Co-infections of other bugs often play a role in creating symptoms for patients.
Lyme disease is an infection with one or more species of Borrelia bacteria, however other infections are often present too. We call these additional bugs ‘co-infections’ and they can be bacterial, viral, or parasitic.
Bartonella and Babesia are both common co-infections that can be present in a person with Lyme disease. It’s not unusual for these co-infections to be driving the majority of a person’s symptoms.
This is important to know because the treatment for each is different. For example, Babesia is a red blood cell parasite so antibiotics directed at the Lyme bacteria will not affect it. Often, our doctors only know of Lyme disease as an infection with the bacteria, Borrelia burgdorferi.
Lack of knowledge about the different species of Borrelia and it’s co-infections is just one of the many layers that make this condition so complicated and therefore difficult for most to identify and treat effectively.
Possibly the most troubling aspects of this illness is that there are no clear set of symptoms that all Lyme patients possess. It has been called “The Great Imitator,” since it can cause a variety of symptoms in different people. One person can have joint pain that moves from location to location while another person might only be experiencing neurologic symptoms, yet they have the same infection. Unfortunately, this means the infection is usually not identified in its early stages when its easiest to treat.
Lyme disease and its co-infections are carried by ticks. There is mounting evidence that these infections can also be passed by other biting insects. Less than half the people who test positive for Lyme disease recall a tick bite. When bitten by an insect that transmits Lyme, there is a specific rash than can happen on the skin that looks like a target made up of expanding red rings called an erythema migrans (EM) rash.
A common misconception, even in the medical community, is that this rash is always present when Lyme is transmitted. The research shows that this rash happens in less than 50% of patients with Lyme. When a person has an EM rash, we know there is Lyme infection present as there is no other known cause of an EM rash.
Other than an EM rash or an embedded tick, there may not be any immediate signs of a Lyme infection. Within a week of infection, people often experience symptoms that look like a mild flu. In many, this sequence of events is not put together in a way that points to an infection with the Lyme bacteria. As the next few months unfold, vague and seemingly unrelated symptoms begin to appear.
Author: Dr. Shaun Riddle
July 26, 2018