Stealth Infections – Do They Play a Role in Chronic Disease?

Stealth infections which are good at hiding from the immune system, may be the underlying cause of many chronic conditions such as chronic fatigue, fibromyalgia, weight gain, thyroid, heart disease and neurological disorders and more.

Stealth infections are not easy to diagnose as they are not always detected through standard pathology testing; however, they can often be the missing culprit.

What are Stealth Infections?

These infections are bacterial or viral infections that reside inside the cells and are capable of hiding from the immune system.

Stealth infections include Epstein Barr Virus, Streptococcus and Borrelia Burgdorferi. These can cause conditions such as glandular fever, Lyme disease or PANDAS (Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus).

Professor Kerry Bone, a co-founder of MediHerb, defines Stealth Infections as ‘Any pathogenic micro-organism employing strategies to persist in the body by hiding from, evading, misdirecting or even suppressing the immune response, leading to chronic disease or lack of well being.’

How Can Stealth Infections Affect Health

Chronic infections caused by stealth microbes can lead to persistent immune problems that result in autoimmunity, damage to cell membranes and disorders of the central and peripheral nervous systems. These infections can produce symptoms such as fatigue, weight gain, impaired sleep, muscle pain, anxiety, and cognitive impairment.

These symptoms are often attributed to conditions such as unexplained fibromyalgia or chronic fatigue syndrome.

The 3 Major Stealth infections are:

1. PANDAS

PANDAS is a rare autoimmune condition found in children that has been linked to the Streptococcus bacteria, more specifically Group A Beta-Haemolytic Streptococcus (GABHS). This bacterial infection commonly presents as a sore throat. Research also shows that this group of bacteria is associated with other conditions such as rheumatic fever, which can cause a range of heart and joint inflammation, poor muscle control, and reduced coordination, often found after leaving a sore throat untreated. PANDAS is created when the immune system is trying to attack the Streptococcal bacteria, yet its defenses are misdirected and also attack part of the brain. This causes a range of abnormal behavior such as neurological or emotional problems.

Symptoms Associated with PANDAS are:

• Hyperactivity
• Changes in mood
• Constant blinking of the eyes
• Grunting and repeatedly saying words
• Nervous Tics
• Loss of attention
• Difficulty with reading/writing
• Anxiety

How do you know if your Child has PANDAS?

A child with undiagnosed PANDAS may experience repeated rounds of the strep infection concurrent with the symptoms above, as once the brain has been attacked, strep may continue to return.

After each strep attack, recovery of damaged brain tissues is not always possible and, therefore, the child may eventually develop a chronic psychiatric disorder. It is essential continually to monitor symptoms and overall health, as the reduction of strep antibodies and symptoms does not mean they will not return.

It is essential to work with a Functional/Integrative Medicine Practitioner who is aware of PANDAS and the required treatments. Those not aware might not prescribe holistically and will therefore allopathically treat for OCD, ADHD or behavioral disorders.

That’s not to say that if your child has Streptococcus antibodies that they have PANDAS. It is also important to assess other causes of behavior change in children too, even if a Streptococcal test is negative, as other bacteria, viruses, dietary and lifestyle choices might cause similar neurological symptoms.

2. Lyme Disease

Lyme disease is most commonly spread by ticks and predominantly caused by the bacteria Borrelia Burgdorferi.

Borrelia burgdorferi is a bacteria that can spread quickly and bury itself in tendons and muscles. There is generally a localized infection at the site of the bite, which appears as a rash in the shape of a bull’s eye; however, this rash is not the only symptom of Lyme infection. It is estimated that only 50% of those infected with Borrelia Burgdorferi will present with a bull’s eye rash, so all symptoms associated with Lyme should be comprehensively reviewed.

Symptoms of Lyme Disease
Many, or just a few of the following symptoms, may be experienced if you have Lyme Disease:

• Rashes that can exist anywhere on the body
• Muscle or joint pain
• Dizziness
• Fatigue and weakness
• Arthritis
• Memory loss (generally short-term)
• Cognitive impairment
• Shooting pain anywhere in the body
• Numbness in the extremities
• Anxiety or panic attacks

It is crucial that Lyme is detected and treated promptly as these symptoms can intensify quite quickly and, left untreated, the pathogens may enter the nervous system and brain. Since Lyme is not listed as a notifiable disease in Australia or the UK (although it is in the US and Canada) those infected with Lyme face a significant problem as quick detection is not always possible.

As with other stealth infections, Lyme disease may be wrongly diagnosed, and this misconception of tick-borne illnesses may instead be diagnosed as neurological disorders, fibromyalgia, arthritis, chronic fatigue, autoimmunity, memory problems or digestive disorders.

