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[Begin Dr. Horowitz Video]

00:00:00

Dr. Horowitz: Babesiosis is a tick-borne disease which is associated with Lyme disease. I was the first doctor in the Hudson Valley to discover it approximately 12 or 13 years ago. And its now in the ticks in the Hudson Valley. They did a study back in 2009 by a doctor, Dr. Tokarz; so now when you get a tick bite in the Hudson Valley you not only have a chance of getting Lyme disease but you also have a chance of getting Babesia, which is a malaria-like organism.
00:00:28

So what that means is--is that if youre a patient who has been suffering from Lyme disease and you tend to have day sweats, night sweats, which can be drenching, chills, which can be shaking chills, you might have tremendous fatigue and joint pain, but--so all of your Lyme symptoms get worse, but there is this malarial component of day sweats, night sweats, chills, and some atypical symptoms--are cough and air hunger--. Patients will for example not have asthma, not have allergies, not have emphysema, and theyll complain of this cough they can't get rid of or this air hunger, the shortness of breath; those are the most classical symptoms of Babesia.
00:01:08

So if you were going to your doctor in the Hudson Valley and you had symptoms of good and bad days where some days youre ill and you feel tired and you have muscle pain and you have joint pain, you might have tingling and numbness, which comes and goes and migrates, muscle and joint pain that comes and goes and migrates, you have headaches, stiff neck, tingling and numbness, memory concentration issues--I can't sleep, I can't fall asleep, Im waking up in the middle of the night, Im depressed, Im anxious--those are all symptoms of Lyme disease, but theyre much worse when you have Babesia. So Babesia makes Lyme three-times worse.
00:01:43

So if you have a horribly bad case of Lyme disease that youve not gotten over one of the first things you need to think about is, do I have Babesia? Has it gotten in from the same tick? And the way that you know in part is because you have these malarial-type symptoms of day sweats, night sweats, chills, fevers.
00:01:59

Transcript by: Shelley Chance DBA Pro Docs www.prodocservices.com

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Now the problem with diagnosing it is that doctors are taught that there is a blood test thats called a Giemsa stain. Its a smear where they look under the microscope and theyre supposed to be able to find the organism. The problem is--is that if theres not a lot of organisms in the blood and they call this the level of parasitemia because its a parasite Babesia--you won't be able to see it under the microscope. Its difficult to find. So when I started looking in the Hudson Valley 13 years ago I couldnt find it on a Giemsa stain. I had to start sending out to my blood tests to other labs where we did Babesia titers.
00:02:35

So there--there are several things you need to know about the diagnosis which is the Giemsa stain is very difficult unless youre very, very ill. Babesia, there are several strains, so here in the Hudson Valley most doctors might check for one called Babesia Microti. Thats the most common one that doctors usually look for. So you can do that by titer; its called an IFA, immuno-fluorescent antibody. But theres another strain of Babesia called Babesia WA1 Duncani, which won't test positive by Babesia Microti testing. So you could still have the malarial symptoms; you say oh, I looked for Babesia and I didnt find it, but its because in fact youve got this other strain of Babesia. And we did testing through Lab Corp; it was about a year and a half ago and I presented this at one of the International Lyme Conferences. Nineteenpercent of all the blood tests that I sent out for patients and that includes Poughkeepsie, Wappingers Falls, all the way down from Winter Park, Florida to Hamlin, Maine, the entire northeast seaboard, Ive been getting Babesia WA1 Duncani in 19-percent just doing a regular blood test for Babesia WA1 Duncani. Most of the doctors do not test for this strain of Babesia.
00:03:47

Now the other thing thats confusing is when the doctors look for Babesia theyve been taught in medical school that there are certain symptoms apart from the malarial symptoms of day sweats and night sweats and chills that youre supposed to get an anemia. Its called a hemolytic anemia, meaning the red blood cells burst apart and youre supposed to look for that to see if someone has Babesia or their liver functions might go up or their platelet count might go down. Its called thrombocytopenia. The problems is--is that the strains of Babesia that were seeing in the Hudson Valley generally do not cause that. We see subclinical presentation; so in other words its just kind of making your Lyme a lot worse and youve got these malarial-type symptoms with it.
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00:04:30

The type of Babesia that causes those types of really bad symptoms is a form that they mainly see in Europe called Babesia Divergens. And I was called up by the Chinese government. They flew me to Beijing and Shanghai about a year and a half ago to meet with their CDC and their government to discuss Babesia because they were starting to see it in China and they--they weren't identified as species. They couldnt tell; like it looked like Babesia but they weren't seeing the anemia, they weren't seeing the lab manifestations and they couldnt identify the species. So they knew that I had a lot of experience and several of the other experts they called over from the United States couldnt help them, so I was there for one week meeting with their CDC and their government discovering--you know discussing Babesia, how you treat it, how you look for it in patients.
00:05:14

