Yale and state researchers develop improved test for new tick disease

New Haven, Conn.–Yale and state scientists have developed a new,
simpler and more reliable blood test to detect a recently discovered
disease called ehrlichiosis, which is carried by deer ticks.
The test will make it less cumbersome for patients with the telltale
flu-like symptoms to be screened for the disease. It also will allow
researchers to determine whether ehrlichiosis may be as widespread as
Lyme Disease in the Northeast.

The new ELISA test was developed by Dr. Jacob IJdo and Dr. Erol Fikrig
in the Rheumatology section of Yale Medical School’s Department of
Internal Medicine in collaboration with Dr. Louis Magnarelli at the
Connecticut Agricultural Experiment Station. Details of the test were
published in the November issue of the Journal of Clinical Microbiology.

The organism, Ehrlichia equi, is carried by the same tiny deer tick that
carries the Lyme Disease bacteria and, like Lyme Disease, causes
flu-like symptoms such as headache, fever and muscle cramps. But unlike
Lyme disease, Ehrlichia equi does not produce a bull’s eye rash, which
makes it more difficult to diagnose, said Dr. IJdo, a
physician-scientist.

Another problem hampering diagnosis is that testing for ehrlichiosis is
time-consuming, costly, and is only performed in specialized research
laboratories. “With the old test a person could test two dozen blood
samples a day,” Dr. IJdo said. “With the new test it is easy to scale up
the testing for large numbers of blood samples.”

There are indications that ehrlichiosis infections could be more
prevalent because the numbers of confirmed cases are increasing each
year, Dr. IJdo said.
“The state of Connecticut started doing surveillance for ehrlichiosis in
1995, and each year the number of cases has doubled,” he said. “Last
year there were more than 200 cases in Connecticut.”
Because the same tick is responsible for transmission of both organisms,
ehrlichiosis can be expected in the same areas where there is Lyme
disease, which are principally the Northeast and the upper Midwest.

The new ELISA test uses a recombinant protein that can be produced in
large quantities. The test is better because it is standardized,
automated and more sensitive, said Dr. IJdo.

“Now we can conduct better surveillance of the disease,” he said. “It
took several years to educate people about Lyme Disease, and it may take
some time to inform people about Ehrlichia equi. With the ELISA we are
set up for next summer’s tick season.”

Testing for ehrlichiosis is conducted by the Connecticut Department of
Public Health and Yale’s Department of Epidemiology and Public Health
with financial support by the Centers of Disease Control and Prevention
(CDC). The test is free for any physician who suspects a patient of
having ehrlichiosis. “This is to encourage physicians to submit blood
samples so that we can get a better idea how prevalent the disease is,”
Dr. IJdo said. It is not yet known if ehrlichiosis can have the same
serious long term effects as Lyme Disease if untreated, Dr. IJdo said.
Untreated Lyme Disease, which is caused by the spirochete Borrelia
burgdorferi, can result in chronic arthritis and nerve and heart
dysfunction.

What is the treatment if any Tick Disease is diagnosed? Antibiotic?

Unfortunately, they are different. Lyme is treated with various
antibiotics, such as doxycycline or minocycline. Borreliosis is
treated with mepron, which is an anti-parasitic, I believe. I
don’t know what Erlichiosis is treated with. I am certainly no
expert. At Fire Island, we have been warning visitors for a
couple of years now that deer ticks carry 3 diseases, not just
Lyme Disease. It’s a mess.