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Rickettsia 364D Rickettsia 364D Rickettsia species 364D (Rickettsia philipii), the etiologic agent of Pacific Coast tick fever (PCTF). Transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. As of 2016, fourteen cases (14) cases reported (all in California); 1st case in 2008. Most cases in Northern CA. The Pacific Coast tick’s range includes most of California, southern Oregon, and northern Baja California, Mexico. Symptoms: Fever, headache, eschar(s) [Eschar is dead tissue that falls off (sheds) from healthy skin.] Click here for journal article on Pacific Coast Tick Fever Left: Pacific Coast Tick – Female, Male and Nymph (Photo: Ervic Aquino, CA Dept. Public Health) ©LDA. 2016. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Ehrlichiosis/Anaplasmosis Scientists used to separate ehrlichiosis into two entities caused by the bacterium Ehrlichia: Human Monocytic Ehrlichiosis (HME) and Human Granulocytic Ehrlichiosis (HGE). After further study, they determined that HGE is actually caused by a bacterium, Anaplasma phagacytophilum. HME is caused by a bacterium, Ehrlichia chaffeensis. Symptoms of ehrlichiosis/anaplasmosis include: fever, malaise, headaches, chills, severe muscle aches, vomiting, anemia, lung infection, decreased white blood cells and platelets, elevated liver enzymes, seizures, encephalopathy, meningitis, confusion, ataxia and cranial nerve palsy. Co-infection with Lyme can cause more severe symptoms. Death can result. Treatment is with doxycycline. Ticks that transmit anaplasmosis include Ixodes scapularis (deer tick or black legged tick) and Ixodes pacificus (western black legged tick). Ticks that transmit ehrlichiosis (HME) includeAmblyomma americanum (lone star) and Dermacentor variabilis (American dog). Ixodes scapularis (deer tick or black legged tick) and Ixodes pacificus (western black legged tick) ticks have been shown to carry the ehrlichiosis bacterium, but to date, transmission is still in question. ©LDA. 2014. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Colorado Tick Fever Colorado Tick Fever Colorado tick fever (CTF) is a disease caused by an RNA virus, Colorado tick fever virus (CTFV). Symptoms, which are often non-specific, begin 3 to 5 days after the bite with an abrupt onset of fever and any of these: headaches, chills, malaise, photophobia, myalgias, nausea, vomiting, diarrhea and abdominal pain. In 5 to 15% of cases a rash occurs. Neurologic complications may also occur. 50% of patients have single recurrence of fever (“saddleback” fever). IFA titers for diagnosis. PCR (Polymerase Chain Reaction) is the test most often used to diagnose the disease. CTF is transmitted by Dermacentor andersoni (Rocky Mt. wood tick) which causes illness from the Western Black Hills to the West Coast in the USA. Some cases of transmission through blood transfusion have been reported. Treatment consists of supportive care. ©LDA. 2014. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Bourbon Virus Bourbon Virus Five cases of the Bourbon virus, a thogotovirus, have been confirmed since it was first discovered in Bourbon County, Kansas, in 2014, and cases have since been found in Oklahoma and Missouri. Transmission: The premise of Amblyomma americanum (lone star tick) as vector is supported. Symptoms: Fever, headache, tiredness, rash, other body aches, nausea, vomiting, leukopenia, thrombocytopenia. May cause death due to acute illness. No tests. No treatment, except for supportive therapy for symptoms. Electron microscopic images virus particles from virus from CDC. ©LDA. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Babesiosis Babesiosis is a Malaria-like illness caused by a parasite, either Babesia microti, B. duncani, B. divergens, MO-1. It is sometimes fatal in the elderly or those with no spleen. Babesiosis may be more severe in patients with co-existing Lyme disease. Symptoms include: fever, chills, fatigue, headache, muscle pain, sweats and anemia. Tests for Babesiosis: blood smears, IFA (IgG & IgM), FISH (Flourescent in-situ Hybridization) and PCR may be ordered.