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Bartonella spp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region

In Response: We offer the following comments to Beard et al. (1) and Raoult (2) regarding their respective responses to our recent article (3). Before 1990, Bartonella species were not known to infect animals or humans in North America. If not for the AIDS epidemic, the expansion of literature about Bartonella spp. might not have occurred (Figure). In 2010, in collaboration with Raoult (4), we posed a question in Emerging Infectious Diseases, “Could ticks transmit Bartonella spp.?” That article elicited an editorial response emphasizing the lack of evidence supporting tick transmission of Bartonella spp. (5). Subsequently, Bartonella birtlesii transmission by Ixodes ricinus ticks was proven experimentally (6).

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