Bartonella, Babesia and Chronic Fatigue Syndrome

A pilot study has found evidence of Bartonella and Babesia infection in almost half of 50 blood samples from patients suffering chronic fatigue syndrome, also called myalgic encephalomyelitis (ME).

Bartonella species comprise a group of vector-borne bacteria transmitted primarily via arthropods like fleas, lice and potentially ticks, but also by the animals that harbor the bacteria in their blood. For example, Bartonella henselae is associated with cat scratch disease, which until recently was thought to be a short-lived (or self-limiting) infection. There are at least 45 different known Bartonella species, of which 18 have been found to infect humans.

Improved methods for detecting Bartonella infection in animals and humans have led to the diagnosis of bartonelloses in patients with a spectrum of chronic symptoms, as well as in some patients with neuropsychiatric symptoms.

Babesia comprises another group of vector-borne bacteria that are transmitted mainly through tick bite, although there are reports of transmission by transfusion of infected blood, transplacental transmission and infection in organ transplant recipients.

Babesia and Bartonella are often suspected as co-infections with Lyme disease, and a previous NC State study detected co-infections with both genera in patients with unspecified chronic illnesses.

For this study, 50 participants were selected from a cohort of 173 individuals enrolled in a larger study aimed at detecting Bartonella in the blood of people with chronic illness and extensive animal contact. All participants reported fatigue lasting over six months and one or more neurological symptoms, specifically including: difficulty remembering, disorientation, irritability, rage, aggression, difficulty sleeping, seizures, tremors, headache, mental confusion, hallucinations, and anxiety/panic attacks.

Quantitative polymerase chain reaction (qPCR) amplification and DNA sequencing of blood or enrichment blood culture samples confirmed infection with Babesia, Bartonella, or both genera in 10, 11 and two (23 of 50) participants, respectively.

“ME/CFS diagnoses are primarily based upon immunological biomarkers that can have numerous influences,” said Edward Breitschwerdt, study author and Melanie S. Steele Distinguished Professor of Internal Medicine at NC State’s College of Veterinary Medicine.

“Our goal was to detect the DNA of specific pathogenic microorganisms, to provide molecular evidence of infections that might contribute to or cause a patient’s chronic illness. While this small cohort of chronically ill people can’t be generalized to the entire ME/CFS patient population, this study provides documentation supporting a potential role for Babesia and Bartonella infection in patients with presentations consistent with ME/CFS. Therefore, the somewhat unexpectedly high prevalences in our study are a jumping off point for further exploration.”

The study, supported in part by the Steven & Alexandra Cohen Foundation, appears in Pathogens.