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Medical Group first to find bacteria unseen in humans

EGLIN AIR FORCE BASE, Fla. -- The 96th Medical Group's laboratory provided the first-ever human-blood sample of a spirochete bacteria, known to cause tick-borne relapsing fever to be cultured at the Centers for Disease Control.

The bacteria, borrelia turicatae, had previously only been cultured in animals, according to Maj. (Dr.) Benjamin Stermole, Eglin's infectiologist.

The rare spirally twisted bacteria was found after a primary care doctor ordered a malaria smear sample for a sick Soldier. After review of the patient's blood sample, Dolli Lane, 96th MDG laboratory technician, realized she had something unusual and alerted others.

What she noticed when scanning a red blood cell sample looking for malaria, was one spirochete was outside the red blood cells. At first, Lane said she wasn't sure what she was looking at.

She found a few more spirochetes and decided to pull reference materials and bring in another lab technician to verify what she was seeing.

"It was unusual because you wouldn't see this bacteria in the blood we were reading," said Lane.

According to Staff Sgt. Christopher Boyd, 96th MDG hematology lab section chief, the spirochete bacteria could have easily been overlooked. It is not typically spotted using the particular slide stain used.

In addition, spirochetes are only visible if the blood sample is drawn during a patient's fever spike. The fever is brought on due to increased bacteria volume in the body, according to Stermole.

"I thought, 'maybe what she (Lane) saw was caused by one of the substances used to make the slide,'" said Boyd. "When I saw the spirochete slide, it was consistent with that type of bacteria. That's what tipped us off to look into this further."

To find a definitive answer about the bacteria, the hospital's head microbiologist, pathologist and infectious disease doctors evaluated the sample. It was decided Eglin's lab technicians would send the samples to the CDC to test the bacteria's DNA.

"We don't have the equipment needed to identify the bacteria here and neither do our reference labs. It had to be sent to a research lab and CDC is generally the place for anything not available at commercial reference labs," said Stermole.

Boyd immediately contacted the CDC to explain the case and emailed photos of what was found under the microscope. As a result, the CDC accepted the samples for review.

"This infection doesn't happen very often. The ability to culture this bacteria allows us to study it on a level we haven't been able to before," said Stermole. "The cultures can be tested against different antibiotics to learn which ones are effective. We can also use this human isolate in animal models to see if it acts the same way as previous isolates, which may be found to be different subspecies. Essentially, we can prove the animal models can adequately represent human infections. There is a lot of information to be gathered after a bacteria DNA is cultured."

Within days, the CDC contacted the patient's doctor, the pathologist and the infectious disease doctor. Soon thereafter, they learned the bacteria was Borrelia turicatae [spirochete bacteria species] which is known to cause tick- borne relapsing fever.

The affected Soldier contracted the bacteria from a tick bite while living in an old stable during a field exercise in West Texas.

After the infection identification, the patient was given the correct antibiotic and showed almost 100 percent improvement 24 hours.