Are you aware of the animal-borne disease called Bartonellosis?

Do you ever have a beloved cat at home that bites you or gives you a little nibble? Most of the time, we take it for granted and forget about it. But sometimes, after such a small incident, the wound swells up a little, and after a few days, lumps like boils appear in places like the armpits and neck, and the body may feel feverish. We think it's a cold. But behind this could be a group of bacteria called `Bartonella`. Today we are talking about a disease called `Bartonellosis` that can be transmitted to us from these animals. Don't worry, let's understand this simply.

Simply put, what is Bartonellosis?

Bartonellosis is not a single disease. It is a group of infectious diseases caused by bacteria called Bartonella. There are currently 22 known species of this bacteria, of which about 15 species can cause disease in humans.

This disease is important to us because it is a zoonotic disease . This means that we can get it from our pets or other animals in the house. This bacteria is spread from one animal to another and from animals to us through vectors such as fleas, lice, or sand flies. Also, if an infected animal bites or scratches you, the bacteria can enter your body, even directly.

What are the causes of Bartonellosis?

The `Bartonella` bacteria is like a parasite that sneaks into our bodies. Once inside the body, this bacteria directly targets our red blood cells , macrophages , which are important cells of the immune system, and endothelial cells, which line the inside of our blood vessels. This bacteria causes disease by entering these cells and hiding inside them.

The disease caused by the Bartonella bacteria varies depending on the species. There are three main types that we see and talk about most often.

What are the symptoms of Bartonellosis?

Common symptoms of Bartonellosis include fever, chills, fatigue, and headache. However, as we discussed earlier, specific symptoms vary depending on the type of bacteria causing the disease.

Cat Scratch Disease

This is the most common type of Bartonellosis. Symptoms may appear a few days or weeks after a cat is bitten.

• The site of the lesion: It starts as a red spot, then after about a week, it develops into a small bump. It is not painful or itchy. Sometimes it fills with fluid, then dries out, and heals within 1-3 weeks, leaving a scar.
• Lymphadenopathy: This is the main symptom of this disease. The lymph nodes near the wound become swollen. For example, if there is a wound on the arm, the nodes may swell in the armpit, if there is a wound on the leg, in the groin, or if there is a wound on the neck, the nodes may swell in the neck. When touched, these swollen areas may be painful, warm, and may even turn red. In some people, these may also become infected.
• Other symptoms: Body aches, fatigue, headache, fever, loss of appetite, sore throat, and weight loss may also occur.

In a healthy person, these symptoms usually go away in two to three months without treatment. However, in someone with a weakened immune system, the bacteria can spread to the eyes, liver, heart, brain, spleen, or even bones, causing severe infections.

Carrion's Disease

This is not very common in Sri Lanka. There are two main stages to this.

• Acute stage (Oroya Fever): This is characterized by sudden onset of high fever, chills, severe headache, weakness, and pale skin. The destruction of red blood cells can lead to anemia, which can lead to more serious conditions such as difficulty breathing and chest pain.
• Chronic stage (Verruga Peruana): After the acute stage, red-purple bumps (Peruvian warts) begin to appear on the skin. Over time, these can blister, ulcerate, and bleed.

Trench Fever

This is also not common in our country. In this case, about 5 weeks after the bacteria enters the body, fever, headache, dizziness, and body aches suddenly appear. The most unusual thing is that the fever can subside for about 5 days and then reappear.

How to accurately diagnose this disease?

Because the symptoms of Bartonellosis are similar to other common bacterial infections, it is difficult for even a doctor to confirm it based on symptoms alone. Therefore, blood tests are required to determine this for sure.

Your doctor may take a blood sample and perform specific tests such as PCR (Polymerase Chain Reaction) or DNA Sequencing to look for DNA fragments of the Bartonella bacteria. They may also perform tests to look for antibodies that our bodies produce against this bacteria.

If the disease is severe, a small piece of infected tissue (e.g., a swollen lymph node) may be taken (biopsy) and examined.

What are the treatments for Bartonellosis?

The good news is that a mild infection like Cat Scratch Disease in a healthy person can usually resolve itself in a few months without antibiotics.

However, if your symptoms are severe, or if you have a weakened immune system, your doctor will likely prescribe antibiotics. This treatment usually lasts for 4-6 weeks. They will also give you medication for fever and pain.

• Cat Scratch Disease: Antibiotics like `Azithromycin`, `Rifampin`, `Ciprofloxacin` are usually given for this. Drugs like `Penicillin` and `Amoxicillin` are not effective because this bacteria is resistant to them.
• Carrion's Disease: This is treated with drugs like `Ciprofloxacin` or `Chloramphenicol`. If the anemia is severe, blood transfusion may also be required.
• Trench Fever: This is treated with `` Doxycycline(Medications such as Doxycycline or Gentamicin are given for 2-4 weeks.

How can you protect yourself from this disease?

Staying safe from this disease is not that difficult. It's enough to follow a few small steps.

• Protect your pets (cats, dogs) from fleas and other parasites by providing them with the necessary treatment at the right time.
• Avoid scratches and bites as much as possible when playing with your cat. Be sure to wash your hands thoroughly with soap after playing with your cat.
• Protect yourself from lice (especially body lice). Stay clean.
• Protect yourself from sandflies in areas where they are common. Use insect repellents and mosquito nets.
• If you have a weakened immune system, have a pet, or have other concerns, talk to your doctor for advice.