I think the most important thing here in the Hudson Valley is there is a questionnaire that I use that all doctors in this area should be using--really in the United States. And its a 38-item questionnaire. It was initially developed by another doctor and weve taken it and weve given it to all of our patients in the practice when they come in. Now if youre for example a Psychiatrist who is seeing someone who is depressed or anxious, they may not tell you theyre having malarial-symptoms of Babesia. Or, they may not tell you theyre having good days and bad days where their joint pain and their muscle pain migrates and moves around their body.
00:05:50

Lyme is a systemic illness, so it has all of these other symptoms. You can hand out this questionnaire to your patients when they come in for routine visits. The first question is do you have fevers, day sweats, night sweats, chills; do you have cough, do you have air hunger? In other words, do you have these malarial-symptoms? So thats the first way that you could easily as a doctor ask your patients whether theres a likelihood of Babesia.
00:06:14

Now there are other differential diagnoses that cause sweats. You could have malaria. You could have traveled to India. You could have tuberculosis with drenching night sweats but then that would be with a very bad cough. You could have non-Hodgkins Lymphoma. You could be in menopause. You could have hyperthyroidism. In other words, its not one thing that causes sweats and chills. But you need a differential diagnosis and if youre ruled out those other causes which are really the most frequent causes of sweats or chills then the likelihood if youve
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had a tick bite in the Hudson Valley is youve been exposed to Babesia. But the testing is so unreliable you need to understand that if the Giemsa stain is negative and the Babesia titer is negative for Babesia Microti, you need to check for this other strain of Babesia called Babesia WA1, Babesia Duncani, but theres also patients who need to also have DNA testing called PCR, polymerase chain reaction, or sometimes the titers, the antibodies are not formed so you dont get a positive titer. You only find the DNA of the organism in the blood, or you find the RNA of the organism in the blood and thats called the FISH test. It stands for fluorescent in situ hybridization. And this is a test thats done from Igenex Laboratories in California.
00:07:30

So what I suggest to people is called a Babesia panel approach. You can't pick it up on one test. You want to do a panel approach with these different tests if youve ruled the patient out for these other diseases that cause sweats and chills and especially if they have a multisystemic illness of good days and bad days, women usually flare right before, during, or after their menstrual cycle with Lyme disease, and especially if you had a case of Lyme where youre not getting over it and youre very, very ill. And thats--thats basically the way that we do it in our practice.
00:08:06

Question: I just want to make a note here. Is--is this something that seems to be growing in the Hudson Valley? Do you see more--more of this or is there a growing concern?
00:08:19

Dr. Horowitz: Babesia is definitely growing in the Hudson Valley. There was an article that was published by Dr. Joseph several years ago that theres been a 20-fold increase in Babesiosis in the last several years. Now I want to point out that theyre looking at some of the cases that have been directly reported to Health Departments and the rest. Im not quite sure with Babesia WA1 Duncani, but when I--my Lab Corp testing is positive--Im not quite sure how often that makes it into their testing at this point, but we know that Babesia has increased and I would say that Ive seen at this point over 12,000 chronic Lyme patients. They come from all over the United States. They come from Europe. They come from all over the world to see me.
00:08:59
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They have Babesia all over the--the world at this point in time. It is a--its a spreading epidemic the way Lyme is. I know some people dont necessarily think of it as an epidemic, but from what Im seeing this disease is spreading in epidemic proportions because the testing is just inadequate to really pick it up. So Babesia is spreading; its now in the ticks in the Hudson Valley. This study by Tokarz that was done they found that 71-percent of our ticks in this area contain one organism, so that could have been Borrelia Burgdorferi, the organism that causes Lyme. Borrelia Miyamotoi which is the organism of relapsing fever in Japan--so heres the problem; youve got Lyme-like symptoms with muscle and joint pain thats moving around your body and tingling and numbness moving around and your memory is off and you can't sleep and youre very tired and you have headaches and stiff neck, but you dont test positive for Lyme because its another strain of Borrelia. Now thats in the ticks in the Hudson Valley.
00:09:55

Weve got Ehrlichia and Anaplasma and theyre now showing Babesia in the ticks in the Hudson Valley; this was proven several years ago. Even Powassan Virus, theres a very dangerous virus thats in the ticks here now in one or two-percent of the ticks, so that can be lifethreatening. So with one tick bite you can get Lyme disease, Borrelia Burgdorferi, Borrelia Miyamotoi, Anaplasma, Babesia, Powassan Virus, and we see patients who come into us--part of the reason they dont get better is they have these multiple infections at the same point. They have Lyme, they have Ehrlichia, they have Anaplasma, they have Bartonella which is Cat Scratch Fever; they have Mycoplasma species, they have Rocky Mountain Spotted Fever, QFever--all of these different tick-borne infections can get into patients and they overwhelm the immune system.
00:10:44

So we are definitely seeing more and more Babesia, but especially this other strain of Babesia WA1 Duncani, doctors in our area definitely need to start looking because as I said, this was Lab Corp testing where I found almost 20-percent of my patients from Maine all the way to Florida and it included Poughkeepsie and Wappingers, they were testing positive for this strain and you would not pick it up looking for Babesia Microti. So its very tricky; you need to understand all the different strains of Babesia. And its even trickier because there are 100 different strains. Theyre called piroplasms; its a general class of these parasites, and many of them we probably can't test for. So its--its very difficult. You need to really understand the
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clinical symptoms of malarial-like illness, and know that if a patient has Lyme disease and they havent gotten better, you look for it. You look for these malarial symptoms, but I really would suggest giving out this questionnaire and asking patients.
00:11:42

