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.

I think it’s called fifth disease because it’s one of five common
childhood diseases. (Although I doubt most of those are common anymore)

What are the symptoms? Contagious? How long does a child get it for on
average?

Slight fever, mild ‘ill’ feeling, a rash that initially appears only on
the face (giving a ‘slapped cheek’ appearance) and later spreads over the
trunk and limbs.

Hello. my son had Fifth disease when he was about four or five.
He had red cheeks, which has led to the disease also being called “slapped
cheeks”.

He also had a low grade feaver and a slight, lacy rash on his chest and
torso.

If your child has these symptoms the child should be seen by a doctor
immediately, not because fifth disease is dangerous but because the
symptoms mimic some of the symptoms of scarlet fever.

My son’s pediatrician said fifth disease was pretty common and he’d never
heard of any complications from it.

I think it’s called fifth disease because it’s one of five common
childhood diseases. (Although I doubt most of those are common anymore)

There was a huge outbreak of fifths where I live and I had it in 4th grade. It
was horrible!!! I was sick for so long, and I gave it to my mother, and it
kicked in arthritis of her hands. We were both sick for many weeks, and
couldn’t get out of bed. I still feel so guilty about making my mother so sick
even though I know it wasn’t intentional.

I have polycystic kidney disease, and I am currently on dialysis.

I have studied this disease, and it is definitely genetic. If your family
has not history of this disease, then it is very probable that what you may
have is one of the many disorders that mimic it. As they are to numerous to
mention, I suggest you consult a nephrologist for the answers to your
problem.

Just because a disease is genetic does not mean that it is inherited. Genes
can and often do mutate. In fact, the percentage of PKD patients who have the
disease because of a spontaneous mutation is quite high–10-20%, as a previous
poster noted.

Also, PKD occurs in many degrees of severity. Only about half the people with
the disease go on to develop kidney failure. It is possible to have such a
mild case that one may live a long, apparently healthy life never experiencing
any symptoms of kidney disease.

I have PKD and two living parents in their late seventies who do not have the
disease. We hope to participate in a study of the mutant PKD gene.

As you know, we’ve had to learn a lot more
recently about anthrax than we ever thought we’d need to.
This painful experience has taught us that the more you know
about this serious threat, the less terrifying it becomes.
NBC’s chief science correspondent, Bob Bazell, reports on
the top 10 things we all need to know about anthrax.

WHAT DOES ANTHRAX LOOK LIKE?

All the material that has tested positive so far has
been a brownish, grainy substance. Experts say this means it
is likely a crude preparation. A more sophisticated lab
could put it into a very fine white powder.

WHAT ARE THE DIFFERENT KINDS OF ANTHRAX DISEASE?

More than 95 percent of cases are cutaneous or skin
infection. If bacterial spores get into the lungs, they can
cause the much rarer but much more deadly inhalation
disease.

WHAT ARE THE SYMPTOMS OF SKIN EXPOSURE TO ANTHRAX?

It begins with a swollen area on the skin – similar
to a large insect bite. As we mentioned earlier, it swells
more over several days and eventually a black scab forms in
the center. Patients often have fever and a headache.

HOW DO I KNOW TO SUSPECT ANTHRAX?

There is very little reason to suspect you’ve been
exposed unless there has been a specific incident where you
live or work. That is why the public health system has to be
on alert for a possible attack.

HOW CLOSE TO ANTHRAX SPORES DO I HAVE TO BE TO BECOME
INFECTED?

Anthrax has to be inhaled in the lungs or pass
through a cut in the skin to cause disease – simply touching
them will not make you sick.

HOW LONG IS THE TIME FROM EXPOSURE TO INFECTION?

Anthrax symptoms usually appear in one to six days.

CAN ANTHRAX BE TRANSMITTED FROM PERSON TO PERSON?

No. Anthrax is not a contagious disease. You cannot
get it from someone else and you can’t give it someone else
if you have it.

CAN I GET ANTHRAX FROM EATING OR DRINKING?

Only very rarely. Only when people eat meat from
anthrax-infected animals. Otherwise it is not a threat in
water or food.

IF I SOMEHOW CONTRACT ANTHRAX CAN IT BE TREATED?

Yes, if anthrax is treated in the first few days for
the inhalation form or the first weeks for the skin form
it is almost always curable.

WHAT ARE THE TREATMENTS?
We’ve heard a lot about the antibiotic Cipro. But it’s important
to reiterate that many common antibiotics including penicillin and
tetracycline are effective against anthrax.

Most health departments have research on the century old tuberculosis
deaths and information about the 1908 BCG tuberculosis vaccine.

In 1900 when tuberculosis was the #1 disease killer, Michigan doctors
did NOT wish that United States taxpayers money spent on looking for a
tuberculosis vaccine. Michigan was the home of the original 1908 evil
doctor’s curse: I’ll see you and your siblings sick and dead before I see
you receive the 1908 BCG vaccine to fight the #! disease killer
tuberculosis family bacteria.
They wanted the taxpayer money to be spent on disease
studies and the buildings where the tuberculosis patients were treated.

The Tetanus vaccine had already been discovered. The Bible trinity was
known as Father (God), Son, and Holy Spirit. The Bible gave several blood
references, one of which says, “For the life of the flesh is in the blood.”
Meanwhile, it was also know that pathogens used the blood as a vessel to
travel to various body parts.

The evil Michigan doctors used government-funded money to treat (but not
cure) and to study the bacterial damage done to the human body by the
various tuberculosis bacteria-family germs. The prescription drug law would
form a new trinity using them as the god-figure, health saboteur, and
anti-Christ. They would promote the opposite of “For the life of the flesh
is in the blood” by saying, “Suck the blood from the flesh; blood means
nothing!” (Biopsies are tissue only!)

