HARD SCIENCE ON LYME: Are FDA-approved tests better or worse?

17 Jun

The FDA gave its blessing to Lyme tests that miss as many as half the cases or more. The CDC thinks this should be good enough for patients. But patients insist on tests with better sensitivity from specialty labs in spite of having to pay out of pocket. Why is the government trying to prevent them from using all the tools in the arsenal when failure to diagnose has profound, life-altering consequences? Continue reading

HARD SCIENCE ON LYME: Ticks can transmit infection the first day

28 Aug
rish tick bite graph

A new article has resurrected the old myth about disease transmission being impossible before a certain time after the tick bites. In the New Haven (CT) Register this week, Dr. David Katz writes: “Ticks need to be embedded for 24 hours or more to transmit Lyme.” This is an improvement on the usual 36-48-hour minimum we usually see, but it is still misleading. See the science and judge for yourself. Continue reading

HARD SCIENCE ON LYME: How “Comforting” Was Your Diagnosis of Chronic Lyme?

02 Jul

In his interview with Terry Gross on Fresh Air, journalist Michael Specter says that patients are desperate and that “chronic Lyme” is “more comforting” for them to grab onto than a vague, incurable diagnosis of post-treatment Lyme disease, the preferred IDSA terminology – and a concept that is “recognized,” he points out. He thinks he is being sympathetic and doesn’t seem to realize how condescending and very offensive this sounds to Lyme patients. Continue reading

HARD SCIENCE ON LYME: Let’s get real – the testing is no better than a coin toss

01 Jul
coin toss

The organized medical community doesn’t believe in chronic Lyme disease, said Michael Specter in a recent interview on NPR’s Fresh Air, and he appears to buy into this myth, too. We do know that some people don’t get better after treatment, he said, but the term “chronic Lyme” is vague, Besides, it’s hard to say you have the disease if there’s no evidence of the disease, he said. Continue reading

HARD SCIENCE ON LYME: Research Finds Bartonella Transmission from Tick to Host

26 Jan

It has long been known that ticks harbor Bartonella and that humans who have Lyme disease may also have Bartonellosis. However, the actual transmission of Bartonella from tick to host has not been demonstrated until a mouse study by Drs Reis and colleagues was published in May 2011. The study is available free on line for those interested. “This work represents the first in vivo demonstration of a Bartonella sp. transmission by ticks. It . . . corroborate[s] a prospect that ticks play a role in the natural cycles of some of the bartonellae including those pathogenic for humans. Consequently, bartonelloses should be included in the differential diagnosis for patients exposed to tick bites.” Continue reading

HARDSCIENCEONLYME: Researchers Discover New Tick-Borne Illness Caused by Borrelia miyamotoi

22 Sep

Researchers have recently discovered that another species of Borrelia transmitted by deer ticks causes illness. The species, Borrelia miyamotoi, was discovered in Japan in 1995, but occurs in Asia, Europe and North America as well. A new study confirms that B. miyamotoi causes human disease "including relapsing disease that may last for months and may not respond to inappropriate antimicrobial drug therapy." Because B. miyamotoi is transmitted by an array of ixodid ticks and can be passed via the ovaries from one tick generation to the next, it "greatly expands the potential geographic distribution of this disease". The study notes that further investigation of possible B. miyamotoi infection in humans is warranted wherever I. pacificus, I. persulcatus, I. ricinus, and I. scapularis ticks are found. Continue reading

HARDSCIENCEONLYME: Can Lyme Disease Cause Alzheimer’s Disease?

25 Aug

The cork-screw shaped bacteria that causes Lyme disease, Borellia burgdorferi (Bb), are called spirochetes. Other types of spirochetes include those associated with syphilis and dental spirochetes. Chronic spirochetal infection can cause slowly progressive dementia, brain atrophy and amyloid deposition in late neurosyphilis. A new study by Dr. MiKlossy, reviewed all the data available in literature to determine the role that spirochetes, including Bb, play in Alzheimer’s disease (AD). Continue reading

HARDSCIENCEONLYME: Horse Treated for Lyme Improves, Relapses, then Dies

04 Aug

A 12-year-old thoroughbred was examined because of signs of depression, neck stiffness, and poor performance and a reluctance to raise its neck and head above a horizontal plane. The horse responded well to doxycycline treatment for 60 days and returned to normal exercise. However, 60 days after treatment was discontinued, the horse again developed a stiff neck and rapidly progressive neurologic deficits. The horse's condition deteriorated rapidly despite IV antibiotic treatment, and the horse was euthanized. Postmortem examination revealed findings consistent with a diagnosis of neuroborreliosis (leptomeningitis, lymphohistiocytic leptomeningeal vasculitis, cranial neuritis, and peripheral radiculoneuritis with Wallerian degeneration). Nervous system infection with B burgdorferi should be considered in horses with evidence of meningitis and high or equivocal serum anti-B burgdorferi antibody titers. Evaluation of immune function is recommended in adult horses evaluated because of primary bacterial meningitis. Continue reading

HARDSCIENCEONLYME Lyme disease prevention. Two Effective Practices?

