Know thy Enemy: Anaplasmosis

Anaplasma are gram negative, obligate, intracellular bacteria. Anaplasma bacteria infect white blood cells and circulate throughout the bloodstream. (which means Anaplasmosis can be acquired by blood transfusion as well as tick bites). Anaplasmosis is transmitted by the bite of black legged ticks, (ixodes sculpularis) also known as the “deer tick”. The bacteria is found predominately in the upper northeastern and midwestern states. Studies have shown the largest vectors for this bacteria are white footed mice, raccoons, and grey squirrels.

engorged-tick

Anaplasma infect white blood cells and are most often found inside neutrophils. There they alter the neutrophil’s function. They form microcolonies of bacteria within the vacuoles called morulae. Morulae can be seen on peripheral blood smears. Though I don’t believe anyone has ever put my blood on a slide and viewed the smear to see if they could see any morulae in mine. My blood tests positive for anaplasmosis. Once inside a host’s neutrophils, the bacteria trigger a variety of immune and inflammatory responses on a cellular level. Anaplasma bacteria influence the host cell functions and cause injury to the host’s cells, tissues, and organs.

tick-relatedfig5_large

The first case of Anaplasmosis was in Wisconsin in 1990. A patient developed a febrile illness and died two weeks after a tick bite. Blood smears revealed clusters of bacteria in her neutrophils (a specific type of white blood cells)

Originally, through taxonomy and classification rules I simply do not understand, and can’t explain, anaplasma used to be classified with another Tick Borne infection, ehrlichiosis. Then they were separated into two different classes of bacteria. Human Ehrlichiosis, and Human Granulocytic Anaplasmosis(HGA)

I have Anaplasmosis. The first test I had for it was done in August of 2015. It was positive.

4,000 cases of Anaplasmosis were reported to the CDC’s Morbidity and Mortality weekly since the disease became nationally reportable, but it is thought to be much higher.

deer tick tock

Signs and symptoms of Anaplasmosis can include:

  • fever
  • headache
  • muscle pain
  • malaise
  • facial palsy
  • demyelinating neuropothy
  • brachial plexapothy
  • chills
  • nausea/abdominal pain
  • cough
  • confusion
  • respiratory distress syndrome

Anaplasmosis can be fatal. Severe presentations include

  • hemorrhage
  • neurological problems
  • difficulty breathing
  • renal failure

It is believed that patients with immune suppression experience more severe disease as well as higher fatality rates.
Most deaths are cause by opportunistic infections like candida pneumonitis and pulmonary aspergillosis in immune compromised patients.

NIAD (National Institute of Allergy and Infectious Diseases) found that co-infection with Anaplasma also resulted in more severe Lyme diseases in coinfected patients.
Yet, in the same study, mice co-infected with babesia and borrelia did not effect each other’s diseases severity.

deer tick actsize

As with RMSF, the CDC states that administration of sulfa drugs during acute illness worsens diseases severity. Again, when I got sick, I sought help at an emergency clinic and a local emergency room. I had many of these symptoms and reported a history of many tick bites. Yet nobody ran any tick tests. I was wrongly diagnosed with a kidney infection due to elevated white blood cells and abdominal pain, fever, vomiting, muscle aches, chills, headache, and neuropathy. I was given sulfa drugs and sent home. Unfortunatley, there is no way to know which of my many infections caused my specific problems. There is quite a bit of overlap in symptoms between tick borne infections. Maybe it was Anaplasma. Maybe it was something else. Maybe the sulfa drugs I should not have been prescribed made it progress to severe diseases. There is just no way to know.

As with many other tick borne diseases, the CDC recommends that diagnosis be made clinically based on signs and symptoms later confirmed by blood test. Again, they specifically state here that treatment should never be delayed pending receipt of lab tests or due to a negative lab finding. And they state that treatment should be continued until at least 3 days after fever ends and after evidence of other clinical improvement.

There are no ambiguous grey areas of testing or treatment when it comes to Anaplasma. Yet, just as with Rocky Mountain Spotted Fever, my very positive tests and accompanying awful symptoms still did not bring me relief from my suffering. I was given the excuse that I had been given oral doxyxycline. Therefore Anaplasma could not be what was making me sick. Despite the fact that I had most symptoms and had a fever for several years. The response n the part of Doctors in my case has made absolutely no sense. Again, find me one source that says treatment should stop when there is still fever and still symptoms. You will not find anything because it is quite clear cut. This is a very bad nasty bacterial infection that should not be taken lightly.
I was eventually dismissed by multiple infectious diseases doctors, despite symptoms and positive blood tests, simply because that was the simpler action. Nobody told those ID Doctors that Anaplasma never needs more that 7-10 days of antibiotics. Nobody told these physicians to use some sort of surveillance definition. This is totally clear cut. If you test positive, have fever, and other symptoms you need treatment. It was withheld from me and I was allowed to continue to get sicker and sicker until I finally took matters into my own hands and gave up on the broken health system and my medical insurance and sought an LLMD.
Now, after it was ignored for so long, the LLMD is faced with the terrible task of trying to sort out my many diseases and take care of all of them, when all of them were allowed to progress to severe disease, when they could have been fixed before they ever got that far.

This is the sad truth of Anaplasma and my experiences with this potentially deadly bacteria so far. The war still rages on….

Leave a Reply