Its even spreading in the blood supply, so now the problem also is--and the Red Cross has been discovering this is that you can get Babesia not just from a tick bite but you can get it from a blood transfusion and a mother can also pass it onto her unborn child. So youre looking at Babesia being transmitted in many, many different ways. So if youre very young or very old and your immune system doesnt work or youve had your spleen taken out, these are the people that are really at-risk for very bad cases of Babesia, those are the ones who could die from this parasitic illness.
00:12:16

So we have to be very, very careful in screening the blood and the problem is--is theres all these different strains of Babesia and its--its problematic. I presented at a Congressional Public Hearing approximately six months ago at Skidmore College, and the Red Cross was there discussing Babesia in the blood supply. And it is becoming a concern. So there needs to be better testing; we need to test for not just Babesia Microti but these other strains of Babesia, WA1 Duncani, and I think one way maybe they could also screen the blood supply is by using this questionnaire because if someone has had Lyme disease the odds of them having Babesia is certainly much higher.
00:12:55

So if you were about to donate blood and you said yes, Ive had Lyme, the odds are is that if youve had these malarial symptoms of day sweats, night sweats, chills, air hunger, cough that you can't explain, you may have Babesia. And in Connecticut, back in 2005 when people were donating blood, they found that if they were positive for a titer for Babesia, their blood test was positive, they had the parasites in their blood. So also when youre screening the blood supply, anyone who has a positive Babesia titer, you would not want to accept that blood into the blood supply at this point. So this is a real spreading problem, including from mother to children because not all the antibiotics we use to treat Lyme and Babesia can be used in pregnancy. So its also a problem for a mother who might get a tick bite while shes carrying a child. The classic drug regimen, Clindamycin and Quinine can be used in the third trimester of pregnancy;
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you will not affect the fetus at that point, but otherwise the babies can be very sick when theyre born. So again, obstetrician, gynecologists need to be paying attention, giving this questionnaire out, asking the pregnant women about whether theyre having malarial-type symptoms. So its very important that all of the specialties in healthcare know about this because Lyme disease is the great imitator. And Babesia is now--the ticks are co-infected at the same time with Lyme and Babesia simultaneously. So its a very, very big problem.
00:14:19

Question: With diagnosis being so hard to come by it seems--what does that mean for treating this strain or this specific--?
00:14:28

Dr. Horowitz: The treatment is difficult. I learned about Babesia years ago because one of my patients who came to me, she was in a wheelchair. She had been seeing another Lyme Literate Doctor. Shell actually be in my book. I have a book coming out on Lyme disease and Babesia and co-infections called Silent Epidemic. Its going to be coming out through St. Martins Press next year, and its called Solving the Mystery of Lyme Disease and Chronic Illness. And it describes these co-infections like Babesia. And the way I learned about it is this woman in the Hudson Valley was in a wheelchair being treated for Lyme and she couldnt walk. And she was having these sweats, these drenching sweats at night. So I basically said to her, maybe we should test you for Babesia. Its never been found here, but we should look for it. And upon giving her the treatment, I had done some initial studies on a drug called Mepron (Atovaquone). It was a drug I used years ago in my residency for AIDS patients with Pneumocystis pneumonia. It was a newer treatment. I had actually done some studies and presented them at the International Lyme Conference back in 1998, before the drug was published in the New England Journal of Medicine, the year afterwards or a little later by Dr. Krause. And we gave this patient Mepron and Zithromax. Within seven days she started walking out of her wheelchair. And shes still walking. And I saw how powerful Babesia was in keeping people sick.
00:15:51

So the drug regimens unfortunately the only ones out there that doctors know about are generally Cleocin and Quinine, Clindamycin and Quinine and its a very difficult regimen to
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tolerate. Quinine causes rashes, nausea, vomiting, ringing in the ears; half of the people have a very difficult time tolerating it. So its--and its not effective for all patients. I did a study back in 1999 where we showed that many patients failed Clindamycin and Quinine. So we then took those patients and put them on this new regimen, Mepron and Zithromax. Many of them did better, but still were not cured. So people need to know that this is--can be a chronic persistent infection. And Dr. Krause published on Persistent Parasitemia in Babesia in the New England Journal back many years ago and Ive also done studies showing Babesia can persist.
00:16:41

So just as Lyme can persist in the body, Babesia can persist, Bartonella Henselae, Cat Scratch Fever can persist, Mycoplasma can persist, and thats one of the reasons these patients who have Lyme Disease do not completely get over it--is because theyre multiply co-infected and these organisms persist.
00:16:59

