Of Rabbits and Men


Tularemia is known as a rabbit disease which is spread to those who handle them including hunters and cooks; however, at the recent Lyme Disease Association 17th Annual Conference on Lyme and Tick-Borne Diseases, Timothy Lepore, MD, FACS, surgeon at Nantucket Cottage Hospital, explained that it is also a disease of those who work with the land such as landscapers and farmers, as well as those who get bit by a tick. There are cases reported in every state but Hawaii, and many other wild and domestic animals can be infected. The highest rates of infection are in Arkansas.

Tularemia first appeared in the United States in Massachusetts in 1937 after importing 30,000 to 40,000 rabbits per year from Europe. Importing came to an end in 1947.

Francisella tularensis, a gram negative, aerobic, pleomorphic, highly persistent intracellular pathogen, spread via the lymphatic system can cause fever, chills, headache, myalgia, extreme fatigue, glandular (swollen glands), oropharyngeal (sore throat, nausea, vomiting and diarrhea, abdominal pain and intestinal ulcerations), conjunctivitis, pneumonic (dry cough, respiratory difficulty and chest pain), ulceroglandular (skin ulcer at infection site) and can be septic and lethal. Symptoms typically develop within three or four days of inoculation but can take up to 10 days.

Tests: Tests for Tularemia are not widely available but direct examination of biopsy specimens or secretions by fluorescent antibody or Gram or histochemical stains are often helpful. F. tularensis can also be demonstrated microscopically with fluorescent-labeled antibodies. Antibodies are not typically present in the first ten days after exposure. Patient samples should come from sputum or pharyngeal washings, as the organism is not present in large numbers in blood. Polymerase chain reaction (PCR) tests can also be utilized. It is imperative that lab personnel take strong precautions as it is quite easy to become infected.

Treatment: Antibiotic therapy with Gentamicin (5mg/kg/day, IM or IV) or streptomycin (1 gm twice daily, IM). The recommended treatment period is 10 days. In vitro susceptibility studies indicate that quinolones and fluoroquinolones are also effective against F. tularensis, thus providing an additional option for physicians. Tetracyclines and chloramphenicol can also be used, but a higher rate of relapse is associated with these agents, as they are bacteriostatic rather than bactericidal. Thus, it is recommended that treatment with these medications be extended to 2-3 weeks. If treatment is initiated quickly the mortality rate for tularemia is around 1-2%; however, one-third of untreated patients will die, usually from pneumonia, meningitis or peritonitis.

Transmission: Transmission can occur through the skin or mucous membranes when handling infected animals as well as through tick bite, contact with fluids from infected deer flies, mosquitoes or ticks, handling or eating undercooked rabbit, drinking contaminated water, inhaling dust from contaminated soil, and handling contaminated pelts or paws of animals. It can also be inhaled from infected hay, grain, or soil. Dr. Lepore had patients who contracted it from their pet dog who shook rain water on them after chewing on a dead rabbit, as well as from folks eating road kill, a person who held sick animals, and a gentleman who slept with his pet bunny.
Tularemia, in aerosol form, is considered a possible bioterrorist agent that if inhaled would cause severe respiratory illness. It was studied in Japan through 1945, the USA through the 60’s, and Russia is believed to have strains resistant to antibiotics and vaccines. An aerosol release in a high population would result in febrile illness in 3-5 days followed by pleuropneumonitis and systemic infection with illness persisting for weeks with relapses. The WHO estimates that an aerosol dispersal of 50 kg of F. tularensis over an area with 5 million people would result in 25,000 incapacitating casualties including 19,000 deaths.

In a mass casualty situation – treat with oral agents for 14 days using Doxycycline (adults 100mg by mouth twice a day, children under 45kg 2.2 mg/kg by mouth twice daily) or Ciprofloxacin (adults 500mg, by mouth twice a day, children 15mg/kg by mouth twice a day).

Those performing autopsies should avoid bone sawing or any procedure likely to cause aerosolization and exposed people should wash with soap and water. In environmental contaminations use a 10% bleach solution for spraying and cleaning using alcohol 10 minutes after using bleach. There have been no reports of human to human transmission.

Up until now, the powers that be have pretty much denied the existence of Lyme Disease in the South. A great example of this happened recently when children from Arkansas were denied treatment because the Director of the Infectious Disease Program stated that although they have ticks that transmit LD, there aren’t any recorded cases.  https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/

This illogical ideology is about to change thanks to the work of Kerry Clark, PhD, MPH, Professor of Epidemiology & Environmental Health at the University of North Florida. At the recent Lyme Disease Association (LDA) 17th Annual Conference in St. Paul, MN, Clark presented his work showing that Borrelia burgdorferi sense alto (Bbsl) DNA has been detected in scores of human patients and dogs from the South, who had no travel history to Lyme endemic regions. Bbsl was isolated in culture from patients from both Florida and Georgia – never before described in scientific literature.


