Beyond Borrelia - co-infections in tick borne illness

Perhaps the most well known consequence of a tick bite is Lyme disease, or infection with Borrelia burgdorferi.  But we’re finding that this is just the tip of the iceberg when it comes to tick borne illness.

Borrelia burgdorferi is one of many bugs that can be transmitted from a tick-bite. We refer to these other bugs as tick borne co-infections, or infections that can be transmitted alongside each other by a tick bite. And we’re finding that co-infection in our patients is becoming the rule rather than the exception.Common tick borne co-infections include: 

• Babesia

• Bartonella

• Anaplasma/ehrlichia

• Rickettsia species

• Tick-borne encephalitis virus

• Powassan virus

• Relapsing Fever Borrelia

To complicate matters further, there are also non-tick borne co-infections that need to be considered in patients with tick borne illness.  These infections are commonly occurring or reactivated in patients with tick borne illness but they are not necessarily transmitted by the tick. Common non-tick borne co-infections:

• Epstein barr virus

• Herpes Simplex virus

• Human herpes viruses

• Cytomegalovirus

• Chlamydia species

• Mycoplasma species (may or may not be tick borne)

So why is all of this important in suspected tick borne illness? 

1. It may explain why there is such a diversity in how Lyme disease and tick borne illness presents. Your symptom presentation and severity will depend on the unique constellation of infections as well as your unique immune response to them.

2. Testing for Borrelia burgdorferi alone in the context of tick exposure may lead to undiagnosed co-infections. This can lead to misdiagnosis and/or treatment failures as different co-infections may require different treatments.

So how do you know which co-infections to test for?

Symptoms serve as the best clues to which co-infections might be present and can help inform testing and diagnosis.  

The takeaway -- It’s important to test for co-infections in cases of suspected tick exposure and/or positive Lyme testing, especially if treatment for Lyme disease alone has failed. It’s also important to remember that tick borne disease will look different in different people, which can be problematic for diagnosis. 

Stay tuned for more details about the common co-infections and their symptoms!

Dr. Carolyn Mukai, ND

Call Tandem Clinic at 604 670 0590 or schedule online here