As human beings, we are exposed to numerous bacteria and viruses every day. Usually our immune systems do a pretty good job of protecting us from this onslaught of potential invaders, but it’s not perfect. One of the ways bacteria catch an immune system off guard is when they’re transmitted through tick bites. In these cases, the pathogens are transmitted directly to the bloodstream of the host as the tick feeds. This can potentially be quite damaging, as many different strains of bacteria can be transferred simultaneously, depending on the tick. One of the most prominent of these is Lyme disease, caused by the transference of the Borrelia bacteria. But there are plenty of other, less well-known pathogens waiting in the wings. One of these is called ehrlichia bacteria. But what are the symptoms of ehrlichia bacteria infection? And is there a connection with Lyme?
Ehrlichia is a genus of the Rickettsiales bacteria that are transmitted to vertebrates via ticks. They cause the disease ehrlichiosis, which was traditionally thought of as an animal-based disorder, mainly associated with dogs. The main mechanism of the disease is the infection and destruction of white blood cells, which form an integral part of the human body’s immune system. Ehrlichiosis is rarely fatal by itself, but the immunosuppression it causes can severely hinder the body’s ability to defend itself, paving the way for other diseases and disorders to take hold. Most cases of ehrlichiosis are reported during tick season (April to September), but there have been instances in every month of the year. If a winter is particularly warm, or if the climate doesn’t cool in a certain geographical area, then ticks can happily survive and feed at any time.
Ehrlichiosis has traditionally been associated with dogs rather than humans.
So what are the symptoms of ehrlichia infection? Unfortunately, the initial presentations are highly generic and generalized. Symptoms usually begin a week or two after the initial tick bite, which can cause problems in and of itself. Ticks are adept at concealing themselves, so much so that often people don’t realize they’ve been bitten. Although ticks usually attach themselves to their hosts on the leg, they will crawl to find a sheltered spot before they bite. This can lead to the host not ever knowing they’ve been bitten. In time, the tick will drop off, with the symptoms starting up a few days later. Because the symptoms are nonspecific, without the smoking gun of a confirmed tick bite, the chances of misdiagnosis or non-diagnosis are high.
The initial stages involve symptoms similar to the flu. These can vary in severity and usually include fever, chills, headaches, malaise, fatigue, and generalized aches and pains. If antibiotic treatment is delayed at this stage, the disease can potentially cause severe illness down the line. Symptoms of late-stage ehrlichiosis include damage to brain cells or the CNS (central nervous system), respiratory failure, hemorrhaging, organ failure, and even death. Risk factors for these kinds of extreme late-stage symptoms include delayed antibiotic treatment, being very young or very old, and having a weakened immune system.
So those are the symptoms, but is there a connection between ehrlichia bacteria and Lyme? Unfortunately, there can be. If ehrlichia is transferred into the bloodstream alongside Borrelia, ehrlichiosis can in essence become a co-infection of Lyme disease. Co-infections are particularly dangerous for two reasons: firstly, they often go unnoticed by doctors unless they are particularly Lyme-literate; and secondly, they can compound the effects of the dominant Lyme infection. In the case of ehrlichia and chronic Lyme, the immune system takes a double hit from both infections, which can lead to severe complications down the line for the patient.
Ehrlichiosis can become a Lyme disease co-infection if ehrlichia bacteria is transferred into the bloodstream alongside Borrelia.
So: what to do if you suspect you have an ehrlichia infection? Well, firstly, you should find a medical professional who has specific experience in dealing with vector-borne diseases. Two such labs are Infectolab Americas and BCA-clinic in Germany. The doctors there have long since realized the importance of testing for all possible co-infections. By utilizing a specialized form of the common ELISpot blood test, doctors are able to ascertain whether an ehrlichia infection is present. T-cells are an important part of our immune system; they work as the front line of defense for our bodies. There are two types of T-cells – attacking cells and memory cells. The first are used for eradication of an active infection, while the latter are present when the infection has been present before, or is dormant. By testing these for specific ehrlichia antibodies, doctors are able to reliably diagnose ehrlichiosis, along with numerous other chronic infections.
Co-infections form vital part of the overall Lyme condition, yet they so often go unexamined by doctors. Lyme disease as a whole is becoming more and more visible every year, but diseases like ehrlichiosis have to move into the light with it. Patients only have a chance of combating chronic Lyme if all the potential co-infections are tackled as well.