The take home: Clark is finding strains in the South that the current CDC two-tier testing will never pick up in a thousand years.


The take home: Clark found live Bbsl (bissettii-like strain) in people from the Southeast who had undefined disorders not typical of LD, and were treated for LD even though they were seronegative, proving that B. bissetti is responsible for worldwide human infection.

He also showed DNA of Bbsl in Lone Star ticks which might be a bridge vector of transmission to humans.

To see Dr. Clark’s work, go to: https://www.researchgate.net/profile/Kerry_Clark/publications

Dr. Clark was the first to report finding LD spirochetes in animals and ticks in South Carolina, as well as in wild lizards in South Carolina and Florida. He has documented the presence of LD Borrelia species, Babesia microti, Anaplasma phagocytophilum, Rickettsia species, and other tick-borne pathogens in wild animals, ticks, dogs, and humans in Florida and other southern states.



Although the majority of Lyme disease patients can be cured, at least 10-20% of the patients continue to suffer from persisting symptoms such as fatigue, muscular and joint pain, and neurologic impairment after standard 2-4 week antibiotic treatment. While the causes for this post-treatment Lyme disease symptoms are unclear, one possibility is due to B. burgdorferi persisters that are not effectively killed by current antibiotics such as doxycycline or amoxicillin used to treat Lyme disease. A previous study showed that four rounds of ceftriaxone pulse dosing treatment eradicated B. burgdorferi persisters in vitro using a relatively young late log phase culture (5 day old).

In this study, we investigated if ceftriaxone pulse dosing could also eradicate B. burgdorferi persisters in older stationary phase cultures (10 day old) enriched with more resistant microcolony form of persisters. We found that ceftriaxone pulse dosing could only eradicate planktonic log phase B. burgdorferi spirochetal forms and round body forms but not more resistant aggregated biofilm-like microcolony persisters enriched in stationary phase cultures. Moreover, we found that not all drugs are suitable for pulse dosing, with bactericidal drugs ceftriaxone and cefuroxime being more appropriate for pulse dosing than bacteriostatic drug doxycycline and persister drug daptomycin.

We also showed that drug combination pulse dosing treatment was more effective than single drug pulse dosing. Importantly, we demonstrate that pulse dosing treatment impaired the activity of the persister drug daptomycin and its drug combination against B. burgdorferi persisters and that the most effective way to kill the more resistant biofilm-like microcolonies is the daptomycin/doxycycline/ceftriaxone triple drug combination without pulse dosing. Our findings indicate pulse dosing may not always work as a general principle but rather depends on the specific drugs used, with cidal drugs being more appropriate for pulse dosing than static or persister drugs, and that drug combination approach with persister drugs is more effective at killing the more resistant microcolony form of persisters than pulse dosing.

These observations may have implications for more effective treatment of Lyme disease. Future studies are required to validate these findings in animal models of B. burgdorferi persistence.


Free, full provisional text (pdf file, 2.31 MB):

The Kite Mosquito Patch

Approximately 2 min.


Dr. Anandasankar Ray and his team from the University of California, Riverside, has developed the Kite Patch, a small patch worn on clothing to protect against mosquitos.  The patch blocks the mosquitoes’ ability to track and detect humans for up to 48 hours.  It should be for sale in 2017.  http://magazine.ucr.edu/44

All Kite products are free from DEET or any other potentially harmful or toxic chemicals.  The company is committed to replacing outdated and potentially unhealthy repellents that have dominated the market for decades.

The patch could help protect against malaria, West Nile, Dengue fever, and other mosquito-borne diseases.

http://www.nature.com/nature/journal/v474/n7349/full/nature10081.html  Journal article.

http://well.blogs.nytimes.com/2015/08/11/high-tech-hope-for-repelling-mosquitoes/?_r=0  One person’s review.



In a riveting article (go to link above) STAT obtained Willy Burgdorfer’s documents found in his garage after his death in 2014.

 Approx. 4 min WBUR interview with Charles Piller, author of the link above.

What makes this crucial for MSIDS patients is his fascination and concern with Rickettsia helvetica, something he coined, “Swiss Agent.” The article poses an idea that doctors might be mistaking this infection for Lyme or that this agent could also be another co-infection complicating and confusing cases.

Rickettsia helvetica is known predominantly in Europe and Asia as relatively rare but linked to sudden deaths from heart disease. Other symptoms include facial palsy, deafness, meningitis, chronic muscle weakness, temporary paralysis, debilitating fatigue, severe headaches, and sarcoidosis.