13 May

I thought I would share a few prevention practices identified at the Institute of Medicine Lyme disease workshop as effective by Dr. Mathew Liang of Harvard Medical School. One idea focused a study in Nantucket by Daltroy (2007) on an educational outreach method. The 5-year study randomized 29,000 people traveling by ferry to Nantucket and exposed the study group to an entertainment-based information session about Lyme disease and steps to prevent it. Participants also received a card with a Braille dot on it the size of a tick and a plastic shower card similar to those used for breast self-exam, tweezers, and a map of the island where ticks were prevalent. The study showed a reduction in Lyme disease in the group who received the message, both among year round residents and among visitors, who constitute a high-risk population. Continue reading

HARDSCIENCEONLYME: Lyme Culture Made Easy, Antibiotic Effectiveness, and Mechanisms of Persistence

05 May

Dr. Eva Sapi and colleagues have published an important study today, "Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi". I have included the link to the article, which is available free of charge at Dove Press, at the end of this post and encourage you to read it. The study is broad ranging, but makes a significant contribution to Lyme research in a number of areas: culturing techniques, cyst and spirochete antibiotic susceptibility, and the role of biofilms in persistence. Continue reading

HARDSCIENCEONLYME:  How Tick-Borne Diseases like Babesia and Anaplasma Persist

05 Apr

It is important to understand mechanisms of persistence in tick-borne diseases.  Microbes use different mechanisms to evade the immune system and survive. A study by Anthony Barbet of the University of Florida describes the mechanisms by which babesiosis and anaplasmosis persist in animals.  He notes that many vector-borne diseases remain resistant and states: "Some of the most intransigent of these are infections that induce a 'carrier' state, where the animal remains infected, is still able to transmit organisms to the vector, but may show disease symptoms intermittently or not at all. Indeed, it may be difficult to detect the infection by classical means."  He points to Babesia and Anaplasma as prime examples of this type of persistence and discusses how new and sensitive molecular diagnostic methods have made it possible to demonstrate that "a typical infection course consists of numerous relapsing peaks of organisms separated by time periods when they are not detected."
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HARD SCIENCE ON LYME: Removal of Western fence lizard decreases number of nymphal ticks and number of infected nymphal ticks.

23 Feb

A group of researchers, (Swei, Ostfeld, Lane, and Briggs), did a study on the western fence lizard recently that produced some interesting results. The life cycle of the tick involves three stages and three blood meals. Ticks are born without the Lyme disease bacteria. However, they may acquire it during their first blood meal (as larval ticks), their second blood meal (as nymphal ticks) or their third blood meal (as adult ticks). Lizards host up to 90% of larval and nymphal I. pacificus ticks. Western fence lizards (as well as the southern alligator lizard) are not competent hosts for Lyme disease bacteria. This means they cannot transmit Lyme disease to feeding ticks. But even better, their immune system actively kills the Lyme spirochete in ticks that feed on them. So a tick that feeds on one of these lizards will take its next blood meal without the bacteria that transmits Lyme disease. This eliminates the risk of people contracting Lyme disease from the ticks that have previously fed on the lizard and reduces the infection rate of the ticks generally in the area. You would think that the number of infected ticks would go up in the absence of the lizard that kills the Lyme bacteria. Not so. . . Find out why after the leap. Continue reading

HARD SCIENCE ON LYME: Blood Transfusion Risk of Babesia Unacceptable

18 Jan

David Leiby, of the Red Cross, has declared the risk of blood transfusion for Babesia microti to be unacceptably high. Babesia microti is a coinfection of Lyme disease that is transmitted primarily by ticks. Over the past 30 years, between 70-100 cases of transfusion transmitted Babesia have been reported, with at least 12 fatalities. Although the need to screen for the parasite which lives in red blood cells is now recognized as urgent, the method of screening blood has yet to be determined and several obstacles remain before screening practices are adopted. However, according the Leiby, failure to screen is "no longer a viable alternative". The abstract to the article follows the jump. . . Continue reading

HARD SCIENCE ON LYME: Straubinger’s New Study Shows How Lyme Bacteria survives

02 Jan

One of the hot topics in Lyme disease is whether the bacteria that causes Lyme disease persists. There are a lot of factors that go into proving this, but one is whether there is a “plausible biological mechanism for persistence.” What this means is whether there is a mechanism in biology that might allow the bacteria to survive. Simply put, the Infectious Diseases Society of America says there isn’t and other researchers disagree. The most recent article on this subject is from Straubinger, who is best known for his research on persistence in dogs. The highlights of the study after the jump. . . Continue reading