I thought it strange that Medicare would not ask for paid-for blood tests
to be received tests upon payment. A blood test would be like the patient’s
personal health bible. The patient must establish his or her personal blood
references. I assumed that people remembered Nikita Khrushchev
famous prediction that the United States would perish from within.
He must have known more about the evil doctors than the people.
I also assumed that people knew that the bacterial-produced
tuberculosis disease was the #1 disease killer in the United States for
over a century when the United States prescription drug law was passed.
Taxpayer money was spent to study the tuberculosis (TB) disease, but
never a penny was spent looking for a vaccine. Other countries were also
looking for a TB vaccine and one was discovered.

An old tuberculosis vaccine writing as the following:

B.C.G. Vaccine: a vaccine introduced in France about 1908 by Calmette and
Guerin. The Calmette-Guerin bacillus used is a live attenuated strain of
the Mycobacterium tuberculosis. It may be given to infants who are
especially exposed to the risk of tuberculous infection and to young people
who are shown by the tuberculin test to have no natural immunity to the
disease. It may be given to all medical students, veterinary students and
nurses who have no natural immunity and come into contact with tuberculosis.
It is not used in the United States because chemical means of prevention are
considered more effective and do not interfere with the skin test used in
epidemiology and private practice as a single means to test incidence of
infection in the population.

How do people get malaria? Wrong views about malaria still remains up
to now.

When I was in Taunggyi, a bus conductor said to me, Dr, I am a bus
conductor of Taunggyi-Tachilek bus line. I did not drink raw water at
all but only purified drinking water, and even I did not take a bath
everywhere I was, lest I might catch malaria. But, unfortunately, I
have been infected with malaria.

And when I was on the Tamu-Kabaw valley trip in Sagaing, a
departmental officer asked me if it was right that people got malaria
because of having a bath in spring, drinking spring water or taking
banana or papaya.

I still remember a film I saw when I was young. One episode of the
film featured the actor Zaw Lwin shivering with malaria after drinking
stream water. A short story of a certain journal also featured
suffering malaria owing to drinking raw water in malaria-prone areas.

Elder persons in the nation would warn those travelling to the
countryside or rural areas against taking a bath in stream, drinking
stream water and eating banana and papaya, being worried that they
might caught malaria.

The above-mentioned statements are some of my true stories. These
wrong ideas are rooted to many people.

As a matter of fact, the main cause of being infected with malaria is
“being bitten by malaria-carrying Anopheles mosquitoes”. Malaria can
be transmitted through blood transfusion. Malaria can also be
transmitted from a mother to her fetus. However, such cases are very
rare.

It has been found out for more than 100 years that mosquitoes carry
malarial parasite. Most people still stick to the wrong ideas on
malaria. So, the Ministry of Health laid down three ways to accomplish
its objectives, one of which is “Dissemination of health education
down to the grassroots level”. Only when the people have the right
view about malaria, can they effectively prevent the disease. If
people stick to the wrong ideas such as only drinking boiled water or
purified water and avoiding eating banana and papaya instead of
preventing mosquitoes from biting them, they cannot guard against
malaria at all.

Even the father of the medical science Hippocrates got a wrong view on
malaria that human beings could be infected with malaria by breathing
air from muddy ponds. (Mal = bad; aria = air, Malaria = bad air). So,
he filled up all the ponds with earth and took measures for proper
flow of all small water sources in malaria-prone areas, resulting in a
decrease in breeding of mosquitoes. His idea was wrong, but his
measures led to a fall in the rate of malaria outbreaks.

Among the sources that malarial parasites spread are ponds and streams
and drains where water flows gently. When the mosquito larvae in such
sources grow to mosquitoes, they hide near these sources. And when
people come to these places to drink stream water or take a bath,
surely they may be bitten by the mosquitoes, and they are infected
with malaria. The symptoms of malaria show over a week after being
bitten by malaria-carrying Anopheles mosquitoes. At that time, they
cannot remember that they were bitten by mosquitoes over one week ago
but what they remember was they drank stream water and took a bath in
the stream.

We can notice that the outbreak rate of malaria is high when there is
a greater number of mosquitoes. So in the rainy season when the number
of mosquitoes sharply increases, there grows the occurrence of
malaria.

And it is crystal clear that local people in Yangon and Mandalay eat
banana, papaya and bamboo shoots but they do not get malaria. The
people who live in malaria-prone regions get immune to the malarial
parasites.

The malaria patients do not take drugs systematically. Although the
body temperature falls, malaria has not been cured well. In the mean
time, the parasites are latent and not active in the their bodies. The
PABA (Para-amino-benzoic-acid) content in banana, papaya and bamboo
shoot helps the number of malarial parasites increase. So, a few days
after they have eaten banana, papaya and bamboo shoot, consuming the
PABA, the malarial parasites breed on a large scale, and the disease
resurfaces. Thus, the one who has been cured properly and
systematically does not get malaria by eating banana, papaya and
bamboo shoot or any meals.

However, many people are confused in this point and are influenced by
wrong ideas. Some people are accustomed to hearing that malaria is
caused by malarial parasites. When asked how one could get malaria,
they would answer that it was because of being bitten by mosquitoes.
But, asked how to prevent the disease, they would answer that they
could prevent the disease by drinking boiled water.

Whenever, I visited a village or I was at a meeting, I repeatedly gave
educative talks on malaria to the villagers. Only when they realize
the cause of the disease, will it be easy to make further
clarifications to malaria.

Therefore, I would like to urge all to effectively prevent the fatal
disease by avoiding bites by parasite-carrying mosquitoes and
suppressing the mosquitoes.