So Ive looked over the years for new treatments for Babesia and I presented these at International Conferences and this is part of what I discussed with the Chinese government is using other anti-malarial drugs, like Malarone, which is Atovaquone and Proguanil. Its been used for malaria. It works with Babesia. Lariam (Mefloquine) has some effect on Babesia. Coartem which is a malarial drug works with Babesia. There are herbs like Artemisia; Cryptolepis is an herb for malaria in Ghana where they have a big problem with malaria. And that herb is effective in 94-percent of the cases of malaria. I give it to my Babesia patients. They feel much better and its an herb; its not a drug, well tolerated.
00:17:41

So there are these herbal combinations that I do with the drugs because there is no one drug regimen, and in fact, Dr. Krause who is also a well-known expert Babesia, hes published two years ago that now there is Mepron resistance. So doctors also need to know if you gave a patient the classic Babesia drug, Mepron with Zithromax that doesnt mean the patient is going to be cured. And thats what Ive been seeing for years and Dr. Krause published it in the medical literature just--I think it was about two years ago he published on this. And it was in immunosuppressed patients. But I see this problem because my Lyme patients are immunosuppressed also when they have multiple co-infections. And people dont realize, these multiple co-infections is one of the great reasons why people dont get over Lyme disease,
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including that there is a lot of immune dysfunction. Their immune system is overstimulated. And they have a lot of inflammation. There are inflammatory molecules called cytokines released that cause people--its called sickness syndrome. Theyre tired, theyre achy, there are headaches; when you can lower down the inflammation these people feel better even if the organisms are not completely eradicated. And thats--this will all be in my book describing it. Ive spent three and half years writing this because these patients that come in from all over the world to see me, theyre very ill, the doctors are confused so Im going to lay this out piece-by-piece of everything Ive seen over the last 25 years treating 12,000 patients--it will be in this book when it comes out next year.
00:19:08

Question: Are these co-infections really common with Lyme now and are primary care doctors looking for them, because its usually where people start? They go to their primary care doctor and you know weve done a lot of--Im sure youre aware of Mary Beths stories and our other videos; weve spoken with a lot of people who suffer from Lyme and went through that whole you know--1,000 different doctors, 1,000 different diagnoses. So are doctors looking for this and if not, why and what can they do?
00:19:38

Dr. Horowitz: The co-infections are very, very frequent, so the answer is weve already proven that the ticks in the Hudson Valley--this is the study published by Tokarz et al. in 2009--we know that the ticks in this area have been multiply co-infected. Almost all of the patients who come to me, 99-percent-plus are multiply co-infected. Theyve had Ehrlichia, Anaplasma, Babesia Microti, Babesia WA1; theyve had Bartonella Henselae, Cat Scratch Fever, Mycoplasma, Fermentans, Rocky Mountain Spotted Fever, Q-Fever, several with Tularemia, several with Brucella, different tick-borne infections, all in the same patient.
00:20:15

So the doctors I think are aware of it, but I dont know if they know how unreliable the blood testing is. Now the blood testing is not bad for Rocky Mountain Spotted Fever and for QFever. You can use Lab Corp and Quest. Ehrlichia, Anaplasma--Lab Corp, Quest I dont think is a problem. But Lyme disease, the blood testing using an ELISA followed by a Western Blot
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which is what the Infectious Disease doctors are training people to do--that just does not work. And its not a question that maybe it doesnt work; even New York State did a study back years ago where they corresponded with the CDC and they showed that 81-percent of the patients--this was approximately 1,500 patients who did not have the classic bulls-eye rash with Lyme disease, 81-percent of those failed this two-tiered protocol of doing an ELISA followed by a Western Blot. They did not pick up Lyme disease.
00:21:07

So the problem with the physicians is that if theyre using the blood tests to diagnose Lyme and Babesia, youre going to miss it in a large percentage of cases. The ELISA as a screening test has about a 56-percent possibility of picking it up. That means 56 out of 100 people youll get a positive. Youre going to miss it in about 44-percent of the cases. And thats published in the medical literature. The Western Blot, they only do one strain. Theres 100 strains of Lyme in the United States. Theres 300 strains of Lyme worldwide. Lab Corp and Quest use one strain. Its called the B31 strain. Igenex Labs in California uses two strains, the 297 from Connecticut with the B31 which means their Western Blots turn out to be better. You get more bands on the Western Blot.
00:21:56