Co-Infections
A concern for stealth infections such as Lyme are co-infections, such as Epstein-Barr, Cytomegalovirus, and Candida. These are also infectious diseases that can be activated when there is an immunocompromised state that a patient can develop from untreated chronic infections. Hence, detection is critical. In the case of Lyme, the tick that bites someone can potentially carry other pathogens, meaning that Lyme can imitate other diseases and infections.

Testing for Lyme Disease
The Lyme Disease Association of Australia (LDAA) states that Lyme needs to be diagnosed based on a patient’s medical history, symptoms and testing, however, diagnostic pathology is not always entirely reliable. Lyme disease should not be ruled out based on negative blood test results, as Australian medical tests are not currently able to identify all species of the Borrelia bacteria that can cause Lyme disease or other similar illnesses.

The LDAA suggests that the most reliable testing is currently conducted through the IGeneX laboratory in the USA and Infectolab in Germany.

Regardless of testing, it is essential to find not only one doctor but a whole medical team that correctly understands the pathophysiology and causes of Lyme disease, the reliability of testing and the evidence behind the available treatments to help recover.

3. Epstein-Barr Virus

Epstein-Barr Virus (EBV) is one of eight that belongs to the herpes virus family. This virus is prevalent throughout the world, and it is most commonly transmitted through saliva and genital fluids. It also reproduces readily without detection. Research also shows EBV to be associated with certain types of autoimmune diseases and two kinds of cancer, such as Burkitt’s lymphoma and Nasopharyngeal carcinoma.

Symptoms of Epstein-Barr Virus
Many people who are infected with the EBV virus remain asymptomatic, but for others, it can cause health problems such as glandular fever (also known as mononucleosis). Glandular fever is characterized by:

• Swollen glands
• A sore throat
• Fever and flu-like symptoms
• Spleen enlargement and upper abdomen pain
• Profound fatigue that can last for weeks or much longer
  Jaundice

Symptoms of infectious EBV commonly resolve within 4-8 weeks; however, once this virus enters the human body, it is there forever, lying dormant until the immune system is once again compromised. This is why this stealth infection has been linked with chronic fatigue syndrome (CFS). When there is no clear causation for CFS, EBV may be a likely causative factor and should be assessed accordingly.

Testing for EBV
Medical practitioners can test for antibodies to the following EBV-associated antigens:

• Viral capsid antigen (VCA)
• Anti-VCA IgM appears early in EBV infection and usually disappears within 4 to 6 weeks.
• Anti-VCA IgG appears in the acute phase of EBV infection and is detectable for the rest of one’s life

Treating Stealth Infections

The immune system and nutritional status govern the body’s ability to reduce the damage caused by stealth pathogens. Proper nutritional treatment should be the priority when addressing any stealth infection and its subsequent symptoms. When underlying infections are identified, other treatments include a combined antibiotic therapy (and herbal medicine options), supplementing nutrients to boost the immune system and introducing lifestyle approaches.

Stealth pathogens can disrupt many body systems and spread quite quickly. For example, the primary symptom may start as fatigue but rapidly develop into joint pain, insomnia, and anxiety. Hence, treatment needs to have a multi-factorial approach and be tailored to the individual and their medical history/presenting symptoms.

However, penicillin and other antibiotics only kill the bacteria; they are not treating the attack on the rest of the body. Therefore, a Functional/Integrative Medicine approach is advised, taking into consideration all changes in body systems. Probiotic treatment during and after antibiotics may also be useful to replenish gut flora and further support the bacterial environment.

Key Treatments include:

• Improving the immune response with nutrients such as zinc, selenium, vitamin D and C
• Eliminating persistent pathogens and reducing microbial load
• Reducing systemic inflammation (including neuroinflammation)
• Supporting energy production
• Breaking down of biofilms to enable the immune system to attack stealth pathogens

Dietary interventions are also required, such as a low sugar diet, to stop the further formation of particular bacteria such as Streptococcus, and eliminating known triggers of neurological symptoms such as food coloring, MSG and artificial sweeteners (particularly crucial in PANDAS).

Special diets such as GAPS, Specific Carbohydrate Diet, and Auto-Immune Paleo can also be very effective. (Comprehensive Diet Guides, including meal plans, shopping lists and recipes are available at the Mindd Store.

The best advice is to work with a well-trained and experienced practitioner. You can see our directory of practitioners specializing in these conditions, here: https://old.mindd.org/practitioner-directory/

Written by Lana Micallef, Clinical Nutritionist (BHSc NutMed)