Who's at risk
Researchers to date have discovered that immunocompromised people are at increased risk of Bartonella species-related infection.
"Yet, it's reasonably clear from the research that you don't have to be immunocompromised to develop bacteremia with many
members of the genus Bartonella. As a veterinary internist, I am even more concerned about pets harboring Bartonella species that could be transmitted to people with immunocompromised systems — if they're exposed to organisms," Breitschwerdt
"Using a novel diagnostic testing approach we've developed at NCSU, we've been able to determine that dogs, horses and people
can have chronic infections within their blood. And, by the way, they're not immunocompromised," he adds. "Although we've
come a long way and have the most sensitive diagnostic modality currently for protecting these bacteria, there's still much
work to be done regarding diagnosis."
A veterinarian's most important response to the research findings should be to help keep ticks and fleas off dogs and cats
so that the vectors known to transmit Bartonella species aren't transmitting. Breitschwerdt recommends using any safe, effective products to kill fleas and ticks.
He cautions, however, "Despite how good the products are, vectors and organisms are pretty talented. Don't create expectations
that the products can offer 100 percent guarantee of removal of the potential for infection. Vaccination would get us a lot
closer to our goal."
The second most important step for veterinarians is to continue to follow the literature relative to the importance of the
bacteria and how they cause disease in cats, dogs and people.
Third, advise clients to avoid bites and scratches from cats and dogs.
On the horizon
Major pharmaceutical companies are becoming aware that there is a need to vaccinate dogs and cats against these bacterial
"If these animals are being vaccinated, then one mode of transmission to humans would be cut off," Breitschwerdt says.
"The question is why there is not more recognition in veterinary and human medicine about the importance of the Bartonella species bacteria now," he notes. "Much of what is being published are case reports and series. There's good reason for that
— the type of funding it takes to do large clinical trials is not available.
"Until we can elevate the biomedical importance of this genus to the level that others really think it's important enough
to fund, we're in a tough place."
The way Breitschwerdt and his team of researchers began focusing on Bartonella species in research relative to humans is that they were trying to devise a better way of diagnosing bartonellosis in dogs.
He and other researchers began to develop a diagnostic enrichment culture approach because of queries by veterinarians and
veterinary technicians with disease manifestations similar to dogs. They wanted to know if they could be affected by exposure
to these dogs.
Currently, Breitschwerdt and other researchers are collaborating with Duke University Medical Center, with physicians at UNC
Chapel Hill, with researchers in Brazil and with some researchers Germany.
"It is possible that there will be a tipping point, which, based on our work, will result in improved funding for this genus.
My fear is that, until then, basic science researchers around the world will not be able to keep labs open and do research
if there isn't funding. Many researchers have given up on Bartonella in the United States and internationally because they've struggled to get funding. But this is the worst time in history
to give up. We are getting close to a point where it may not be quite so hard to convince those with influence that this genus
is important enough for studies," he explains.
Breitschwerdt has spent the last two years getting his own company, Galaxy Diagnostics, which employs eight, launched. There's
an animal-health division and a human-health division, both of which offer testing for Bartonella species. Visit
http://www.galaxydx.com/ for more information.
"Given everything we have learned to date about Bartonella, I want to be cautious not to overstate what we know about the genus. It is so much more important than any of us currently
realize, including me. The place where we're in trouble is in proving how the bacteria is causing chronic illness. The issue
is what is Bartonella causing, how does it do it and how long does it take to do it?" he says.
Ms. Skernivitz is a freelance writer in Cleveland, Ohio. She is formerly a senior associate editor of DVM Newsmagazine.