So how do you know if someone has Lyme and Babesia? You dont use the CDC criteria for making this diagnosis. Lyme is a clinical diagnosis. You make it by giving this questionnaire to people, by ruling them out for Lupus and Rheumatoid Arthritis, but the problem is if youve been diagnosed with Chronic Fatigue Syndrome or Fibromyalgia or a case of depression or anxiety where there is nothing going on in your environment where you should be depressed or anxious and you have multi-systemic symptoms, good days and bad days, the symptoms come and go, the joint pain and muscle pain moves around your body and migrates, you take an antibiotic you feel better, the joint pain gets better or it gets worse, a Jarisch-Herxheimer reaction, it seems like a numbness is coming and going, youre dizzy, you have light sensitivity, sound sensitivity, you have memory problems, concentration problems, and youve done--youve ruled them out for B12 deficiency and thyroid deficiency--in other words youve ruled these patients out for someone in their 30s who has no memory, no concentration, theyre tired, theyre achy, if youve done the standard ELISA blood test and its negative, you think its a clinical diagnosis. And you do a Western Blot through a better lab like Igenex. But you look at the Lyme
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specific bands. You look at five bands that are Lyme specific. I call it Lyme bingo. If you have any one of these five bands and youve ruled people out for other diseases--bingo; you have Lyme disease. Those bands are the 23, the outer surface protein-c; the 31, the outer surface protein-a, which means youve not had the Lymerix vaccine, because it could give you a false positive; the 34, the outer surface protein-b; the 39 and the 83-93. Any of those five bands on a Western Blot, the doctors in this area should be asking the lab to report all the bands on the Western Blot, not using a two-tiered protocol. Thats for Health Departments, epidemiologically to screen large populations of people to see if they have Lyme. That is not what an individual practitioner is supposed to do.
00:23:54

And then for Babesia, you use a panel approach, a Giemsa stain, a Babesia immunefluorescent assay, IFA for Babesia Microti, an IFA for Babesia Duncani, WA1, a PCR looking for the DNA, polymerase chain reaction, a FISH testing. Theres five Babesia tests. And you also check for Ehrlichiosis, Anaplasma, Bartonella Henselae, Mycoplasma, Rocky Mountain, QFever; in other words you do a whole panel of tick-borne testing because if any one of those tickborne tests comes back positive and a patient is not well, the likelihood of them having other tick-borne diseases is quite high.
00:24:32

So many of MS patients with autoimmune diseases who have been diagnosed with Lupus, Rheumatoid Arthritis, Lyme causes a non-specific stimulation of the immune system. They get false positive anti-nuclear antibodies. They get false positive rheumatoid factors, assuming they dont have a test called CCP, which is a marker, specific marker for rheumatoid. But if youve been diagnosed with Lupus or Rheumatoid Arthritis or Multiple Sclerosis which many people in this are--Lyme mimics that. And then if you have Babesia on top of it, youre much, much sicker.
00:25:05

So people really need to understand that its in this area; were one of the hot spots in the United States, the whole Northeastern seaboard. And I think doctors look for it but I dont know if the net that they put out is actually broad enough. The net that we throw out is for all of these tick-borne infections, very, very broadly, while also checking them for a complete blood count, for anemia, to see if theres an bio-chem abnormalities, check their vitamin levels, check for
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nutritional deficiencies, check for food allergies, check if they have hormone abnormalities, thyroid, growth hormone. Men have low testosterone sometimes with Lyme. There are many things you need to check; immunoglobulin(s), maybe theyre immune deficient. There are many things you need to check in a sick patient if youve ruled them out, but just know that Lyme is the great imitator. So if Lyme is the great imitator, if youve been diagnosed with Chronic Fatigue or Fibromyalgia, an autoimmune disease, be very, very careful. And if you have sweats that you cant explain and youre not in menopause as a woman, and chills and this air hunger, thats when you really have to start suspecting that Babesia has gotten in there with these other tick-borne infections at the same point in time.
00:26:17

Question: You spoke about this a little bit before and I imagine when you mentioned this questionnaire thats one way of protecting the blood supply.
00:26:28

Dr. Horowitz: Correct.

00:26:29

Question: Any other insights into how we could protect that because it seems--I mean if the prevalence of this is growing and its something we should be concerned about in the Valley, how--?
00:26:37

Dr. Horowitz: The main way that I would be protecting the blood supply at this point is number one, to make sure that this questionnaire is being used because Lyme is a multi-systemic disease. And if patients check off that they have day sweats, night sweats, chills, air hunger, cough you can suspect Babesia. Secondly, youve got to screen using Babesia titers, but not just for Babesia Microti, for Babesia WA1 Duncani. And also understanding there may be other species of Babesia we can't pick up, but all we can do right now would be that.
00:27:08

Now when a patient lets say has a high probability, they have sweats, they have chills, youve ruled them out for hyperthyroidism, theyre not in menopause, they dont have
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tuberculosis, they dont have non-Hodgkins lymphoma, they dont have anything else thats causing--they dont have malaria, you have to suspect Babesia, understanding theres limitations to the test.
00:27:27

In my practice years ago, in approximately 100 patients checked, 39-percent of those patients were positive by DNA testing, PCR, or FISH testing, RNA, when their Babesia titers were negative. That means you could still miss almost 40-percent of these patients. But to screen a large population for blood, its not practical. So we need better technology to screen the blood but in a patient who is at high-risk, certainly we know that if your Babesia titer is positive as theyve shown in Connecticut, they showed parasites in the blood if you had a Babesia titer-those patients need to be eliminated from the blood supply automatically, if theyve had Babesia or their titer is positive. But I would use this questionnaire as a very simple way of screening and if the resources are available you could always do DNA and RNA testing, PCR FISH testing. And in fact, when we were in China, we brought over Igenex. We showed them the FISH test and we proved at that point because they weren't sure in fact if it was really Babesia, they had an 18S ribosomal RNA; they thought it was a parasite, they couldnt tell--we proved it going over there using this test. And they were very impressed with the testing. It was a wonderful back and forth of sharing information and I hope to do that also with our government at some point. Ive shared it in Congress and I hope with Chris Gibson to do it further and I hope this book will bring this out. But this is the number one worldwide vector-spreading epidemic--is Lyme disease. And Babesia is being carried along right with it. The ticks are containing it. So you need to know that any chronically ill patient who has ever had Lyme if youre going to give blood, theres--theres a chance that Babesia may be there and it can be deadly. I mean thats the problem with it.
00:29:13

