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Tick, tick, tick – and more ticks

Person walking outside - identifying tick-borne diseases
New DNA-based testing methods can help to quickly identify tick-borne diseases.

As the upper Midwest’s population of deer ticks expands and spreads, Marshfield Clinic researchers continue to look for ways to more quickly identify tick-borne diseases like Lyme disease, anaplasmosis and babesiosis.

They’ve turned to molecular tests that focus on DNA, the genetic code found in all living things. But in this case, it’s not human DNA, as you might expect, but rather the DNA of the infecting organisms.

DNA tests offer advantages

“Our new DNA-based testing methods are far more accurate and faster than older blood tests,” said Dr. Thomas Fritsche, a Marshfield Clinic pathologist and head of the Clinical Microbiology Section. “Patients can get the appropriate treatment sooner and get well faster.”

“While we still use a traditional antibody test for Lyme disease, we now also offer DNA-based tests for anaplasmosis and babesiosis,” said Dr. Timothy Uphoff, head of the Molecular Pathology Section of Marshfield Labs. “These tests are more sensitive, rapid and offer a definitive answer for either the presence or absence of the infecting organism.”

Dr. Anna Schotthoefer and other members of the Integrated Research and Development Laboratory at Marshfield Clinic Research Institute (MCRI) have collaborated with Fritsche and Uphoff on several tick-borne disease studies that have resulted in new test development.

“We couldn’t have developed our diagnostic tests for patient use without MCRI,” said Fritsche, who has collaborated with Schotthoefer and Uphoff on several published papers and national meeting presentations. This information has furthered understanding of these diseases.

Difficult to find and treat

tick identification card
Click image to download.

Work is still being done to develop a reliable diagnostic test that detects the DNA of the bacterium that causes Lyme disease. Lyme disease is the most common and well-known of the three tick-borne diseases in Wisconsin, but it is often difficult to identify because symptoms vary and don’t appear until three to 10 days after a tick bite. It sometimes starts with a bulls-eye or dusky red, round rash followed by flu-like illness. The disease commonly progresses to severe fatigue, joint pain and swelling, among other symptoms, if not treated early. Often the patient has no memory of having been bitten by a tick.

According to Schotthoefer, the tiny deer tick – much smaller and harder to find than a wood tick – has spread across most of Wisconsin, perhaps because of milder winters in recent years.

She urges anyone working or playing in the woods to take the usual precautions of keeping skin covered with long pants, socks and long sleeves and perform thorough checks for attached ticks after spending time outdoors.

Use a repellent, preferably containing DEET, picaridin, IR3535 or oil of lemon eucalyptus, to repel ticks and mosquitoes.

Care My Way® may be able to help prevent Lyme disease if you do have a tick bite. Download the app to get started.

You may be able to help

If you are diagnosed with early stages of Lyme disease and live in the Midwest, you may be able to participate in research at MCRI to help develop better tests and treatment for Lyme disease. For more information, contact Lisa Larson, MCRI clinical research coordinator, at 715-389-5738.

22 responses to “Tick, tick, tick – and more ticks”

  1. Elaine Alley Wrone/David R. Wrone

    My husband, an 85 year old, had been treated for tick bites several times over the years. His ambulation is severally disabling on the brink of requiring a wheelchair. He has been worked up for Parkinson's, spinal stenosis, arthritis with no finding. A neurologist thought through nerve conduction studies and lab work done in Boston that he has Limb Girdle Muscular Dystrophy. A second neurologist at Marshfield Clinic disagreed and a saliva test done through Emory U. concluded with unknown significance of its findings. Is he a proper subject for DNA-based testing for anaplasma and babesia. If so, he would like to make an appointment for such testing. Thank you

    Reply
    1. Kirsten Shakal, Shine365 Editor

      Hi, Elaine. I shared your comment with Dr. Fritsche. This is the response he has provided: "Anaplasma and Babesia are organisms that are not known to cause long-term effects, like chronic pain or arthritis, so testing for their DNA would be of little value in this instance. When Lyme disease is being considered for either acute or chronic disease, we use the standard blood tests as recommended by the U.S. Centers for Disease Control and Prevention. These have shown high reliability in detecting exposure to the Lyme disease bacterium."