* * These tests were developed & performance characteristics determined by independent labs. They have not been cleared or approved by the FDA; however, the FDA has determined such clearance is not necessary. They are designd for clinical purposes and should not be regarded as investigational or for research. Treatment is often atovaquone with azithromycin or clindamycin and oral quinine. Treatments vary, examples provided as information only. Ticks that transmit babesiosis include Ixodes Scapularis (also called blacklegged tick or deer tick) andIxodes Pacificus (western blacklegged tick) both of which also transmit Lyme disease. Multiple infections may be transmitted from the bite of the same tick. Babesiosis has also been transmitted to humans through blood transfusions. In 2018, the FDA approved a test to screen the blood supply for Babesia microti. See: FDA Approves Tests to Screen Blood Supply for Babesia Resources for transplacental transmission of Babesia: 1. Fox, L.M.; Winger, S.; Ahmed, A.; Arnold, A.; Chou, J.; Rhein, L.; Levy, O. Neonatal babesiosis: Case report and review of the literature. Pediatr. Infect. Dis. J. 2006, 25, 169–173. 2. Cornett, J.K.; Malhotra, A.; Hart, D. Vertical transmission of babesiosis from a pregnant, splenectomized mother to her neonate. Infect. Dis. Clin. Pract. 2012, 20, 408–410. 3. Iyer, S.; Goodman, K. Congenital babesiosis from maternal exposure: A case report. J. Emerg. Med. 2009, 56, e39–e41. 4. Khangura, R.K.; Williams, N.; Cooper, S.; Prabulos, A.M. Babesiosis in pregnancy: An imitator of HELLP syndrome. AJP Reports 2019, 9, e147–e152. ©LDA. 2014. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Rickettsia parkeri Rickettsiosis Rickettsia parkeri Rickettsiosis This disease is found in Eastern & Southern US & Gulf Coast. It is transmitted by Amblyomma maculatum, Gulf Coast tick. Symptoms include headache, fever, variable rash, eschar, which is dead tissue that falls off (sheds) from healthy skin. Diagnosis through PCR testing. Doxycycline is used for treatment. CDC website statement: Confirmation of the diagnosis is based on lab testing, but antibiotic therapy should not be delayed in patient with a suggested clinical presentation ©LDA 2015 This web site provides practical and useful information on the subject matter covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Heartland Virus Heartland Virus map Heartland virus The virus, a Phlebovirus, was discovered in humans in 2009 in the state of Missouri and has been found to date in Oklahoma, Kansas, Arkansas, Indianan, Illinois, Kentucky, Tennessee, North Carolina and Georgia. It is transmitted by Amblyomma americanum, lone star tick. Symptoms: fever, leucopenia (decrease in the number of total white blood cells count), thrombocytopenia (low platelet), tiredness, headaches, muscle aches, diarrhea, loss of appetite. Testing: No routine testing available but protocols are in place to allow people to be tested for evidence of Heartland virus RNA and IgM and IgG antibodies. Doctors should contact your state health department if you have a patient with an acute illness that may be compatible with Heartland virus disease. Treatment: None but palliative care. 40 cases as of 9/18, at least 2 deaths. ©LDA. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that LDA is not engaged in rendering medical or other professional services. Seek professional services if necessary. Tick-Borne Relapsing Fever (TBRF) Caused by a bacteria (either Borrelia hermsii, turicatae, or parkeri) and transmitted by the soft bodied tick, Ornithodoros (either hermsi, turicata, or parkeri). The disease is characterized by recurring episodes (3 days on 7 off) of high fever, can be up to 106.7° during certain phases. Each fever episode is followed by signs/symptoms which may include headache, muscle and joint aches, nausea, chills, arthralgia, vomiting, abdominal pain, dry cough, eye pain, confusion. The diagnosis is by microscopy and treatment may be with tetracycline, erythromycin, or other antibiotics. The soft bodied ticks which transmit the disease are usually found in the Western US in higher altitudes in old cabins and animal burrows. ©LDA. 2015. This web site provides practical and useful information on the subject matters covered. It is distributed with the understanding that
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