There is no test in the U.S. for Rickettsia helvetica.

Burgdorfer discovered the pathogen in 1978 in Switzerland. The stacks of papers found in his garage indicate he meant to delve into it further with a prophetic note written in red on top of the stack that stated, “I wondered why somebody didn’t do something, then I realized that I am somebody.”

University of California, Berkeley, medical entomologist and Lyme expert, Robert Lane, states that Rh could cause clinical illness on its own or act with other pathogens worsening cases.

When the discovery of the cause of Lyme was reported in the journal Science in 1982, Burgdorfer identified Rickettsia in Lyme patients’ sera and ticks, but in the final article no mention of it was made.

Currently, the CDC is using molecular techniques on 30,000 sera samples from those with suspected tick-borne illness but will take several more years to finish. It is believed that if Rickettsia helvetica is there, it will be found.

Dr. W. Ian Lipkin, director of the Center for Infection and Immunity at Columbia University, has identified 20 new viruses in ticks, using a process that could result in making tests affordable to patients. He also trying to get funding to include Rickettsia in his research.

We can thank Burgdorfer for contemplating all of this before his death and ultimately contacting Ron Lindorf to retrieve his boxes of research. Willy told him he wanted it available to people on the internet so they could read it for themselves. From there, Lindorf met with Kris Newby, the producer of “Under Our Skin,” the best primer on Lyme Disease out there. http://underourskin.com/#home-underourskin.  If you haven’t seen this film, you need to now. It will explain all the reasons why we find ourselves in a medical quagmire. The sequel, “Emergence,”
http://underourskin.com/sequel/#sequel-home is just as powerful and offers much hope as it follows many patients through treatment to health.

Newby shared the documents with STAT, hoping that an independent report would be made.


NPRM – Act Now!


  Published on Sep 12, 2016

In one of the worse offenses against your rights yet, the CDC issued a Federal Register notice on August 15th to amend the Public Health Act. This notice states that CDC would like to expand their government police powers to apprehend people who look “unwell”. Public comment is only open until October 14, 2016.

Notice of Proposed Rule Making – or NPRM – involves the participation of federally funded state health departments and state facilities giving police power to detain, isolate and quarantine US citizens.  

You Can Be Fined and Jailed for Disobeying CDC Orders
And if the CDC finds you guilty of disobeying their orders and they believe you transmitted an infection to someone else, you can be fined “$100,000 if the violation does not result in a death, or one year in jail, or both, or a fine of no more than $250,000 if the violation results in a death, or one year in jail or both.” Plus they have added this curious language without explanation: “Violations by organizations are subject to a fine of no more than $200,000 per event if the violation does not result in a death, or $500,000 per event it the violation results in a death.”

By the way, this is about far more than just measles.  The language is frighteningly vague and you could get in trouble for coughing too much on an airplane.

http://www.enhancedonlinenews.com/news/eon/20160913005591/en  If the NPRM becomes law, it will affect American and non-American travelers entering the U.S. or traveling between states, particularly on commercial airlines and ships. The CDC is proposing to enlist commercial airline and other public transportation personnel to step up surveillance on and report “unwell” passengers with rashes, cough, diarrhea and other symptoms of illness.  (oh goody, more surveillance)

If the NPRM becomes law, it appears U.S. health officials could hold a person in custody for 72 hours without the right to contact an attorney to appeal the detention. Detainees could be asked to sign a contract with the CDC that gives consent to the “public health measures” being applied to the adult or a minor child, which may include “quarantine, isolation, conditional release, medical examination, hospitalization, vaccination, and treatment.” However, the NPRM states that “the individual’s consent shall not be considered a prerequisite to any exercise of any authority” by the CDC. After release, the person can be electronically tracked and monitored, including by electronic tracking devices attached to the body.

Are you shaking yet?

This is a HUGE overreach of government power .  Americans have until Oct. 14, 2016 to make public comment to the CDC.


1) Contact your U.S. Congressional Representative and both of your U.S. Senators Representatives and ask them to stop this outrageous federal overreach and unnecessary expansion of police powers by demanding the CDC withdraw the proposed rule. To find who represents you in the U.S. Congress and U.S. Senate, register/login to the NVIC Advocacy Portal, https://nvicadvocacy.org/members/Home.aspx, click on the “national” tab on the top of your home page, and the names of your personal U.S. Congressional Representative and your two U.S. Senators will be listed on the right hand side. Click on their names to be linked to all of their contact information. Send your letter by email, fax or regular mail then follow-up with a personal phone call expressing your concerns.

2) Submit public comments with your concerns directly to the CDC on the proposed rule by Oct. 14, 2016 11:59 pm EST.