Question: Now with these co-infections is there a possibility that theyre--Im just kind of envisioning a future or a time where people are getting Lyme co-infections without the ticks; you know if this is in the blood supply or gets in the blood supply is that possible? And has that happened?

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00:29:29

Dr. Horowitz: Some of these other co-infections are in the blood supply. I mean some are. Ehrlichiosis has been shown to be in the blood supply. That just got published.
00:29:36

Question: And theyre just related to Lyme disease though? They come from ticks?
00:29:40

Dr. Horowitz: Well these are people who generally would have gotten the disease from a tick bite but then donated blood.
00:29:45

Question: Okay.
00:29:46

Dr. Horowitz: So we know that you can get other tick-borne infections by blood. We know that thats possible. The problem is--is its very difficult to screen for all of them, but--and its the same problem as I said in pregnant women. Pregnant women you can pass on Bartonella. You can pass on Babesia. You can pass on Lyme. You can pass on Rocky Mountain Spotted Fever or Cat Scratch infections. So the blood supply in pregnancy, these are big areas that need to be looked at very carefully.
00:30:13

So this net of throwing out a broad net for co-infections is really the key. Thats what we do when people come to us for an initial evaluation. We dont just check them for Lyme. We check them for all the co-infections. And thats how we know that these people have been multiply co-infected. At this point, its the rule, not the exception. Thats what doctors really need to understand.
00:30:36

Question: Hmm; Im just going to check and see if there was anything that Mary Beth had wanted us to discuss that we havent yet. I think weve covered quite a bit.

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00:30:50

Dr. Horowitz: There are certain other clinical presentations of Babesia, which can also be deadly. For example, doctors need to know that theres this form of Babesia called ARDS, acute respiratory distress syndrome, or adult respiratory distress syndrome. People can get this from Babesia and die from it. So if youre in the hospital with a white out in the lungs it could be ARDS associated with Babesia. Theyve also had people who you give steroids to; they think that they have poison ivy or they think they have an autoimmune disease. There are people who have died from giving steroids to people with Babesia because they suppress the immune system. So this is even in healthy individuals.
00:31:30

So we need to understand that Babesia is a parasite. Its not treated the same way you treat Lyme disease. So it will persist; even if your Lyme treatment has been effective you can still have Babesia. Now understand you can also get Babesia without Lyme. So for example, we used to think it just existed in Long Island and Nantucket. We never realized it existed in the Hudson Valley. So you can get some of these classical symptoms of anemia, low platelet count, elevated liver functions, kidney function off--it can happen. Its just in the co-infected patients, we generally see Babesia making them much sicker with these sub-clinical presentations. So you need to be careful that you dont read the textbooks. Thats what actually happened with the Chinese government. They were looking for the classical symptoms of Babesia and they were-they couldnt figure out where was the hemolytic anemia? Where was the low platelet count? Where was the problem with the kidney function? And then I explained Babesia Divergens in Europe does this; occasionally in the United States this happens, but a lot of strains of Babesia its these sub-clinical presentations where your Lyme symptoms of your fatigue and your joint pain and your headaches and your emotional problems, your memory, your tingling and your numbness are just all much worse, like three-times worse. And Dr. Krause published in the New England Journal of Medicine that when you have Lyme and Babesia the Babesia suppresses the immune system. He found Lyme three-times more frequently in the blood. In other words, the DNA of the Lyme organism, Borrelia Burgdorferi was found three more--three times more in the blood when you had Babesia, which means Babesia suppresses your immune system.
00:33:03

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So if you have multiple co-infections that can suppress the immune system. If youre a patient with Rheumatoid Arthritis or Lupus who is on immunosuppressant drugs, it may suppress your immune system and you could get much worse. So you have to understand the patient populations and the fact that this can actually be a fatal disease. We dont usually see Lyme being a fatal illness, not that it can't be, but we usually dont see it being fatal--just causing a tremendous amount of suffering. But Babesia can be fatal in the very young, the very old, and people who are immuno-compromised who dont have good healthy immune systems, especially if their spleen has been taken out.
00:33:37

So these are the kinds of patients the doctors just have to be very careful for. If youre ever going to give your patient an immunosuppressing drug, you want to be very careful youve ruled out that they dont have tick-borne infections like Lyme and Babesia because they could get much, much worse.
00:33:51

Question: I think Ive got everything that I need for the video. Is there anything in particular that you prepared that you want to say or--?
00:34:00