      I hope that helps. Thank you for reading Shine365. -Kirstie

      Reply
  2. Rich Warren

    Two of the many bacteria's associated with Lymes, anaplasmosis and babesiosis are listed in this article. Can I assume that this new PCR test will only detect these two bacteria's, and if neither are present, the test result would be negative, but there still could be other Lyme associated bacteria present? If that is correct, and the list seems to be alphabetical, is the research close to adding bartonella to the Marshfield Clinic PCR test in 2017?

    Reply
    1. Kirsten Shakal, Shine365 Editor

      Hi, Rich. I shared your comment and question with Dr. Schotthoefer. This is the response she has provided, "The new PCR test is also able to detect ehrlichiosis, which is caused by bacteria that are closely related to the bacterium that causes anaplasmosis, but it does not detect any other known tick-borne diseases. I don’t believe Marshfield Labs currently plans to add a test that would detect Bartonella to their Tick Panel."

      Thank you for reading Shine365. -Kirstie

      Reply
  3. dan sullivan

    Your "Claim" that no forms of lyme bacteria are found in dormant state is False…Best look at the studies of finding Lyme and co-infections in the bodies and brains of donated corpses ..Over 200 co infections Plus the different forms of lyme bacteria are not addressed nor treated properly by Marshfield clinic…..I know first hand
    ..

    Reply
  4. Lynn Luckeroth

    This has been a bad year for Ticks..I have been finding most of them before they attach. Yesterday I pulled a tiny one from my neck. Today after working in the yard I noticed a large gray spot on my toe…in between my middle toes a tick had attacked itself. I pulled it off and hubby checked to make sure I had the head…it bled a lot. Do I need to wait a certain amount of time before going to the doctor? I was bit my a tick that caused the bulls eye in 1986 and they told me back then it was lyme.

    Reply
    1. John Tracy

      Lynn, we can not give advice on individual cases in this forum. If you have questions or concerns your best option is to call your doctor's office and get a professional recommendation.

      Reply
  5. Carol Warren

    Kirstie – Today, my primary care doctor informed me, that I had the Babesia PCR test last year on May 7, 2015 with negative result. Has that process been given any refinements in the past year, or is one negative test not definitive enough, to make it prudent to have another Babesia PCR test, given that my clinical diagnosis points to Babesia co-infection? I can say my symptoms of body myalgia, anxiety, lethargy and fatigue are more intense and pronounced than that of a year ago.

    Reply
    1. Kirsten Shakal

      Hi, Carol. At this point, answering your questions would be providing individualized medical advice (specific to your experience and symptoms), which we are unable to do on this forum. I encourage you to ask your doctor these questions, and if he is not sure, he should be able to reach out to Drs. Fritsche or Schotthoefer. I truly hope your doctor is able to assist you and you are feeling better soon. -Kirstie

      Reply
  6. Carol Weisbruch

    My husband was tested (blood test) for Lyme disease due to a recent deer tick bite (we live in the Northeast). The results showed that he did have a Lyme infection at one time, but not at present. Both of us had received the Lyme vaccine about 16 years ago and were told that a blood test would show positive for Lyme disease because of the vaccine. However, we were also told that the blood test that is presently used is different and would not show positive as a result of the initial vaccine. Is the blood test used today really any different than the blood tests done years ago? Is it possible for the infection to go dormant for a period? Thank you for any information.

    Reply
    1. Kirsten Shakal

      Hi, Carol. I reached out to Dr. Schotthoefer on your questions. Her response: "I believe you are right in that the Lyme serology test used today would be different from that used 16 years ago." (I will see if Dr. Fritsche can confirm this, too.) "With regards to the question about whether or not infections can go dormant: the answer is we really don’t know, though most physicians and scientists believe our current evidence suggests that infections do not go dormant. Cells of the bacteria that causes Lyme disease haven’t been recovered from patients that complain of chronic, or relapsing symptoms associated with Lyme disease. Though, there is general recognition that about 10% of Lyme disease patients will continue to have some symptoms following standard antibiotic treatment. It isn’t clear why, but generally it is not believed to be due to dormant, persistent infections. Animal models suggest it may be related to a dysfunction of the immune response that was triggered by a Lyme disease infection." Let me know if you have further questions, and thank you for reading. -Kirstie

