"Hard Science of Lyme" discusses new developments in Lyme and other tick-borne disease research. The goal of Hard Science on Lyme is to identify and summarize breaking research on Lyme disease and its co-infections in simple language for patients. It is written by Lorraine Johnson, JD, MBA who is the Chief Executive Officer of LymeDisease.org. Lorraine is has published a number of medical research and commentary articles addressing the science, ethics and health care policy issues in Lyme disease. She also sits on the steering committee of Consumers United for Evidence-Based Healthcare.
This blog has several goals. First, to explore the personal side of Lyme disease and how it affects individuals and families. Second, to highlight useful information for people seeking answers about this complicated illness. Third, to help foster a sense of unity and shared purpose among the many diverse members of the Lyme community.
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 →
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 →
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 →
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 →
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 →
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 →
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." Continue reading →
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 →
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 →
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 →
I had to post this image and encourage anyone interested in biofilms to go visit the website that hosts this interactive introduction to biofilms. Some of you know that biofilms have been implicated in Lyme disease. Drs. McDonald and Sapi recently published on this topic. The gist of the matter is that biofilms may be one of the ways in which bacteria persist in the body. They can provide a protective covering that antibiotics cannot penetrate. It’s a pretty esoteric subject matter, but this website describing how they work is pretty down home. Give it a visit if you get a chance. And, kudos to the University of Montana for making this available to folks like us who just need simple explanations so we know how things work! The link is after the jump. Continue reading →
Breathe a sigh of relief. No, really. It is not that often in Lyme disease that one reads an unbiased study that speaks truth to power, that values integrity in science over dogma. So, pour a cup of tea and I will pull out the most important findings and conclusions about persistence from the recently published study by Dr. Stephen Barthold and Dr. Ben Luft, “Ineffectiveness of Tigecycline against Persistent Borrelia burgdorferi.” Here they are in a nut-shell for those with neither the time nor the inclination to read the entire study (though I must say it is highly recommended!). Continue reading →