In this blog, we will look at Bartonella. You will learn:

• What Bartonella is and how it compares to Lyme Disease
• How Bartonella is spread among humans
• How a Bartonella infection can be addressed

Do you know what Bartonella is and how it spreads? Do you or your clients know why Lyme Disease and its co-infections are becoming increasingly common? If you want to know more about this growing threat and how to best optimize the health of your clients, then this blog is for you. Please read on for answers!  

Do you get stuck clinically with chronic symptoms in your patients?  Would you like to have a larger impact on improving your clients’ issues? 

The key to optimal health is an individual approach using nutrition, lifestyle and exercise. To improve your patients’ quality of life, you need to identify and address the root causes. Our functional medicine course will teach you how to do this. Look into our functional medicine school to have a greater impact on improving your client’s lives.

** Please note: If you want the short summary version of this 

What is Bartonella?

Bartonella is a bacterium that causes the disease Bartonellosis. It can infect humans and animals, including cats and dogs, and cause Bartonellosis. In recent years, Bartonella infections are reported to be on the rise (Álvarez-Fernández A, 2018). 

What we call the Bartonella bacteria is actually approx. 15 different bacterial species (Columbia Univ., 2022). 38 different Bartonella species have been detected in humans and animals and 13- 15 Bartonella species cause disease in humans (Álvarez-Fernández A, 2018). Three species are thought to be responsible for the majority of Bartonella illness: Bartonella bacilliformis, Bartonella quintana and Bartonella henselae (Álvarez-Fernández A, 2018). 

The severity of Bartonella infection is related to the patient’s immune status and how immune-compromised they may or may not be (Angelakis E, 2014). Many human Bartonella infections are poorly understood. It is possible that some of the Bartonella bacterial species are non-pathogenic and do not cause symptoms, at least in immunocompetent people with a strong immune system (Columbia Univ., 2022).

Is Bartonella the Same as Lyme Disease?

Bartonella is a co-infection of Lyme Disease. A co-infection is a simultaneous infection by two or more pathogens that cause disease.  A Lyme Disease co-infection is when a person is simultaneously infected with Lyme Disease and one or more of the other vector-borne diseases. Co-infections may actually be more common than a single infection.

• In a survey of over 3,000 patients with chronic Lyme Disease, over 50% reported confirmed co-infections, with 30% having 2 or more co-infections (Lymedisease.org, 2014). 
• The most common co-infections reported with Lyme Disease are Babesia (32%), Bartonella (28%) and rickettsial illnesses (26%) (Lymedisease.org, 2014). 

Co-infections may explain why some people with Lyme remain chronically ill, even after treatment.

What are the Symptoms of a Bartonella Infection?

The symptoms of Bartonella can vary from mild to severe and life-threatening. Bartonella symptoms usually begin 5 to 14 days after infection (Lymedisease.org, 2022). The early, common symptoms include fever, headaches, fatigue, poor appetite, brain fog, muscle pain and swollen glands around the head, neck and arms. Bartonellosis may include a rash that looks like stretch marks from pregnancy. 

Other common symptoms include blurred vision, numbness in the extremities, memory loss, balance problems, tremors and even psychiatric issues or neurological symptoms.  

Symptoms specific to cat scratch disease are swollen lymph nodes, a pustule (similar to a pimple) at the infection site and possibly fever. In rare cases, it can also cause complications affecting the brain, eye disorders, severe muscle pain, infections of the liver, spleen or bones. 

How Serious is a Bartonella Infection?

Bartonella infection does not always cause obvious illness. Healthy people can test positive for Bartonella but have no history of typical Bartonella symptoms. Those who do get sick often develop only a mild case that usually resolves itself without treatment (NORD, 2020). 

However, Bartonella can cause severe infection in some people. Immunocompromised patients, those undergoing immunosuppressive treatments for cancer, organ transplant patients and people with HIV/AIDS, are more likely to develop severe, life-threatening disease.

Bartonella can cause chronic infection. Some species of Bartonella may lead to a chronic infection lasting months to years, and possibly also causing a range of neuropsychiatric symptoms (Balakrishnan et al. 2016). People may have relapses because the Bartonella bacteria can persist and hide from the immune system (Lymedisease.org, 2022).

These rare symptoms are more common in immunocompromised patients including small children with less developed immune systems. Without treatment, a severe Bartonella infection can be fatal.

How is Bartonella Transmitted or how do People get Bartonella?

Bartonella has been found in 49 out of 50 US states (Lymedisease.org, 2022). It is a vector-borne disease. Bartonella bacteria are transmitted by fleas, sand flies, lice, biting flies and most likely ticks (Deng H, 2018). It is also transmitted by animal bites and scratches. Cats are often carriers of Bartonella bacteria, hence the name ‘cat scratch disease’.

Cat scratch disease is caused by Bartonella henselae and can result from a cat scratch or bite (Columbia Univ., 2022).

It is thought that ticks transmit it to humans but this is not entirely certain. The evidence for ticks as vectors of Bartonella is circumstantial but strong: (Columbia Univ., 2022) 

• People with tick bites and no known exposure to cats have acquired the disease. 
• People who recall being bitten by ticks have been co-infected with Lyme and Bartonella. 
• Scientists have established that ticks can transmit Bartonella to mice. Ixodes ricinus ticks can 

get a Bartonella birtiesii infection from an infected mouse and transmit this infection to another uninfected mouse (Reis et al. 2011). 

• Ixodes ticks can be vectors of Bartonella henselae in addition to Borrelia, Babesia and Annaplasma organisms (Cotte et al. 2008). 
• But the ability of Ixodes ticks to actually transmit Bartonella henselae to humans has not yet been specifically demonstrated (Columbia Univ., 2022).
• In a study of Ixodes pacificus, Western blacklegged ticks collected in California, 19.2% were carrying Bartonella. Five different species of Bartonella were detected (Lymedisease.org, 2022).
• The CDC says ‘There is no evidence that ticks spread Bartonella infection to people’ (CDC, 2022).
• More research needs to be done to establish the role of ticks in spreading the disease. 

Ticks are often infected with multiple pathogens that may be bacterial, viral or parasitic. One study found 45% of ticks were co-infected with up to 5 different pathogens (Lymedisease.org, 2022). This makes ticks a common vector of various diseases including Lyme co-infections.

Finally, a recent study suggests that Bartonella may be passed from mother to unborn child through perinatal transmission (Lymedisease.org, 2022).

How Common is Bartonella?

20’000 cases of Bartonella henselae or cat scratch disease are reported each year in the US (Columbia Univ., 2022). Cat scratch disease caused by Bartonella henselae infection occurs in approximately 1 per 10,000 persons (NORD, 2020). 33% of patients with cat scratch disease are 14 years old or younger (NORD, 2020).

Cat scratch disease occurs throughout the US and worldwide. The incidence is higher in regions with higher temperatures and humidity, which supports large flea populations (NORD, 2020). In the US, the majority of cases occur between the months of July – January and are higher in the South and lower in the West (NORD, 2020).