Dr. Horowitz: I think the only other thing that I think is interesting about Babesia is that its popping up in areas where it was not known to be. And for example there was a place in Tennessee about two years ago where they discovered a new species of Babesia that had never been there. This gentleman was a hunter. He had multiple tick bites. He came down with these malarial-like symptoms. They were able to see that it was a Babesia species but they could not identify the type of Babesia. And this is the problem we have in Europe and sometimes in China, and here also.
00:34:30

So Babesia is popping up in areas of the United States so even if youre in the United States and youre not known to have this illness, people need to realize that this is a spreading epidemic. The birds are carrying the ticks, dropping them off, but there are other species of Babesia that may be starting to pop up that you will not be able to pick up on the blood test. And thats why knowing the clinical presentation of Babesia, malarial-like symptoms, but with
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subclinical presentations--just dont go by the textbook. Just understand how does Lyme present? What is the clinical presentation of Lyme disease with these 38 questions on this multi-systemic questionnaire? And in our book when we validated this against our patients, on the questionnaire if you scored 46 or higher you were two standard deviations above the mean, meaning you almost certainly had Lyme disease and co-infections. So we actually validated this questionnaire in our practice because weve seen so many chronically ill people. This is a very easy questionnaire to give to people but dont think you dont have Babesia in your area if its never been there before. That was why I was discovering it here in the Hudson Valley. Nobody thought it was here before, but it was--simply by taking a proper history from patients saying Im having drenching night sweats doctor. And its like well, why do you have drenching night sweats? You need to look into it. But the problem with medicine now is doctors dont always have the time to take extended histories, but this questionnaire solves the problem.
00:35:57

Have the patient fill it out in the waiting room and give it to you. And if they have circled 30 out of 38 questions and you see fever, sweats, and chills on there, you know as a physician I better be looking for Babesia, understanding the pros and cons of the testing. I mean I would probably say thats one of the most important things that people need to realize at this point in time. And, check for the other strains because 19-percent of my patients are testing positive for other strains of Babesia like WA1 Duncani. Im fairly sure most of the doctors in this area do not know about it. And that can be done through Lab Corp and they will probably be surprised that theyre picking it up way more than they had suspected.
00:36:36

Question: The only other question I would have is knowing that theres such a prevalence of Lyme in Dutchess County and in this--in the Hudson Valley, is there anything specific that people here should be concerned about or worried about or thinking about in terms of Lyme and these co-infections or--?
00:36:52

Dr. Horowitz: The most important point I would say for people in this area is if youve been diagnosed with a Chronic Fatigue illness, with muscle and joint pain, like Chronic Fatigue
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Syndrome and Fibromyalgia, or youve been diagnosed with--Im tired, I can't fall asleep, Im depressed, you have depression--you have to realize that Lyme is the great imitator. And Babesia will make your symptoms worse. I would say to people do not accept those diagnoses. From my standpoint theyre not valid because even in my book when I went through all the medical literature looking at Chronic Fatigue Syndrome and Fibromyalgia, whats interesting, there are similar biochemical abnormalities that happen in the body in Lyme disease, Chronic Fatigue Syndrome, and Fibromyalgia, meaning there are these inflammatory molecules. Theyre called interleukins, interleukin-1, interleukin-6, tumor necrosis factor alpha; these are chemicals that are secreted in these different diseases that make you tired, that make you achy, they affect your memory, they affect your mood.
00:37:52

The point of medicine is always get to the source of a problem. Dont just label a disease, throw a drug at it, and say heres your drug for your depression, heres your drug for your Fibromyalgia, heres your drug for your Chronic Fatigue, heres your Provigil and Nuvigil; get the source of the problem. And that basically means youve got to take an extensive history and physical. You have to know all of the things to check people for. So Ive developed this map of chronic disease called MSIDS, multi-systemic infectious disease syndrome is now what Im calling persistent Lyme with these co-infections. Why? Because when people come to me and theyre chronically ill, they never just have Lyme. They have Lyme, they have co-infections, they may have viruses, they may have fungal problems even with mold, they have autoimmune problems with immune dysfunction, they have inflammation, they have heavy metals and environmental toxins, they have hormonal problems, they may have mitochondrial dysfunction, they have autonomic nervous system dysfunction, they can't fall asleep, they may have depression, they could have overlapping GI or liver function abnormalities, endocrine abnormalities--the point is there are--its like a patient coming into your office with pain in the foot. And the doctor says how long have you had this pain for and they go years. What have doctors done? Oh well theyve pulled out one or two nails out of my foot. Well do you still have foot pain? Yes. You didnt find all the nails that are causing the pain.
00:39:15

This map of chronic disease that I have developed--this is after seeing 12,000 chronically ill patients who have come to me from all over the world, Ive identified why these people are
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chronically ill. Thats what this book is about--about finding out what is this really because doctors are debating right now. Lyme does persist; it doesnt persist; the co-infections are a problem; theyre not. I can tell you for sure because Ive treated 12,000--I see 30 to 35 Lyme patients a day; almost all of them have co-infections and they have many things on this MSIDS map, many different problems. Its not all Lyme. Its not just Lyme disease thats keeping them ill.
00:39:54

