departments in the appropriate states where this condition has been identified. Given the amount of media coverage on this story, we think we have been successful in raising awareness. In regards to the question about monitoring, after our procedural review of comments, every user comment on this blogpost has indeed been posted.
Ah, I had wished that more individuals, especially Mayo Clinic physicians, would have taken an active interest and posted responses to this study, All-the-same, thanks to all whom shared their position(s) and thank you Makala Johnson of Mayo Clinic for putting forth efforts to raise society’s awareness and also for taking the time to reply back to my post.