3) Share this alert with family and friends by forwarding this email or sending them to http://NVICAdvocacy.org on our National page or to our note on National Vaccine Information Center Facebook.


Oct. 11, 2016

Washington, D.C. 20515

RE: Notice of Proposed Rulemaking (NPRM) by CDC and HHS Concerning Quarantine
CDC Docket No. CDC-2016-0068
Dear Representative or Senator LASTNAME,

As a constituent of yours, I am writing to you for your assistance. I have serious concerns about an overreaching proposed HHS/CDC Rule that would expand police powers to forcibly detain, isolate, vaccinate and quarantine citizens. This Notice of Proposed Rule Making was published in the Federal Register on 8/15/16 and is currently open for public comment until 10/14/16.

I am asking you to demand that the CDC withdraw this proposed rule for the following reasons:

· The proposed rule is a violation of civil liberties. U.S. health officials could hold a person in custody for 72 hours without the right to contact an attorney to appeal the detention. Detainees could be asked to sign a contract with the CDC that gives consent to the “public health measures” being applied to the adult or a minor child, which may include “quarantine, isolation, conditional release, medical examination, hospitalization, vaccination, and treatment.” The proposed rule states that “the individual’s consent shall not be considered a prerequisite to any exercise of any authority” by the CDC. After release, the person can be electronically tracked and monitored, including by electronic tracking devices attached to the body.

· The proposed rule is a clear case of federal government overreach. Federal and state laws are already in place to address the control of outbreaks of serious communicable diseases. When similar rules have been proposed in the past they have been withdrawn over concerns of civil rights violations and the cost to implement. http://usatoday30.usatoday.com/news/washington/2010-04-01-quarantine_N.htm

The proposed rule has very subjective and unreasonably broad definitions of illness. The proposed rule defines a potentially “ill” person deserving of special government scrutiny to be someone with “areas of the skin with multiple red bumps, red, flat spots or blister like bumps filled with fluid or pus that are intact or partially crusted over,” warning ominously that “the presence of skin rash, along with fever, may indicate that the traveler has measles, rubella (German measles), varicella (chickenpox) meningococcal disease or smallpox.” These definitions (on pages 54239-40) are very subjective and will open the door for travelers to be detained for something as simple as a skin rash while suffering from a bad sunburn, acne, rosacea, eczema, psoriasis, the hives, or severe allergies and a mild fever that could be due to an old fashioned cold. Measles is not Ebola and chickenpox is not smallpox.







Mycobacterium Drugs For LD

Back in May you may remember the article about Dr. Horowitz having success with Dapsone, a drug commonly used for Leprosy, in his MSIDS patients that didn’t respond well to conventional treatment.  https://madisonarealymesupportgroup.com/2016/05/09/leprosy-drug-for-lyme/.  It was reported that patients improved in all symptoms except for headache.

Recently he and Phyllis R. Freeman published on another mycobacterium drug, pyrazinamide, (PZA).  https://www.jscimedcentral.com/Arthritis/arthritis-1-1008.pdf

He states in the study that co-infection is the rule and that one recent study showed 45% of ticks were co-infected with up to five different pathogens, with up to eight identified in the same tick.  Patients who have Lyme (borrelia) and are co-infected are much sicker and often resistant to standard therapies and often have varied clinical presentations making them harder to diagnose and treat.

The case study has based on a woman with Borrelia burgdorferi, Borrelia hermsii, possible prior exposure to tularemia, exposure to Mycoplasma pneumonia, multiple viruses, fibromyalgia, and rheumatoid arthritis.

This poor woman had been through hell and back for years.  Under Dr. Horowitz’s care she improved from 30% to 50%, but with the addition of Dapsone had a sudden fourfold increase in tularemia titers as well as Bartonella titers turning positive.

While making continuous progress the patient had ongoing joint pain which interfered with sleep as well as ongoing severe blood-filled blisters, oral/genital ulcerations, and increased granulomas.

While a rheumatologist wanted to put her on an immunosuppressive, she and Dr. Horowitz chose to try 500mg (based on body weight) of PZA twice a day combined with rifampin and minocycline.  Her liver was monitored every two weeks and was helped with alpha lipoid acid 600mg and milk thistle 250mg.

Two months later she reported up to 80% of normal functioning, had improvement in her most resistant dermatological symptoms with the resolution of her oral ulcers, and stated that it was the best protocol she had done in the past 20 years.

Horowitz reports that the Dapsone and PZA protocols have been the most effective treatment additions for resistant Lyme and autoimmune symptoms, with PZA being the most effective for dermatological manifestations of Bahcet’s and arthritic/granulomatous changes.