So when this book comes out through St. Martins Press I would suggest doctors and patients read it, because if you have been diagnosed with Chronic Fatigue or Fibromyalgia or Multiple Sclerosis, an autoimmune disease, these are the most common, or even Alzheimers. Your memory is not working and youre young, but you have also multi-systemic symptoms. You have to be careful its not tick-borne. So understand its the great imitator. Know that there is a map of chronic diseases that Ive developed called MSIDS where all of these different factors that keep people ill, you can bring this to your doctor, you can find out, do I have any of these other things keeping me tired and achy and why my memory doesnt work? But know that the source of getting to the problem is the most--most important here, but doctors need to understand what the map is. How do you maneuver through these chronically ill patients that are highly complex? I mean our visits are 30 to 40 minutes per patient. In HMO Medicine its very difficult to do.
00:40:52

When I met with Blue Cross and Blue Shield and MDP at the Congressional Hearing this year I suggested to them try opening up a similar clinic like we have here for chronic diseases, where you only see a limited number of people, but these are the patients who go from doctor to doctor. They have chest pain, they go to the cardiologist, they have chest pain, they have palpitations; I dont know why theyre ill. They have neurological problems with tingling and numbness. They can't find anything wrong. They go to psychiatrists because theyre depressed. They go to the rheumatologist because they have positive autoimmune markers. They go to all these different doctors but none of them are necessarily seeing the whole picture. Theyre not understanding that Lyme is the great imitator and that this MSIDS map is identifying the nails in the foot thats causing the pain.
00:41:35
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This is important because chronic disease is whats bankrupting the healthcare system at this point in America. This is well-known. So what Im hoping this book will do is give a new map, a new model for chronic diseases, not just for Lyme, but for many of these different diseases because even if you dont have Lyme disease and you have Multiple Sclerosis, this model of inflammation and autoimmunity and heavy metals, because heavy metals like mercury causes demyelination like in Multiple Sclerosis, youve got to get to the source of the problem.
00:42:05

So its very important; patients should be concerned, but they also should know if you go outside check yourself for ticks every day. Wear the light colored clothing. Put your pants in your socks, spray Duranon or Permethrin spray on your clothes outside to repel the ticks. Use something like Avon Skin So Soft on your--on your hands and your face and your--anything thats exposed. Do a tick check when you come home. Thats basically--you need to protect yourself. Everyone in Dutchess County who is outside and this could just be in your backyard, needs to be checking for ticks regularly and needs to know the signs and symptoms of Lyme and Babesia and how these co-infections manifest. Every patient needs to educate themselves at this point of how this acts as the great imitator, of how it will mimic all of these other diseases and yet really be Lyme and Babesia and other co-infections.
00:42:57

This is the health of our community. Its the health of the United States. This is the future generations of America that are going to be affected by this. So Im doing my best to offer something to try and help our country, to try and help the world. Ive seen so many ill patients; Ive been able to see why these people stay chronically ill. And I hope that this book will be of benefit, but any of the doctors who wish to train--Ive trained over 100 doctors who come to me and stay in my office and follow me with patients, if there are any doctors in Dutchess County who are interested in doing training, who would like to come to my office and see how I do this, youre invited. Youre invited to see how I help patients because this is not a secret. It will be out in the book next year; people need to understand this because we can't allow this to keep going on in an epidemic proportion because right now the testing is--its just--its bad. Its not going to pick up the majority of these infections for Lyme and Babesia and many of the other ones. So we need to understand the limitations. We need to understand the clinical presentations and what this is going to mean for ourselves, for people going on disability, for future generations whose
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mind doesnt work correctly that they can't work at their jobs--this is a big health problem. And I hope that the Health Departments and the CDC, I hope in the future to work with all of them, so we can work as a team to be able to solve this for our country, because this is a really big problem. And Ive seen enough of these chronically ill patients now to have a sense of why these patients aren't getting better.
00:44:26

So we need doctors who are on both sides of the fence, who dont believe in Chronic Lyme, who do believe in it; we all need to come together and work for the benefit of our community. Its not enough to stay established in a camp and say this is right, this is wrong; its time to have an open dialogue. Its time to listen to doctors who see these chronically ill patients every day because Mary Beth quoted me last time on this--if you dont believe the doctors in the trenches, who are seeing these chronically ill patients, if youre not going to believe someone like me who is just looking out for the welfare of our community and for everyone, who are you going to believe?
00:45:02

So I was very happy that the Chinese government called me up and I could share this, but Im looking forward to sharing it with our government and Congressman Gibson has indicated when this book comes out hes very happy to get this in the hands of the politicians and people to read it. This is the number one vector-borne spreading epidemic worldwide. Lets take a look at this and look what this is doing to the healthcare system, to our families, to our friends; its a terrible epidemic. And Babesia is now really making everything much worse, so Im very happy that Im able to share this with you and explain what Ive seen in all these years of seeing these chronically ill patients. So thank you for taking the time and doing this.
00:45:39

Question: Thank you; that was fantastic.

00:45:41

[End Dr. Horowitz Video]

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