      Reply
    2. Kirsten Shakal

      Carol – Dr. Fritsche shared, "My colleague who works with lyme on the east coast relayed that the vaccine shouldn’t interfere with the new tests we are using. The vaccine was a limited number of targets which aren’t included in the current generation of lab tests. A positive test now would be expected to reflect exposure at some point in the past." Thanks, Kirstie

      Reply
  7. Chester G Dombrowski

    As a chronic Lyme disease patient ( Neuroborrielliosis ) I applaud the efforts of MCRF. I look forward to be tested for anaplasmosis and babesiosis at your earliest convenience.

    Reply
    1. Kirsten Shakal

      Thank you for sharing, Chester. -Kirstie

      Reply
  8. Steven

    I think everybody must also realize that while this "might" be an improve test over the traditional western blot….it will be only effective if the lyme is present in the blood. Unfortunately Lyme will only use the blood as an means to travel into other areas of connective tissue in your body…leaving the blood quickly to avoiding the immune system. PS I have had Lyme and confections 5 times over the last 15 years

    Reply
  9. Carol

    I presently have a clinical diagnosis of suspected Babesia co-infection. I did have a tick bite and a reactive Lymes test result in Dec 2010, but conventional testing in 2012 and 2015 shows negative. My hope is this new DNA based test method is applicable in my situation. I will be talking to my primary care provider today about this.

    Reply
    1. Gary Johnson

      How can this help if at all in chronic lymes disease situations or prove or disprove any of the tick diseases for that matter?

      Reply
      1. Kirsten Shakal

        Hi, Gary. Dr. Schotthoefer's response to your question is: "The genetic tests are designed to directly detect the organisms that cause the diseases, rather than our immune responses to the diseases, which is what older tests do. So, the genetic tests are better in that they can confirm or 'prove' that someone is infected, rather than just provide evidence that someone may have been infected. Being able to make better diagnoses of people with tick-borne diseases will eventually help us better understand chronic Lyme disease." I hope this provides some clarification. Thank you for the question. -Kirstie

      2. Kirsten Shakal

        Dr. Fritsche also adds, "The new tests can’t help with a possible chronic Lyme disease situation; we still rely upon the same blood test we have used for many years and which is still used to good effect with proper clinical evaluation by a healthcare provider. The new molecular DNA tests only apply to the other tick-borne diseases Anaplasma and Babesia. Should those diseases be considered as a possibility by the healthcare provider, then there may be a place for them in the diagnostic work-up." This is also noted in the story, but I hope this additional response clarifies the information. -Kirstie

    2. Carol Warren

      I requested from my Primary Care provider yesterday, at the Park Falls Center, to order the DNA test for my condition, clinically diagnosed Babesia. I was told they would check and get back to me. I just received their response, which I will copy and paste the significant portion of the message from my doctor: "We checked with our Lab and we currently do the correct testing for lymes and tick bites. We do not do a DNA based test. Hope this helps."
      I felt your Shine365 article had a rather simple and straightforward message, in the 4th paragraph from the end of the article, and I will quote, "Clinic providers can order a test that can detect DNA of an infection." Did I misunderstand?
      Who can assist me in finding the closest Marshfield Clinic lab facility that will perform this particular lab draw and test?

      Reply
      1. Kirsten Shakal

        Hi, Carol. Sorry for any confusion. To clarify, as stated in the story, "It’s not human DNA, as you might expect, but rather the DNA of the infecting organism." I will get more information for you on specific locations. -Kirstie

      2. Kirsten Shakal

        Carol – Dr. Schotthoefer was able to provide some clarification… "Make sure you are specifically requesting the Babesia PCR test. It is true that we currently do not have a DNA test for Lyme disease. From your provider’s response, the provider may have thought you were asking for a DNA test for Lyme disease. You should be able to get the Babesia PCR test ordered at the Park Falls Center. I believe the lab there would send it out for testing here in Marshfield." I hope this helps, Carol. Please let me know if you have further questions. -Kirstie

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