Bartonellosis: Your Kitten Is Really Cute, But…

This is all about Bartonellosis, an illness you may never have heard of even as doctors are thinking it’s more widespread than anyone thought. Here’s why:
–30% of US households have one or more cat.
–The estimated US household cat population is 86 million.
—Feral (outside, not domestic) cats add another 50 million.

136 million cats is a lot of felines.

The Centers for Disease Control (CDC) estimates that slightly less than half this population (46%) carry the bacterium Bartonella, which cats acquire from a flea bite. Obviously cats confined to your bedroom are less likely to be exposed.

Your cat never gets ill from Bartonella, but can transmit the infection to you. The most common way you get infected is from a scratch or a bite. Less often, and unrelated to cats, you can get bitten by a tick, sand fly, or mosquito carrying Bartonella.

The first manifestation of Bartonella infection is a condition called cat-scratch disease (CSD), which can manifest three to ten days after the scratch or bite. Symptoms may include swollen lymph nodes, especially those nearest the scratch. You might also have a rash, fever, headache, and fatigue. When people see a doctor about this, they usually receive antibiotics. But many people just hope it will go away, or they think it’s a case of the flu and tough it out. Indeed, CSD does clear up on its own, with or without antibiotics.

Ominous Bartonella can live on
But now we know there’s more to CSD and Bartonella than meets the eye. Bartonella can live on in the human body for years–decades even–as an opportunistic infection, meaning it can slowly spread almost everywhere but be kept in an inactive/dormant state by a well-functioning immune system.

You can grow old with dormant Bartonella, die of something else, and never even know you were carrying it. But if your immune system is preoccupied elsewhere (such as with physical or emotional stress or another illness) and turns its back, so to speak, on your Bartonella the infection can awaken and begin spreading havoc.

And then, often years after the original scratch, cat bite, or tick bite, the Bartonella can produce a jaw-dropping array of symptoms. In addition to the standard symptoms of any chronic infection (fatigue, fever, swollen lymph nodes, feeling inflamed, brain fog), you might experience the following:
–A variety of bizarre neurologic symptoms (numbness, tingling, vibrating sensations, seizures, headaches, uncontrollable tics, and other body movements), which you might describe to your doctor as just “weird.” Yes, the Bartonella is in your nervous system.
–Because it’s in your brain, you may experience personality changes, mood swings, depression, and being really sensitive to smells, foods, chemicals, lights, touch, and even electromagnetic fields (EMFs).
–Because Bartonella triggers inflammation you might have muscle and or joint pain.
–Gastrointestinal symptoms like heartburn, diarrhea, abdominal cramping.
–And if it attacks your heart, you might have an abnormal heart rhythm, chest pain, and heart murmurs.

With any symptoms like these, you’re clearly heading for your doctor’s office, and although you may look reasonably healthy, you know something is seriously wrong. You try to describe the crawly sensation in your legs, the vibratory buzzing under your skin, and your panic attacks, and while your doctor is trying hard to connect the dots, none of this fits into her framework of the human body and its illnesses.

To make matters worse, you’ve long forgotten about your cat scratch. In fact, the topic of your cat (or the cat you had in college) never even enters the conversation.

Your physical exam and lab work are all normal. If your doc knows what she’s doing, she checks you for Lyme disease, but that test will be negative as well (unless you do have Lyme–you certainly can have both Lyme and Bartonella simultaneously).

Many doctors later…
Generally, it will take a half dozen doctors sometimes months or even years before Bartonella pops into consciousness. Too often your diagnosis is written off as a somatoform disorder, a polite way of saying it’s all in your head. Unfortunately, there are no consistently reliable diagnostic tests for Bartonella and although the treatment (several months of multiple antibiotics) is effective, many doctors are reasonably reluctant to start patients on antibiotics without some sort of diagnostic evidence.

The key test is finding antibodies that your immune system has created against the Bartonella, but (and as a physician I have to say this is immensely frustrating) the bacterium is really good at staying just below your immune system’s radar so that measurable antibody levels are not produced by your body.

Why am I telling you this?

Because the number of patients who suffer unexplained chronic symptoms is enormous. These are the folks who haven’t felt well in years, have endlessly been told “we can’t find anything wrong with you–your tests are normal.” They’ve been tested up the wazoo for Lyme disease (negative, although as I said, you can have both Lyme and Bartonella if the source was an infected tick), mold toxicity, various chronic viruses, environmental toxins, etc, and nothing has been found.

Until a bright idea comes to your doctor and she asks, “By the way, have you ever had a cat?”

Be well,
David Edelberg, MD