Archive for the ‘Borrelia Miyamotoi (Relapsing Fever Group)’ Category

Milford Pathologist Fires Broadside at CDC Motion to Discuss

https://www.change.org/p/1120418/u/23141062?

Milford Conn. Pathologist Fires Broadside at CDC Motion to Dismiss

Carl Tuttle
Hudson, NH
AUG 15, 2018 —

MILFORD MOLECULAR DIAGNOSTICS
2044 Bridgeport Avenue
Milford, CT 06460
www.dnalymetest.com
August 15, 2018
Media Contact: Kevin Moore, 203-788-8497

FOR IMMEDIATE RELEASE

Milford Conn. Pathologist Fires Broadside at CDC Motion to Dismiss in Groundbreaking $57.1 Million Lyme Disease Lawsuit

Demonstrates that CDC relied on “unreliable” Wikipedia as source to discredit Dr. Lee

Milford, Conn… Sin Hang Lee, M.D., the Connecticut pathologist who, in May, filed a $57.1 million lawsuit against the Centers for Disease Control, in a legal opposition to the CDC’s motion to dismiss his lawsuit, informed the U.S. Court of Federal Claims, that the CDC had relied on unverifiable, non-peer reviewed Wikipedia as a source for informational support to back its motion to dismiss.

To suppress direct detection tests for Lyme disease,” said Dr. Lee, referring to the Sanger DNA sequencing testing method that he employs, and, which is at the heart of his lawsuit, “the CDC is willing to exhaust all of its administrative remedies. When its patented metabolomics technology could not stop Sanger sequencing in science, the CDC told its lawyers to look up Wikipedia for help in a motion to dismiss my lawsuit.”

In 2013, after testing two panels of Lyme disease reference serum samples from the CDC by Sanger sequencing, Dr. Lee informed the CDC that some of the archived serum samples taken from patients with Lyme disease in fact were positive for Borrelia miyamotoi and a novel unnamed relapsing fever borrelia, and published the data in a peer-reviewed article. Years later, the CDC claimed in social media that Dr. Lee published “inconsistent results” ( https://www.change.org/p/the-us-senate-calling-for-a-congressional-investigation-of-the-cdc-idsa-and-aldf/u/15796418 ) while promoting its own, newly patented, unproven metabolomics technology for diagnosis of Lyme disease.

In order to deny the facts that clinical Lyme disease may be caused by a diversity of borrelial strains of bacteria, the CDC instructed its lawyers to quote Wikipedia, an online encyclopedia with no peer review, as the alternative science to discredit Dr. Lee’s work in the U.S. Court of Federal Claims. The CDC attorneys then filed the following with the U.S. Court of Federal Claims:

“However, Borrelia miyamotoi is not a causative agent of Lyme disease. Wikipedia, https://en.wikipedia.org/wiki/Borrelia_ miyamotoi p. 1 (“Although infection [with Borrelia miyamotoi] can cause some similar symptoms [as Lyme disease] including fever, headache, fatigue, and muscle aches, acute Lyme disease often presents with rash, while infection with B. miyamotoi does not; it remains unclear whether B. miyamotoi causes a relapsing fever syndrome”).

In the PLAINTIFF’S RESPONSE TO MOTION TO DISMISS filed on August 13, 2018, Dr. Lee’s attorney, Mary Alice Moore Leonhardt, countered with the following statement:

“The Defendant relied on the inherently unreliable website Wikipedia in its attempt to discredit Dr. Lee, rather than the CDC’s own data. The CDC expressly acknowledges that Borrelia miyamotoi causes hard tick relapsing fever and Borrelia miyamotoi infection causes fever, chills and headache which are common symptoms in Lyme disease, and may cause skin rash in about 8% of the patients (4/51). (CDC, Borrelia miyamotoi Disease, available at https://www.cdc.gov/ticks/tickbornediseases/borrelia-miyamotoi.html
CDC, B. miyamotoi, available at https://www.cdc.gov/ticks/miyamotoi.html Thus, Dr. Lee’s test results detected the presence of two tick-borne illnesses, including Lyme disease and a disease that presents in similar ways to Lyme disease. These results were 100% accurate as confirmed through the DNA sequencing with the Gene Bank.”
The CDC should come out to debate the science and technology in direct detection testing for the diagnosis of Lyme disease instead of hiding behind a wall of lawyers and Wikipedia encyclopedia,” said Dr. Lee. “Accurate diagnosis of Lyme borreliosis must not be stopped by CDC lawyers.”
###

* The official documents with Appendix filed in the U.S. Court of Federal Claims can be accessed through the Drop Box. Complete filing here: https://www.dropbox.com/sh/zkcp96z7eua1fnn/AAA377iX8aZFQZs7BlQbUGb5a?dl=0

Milford Molecular Diagnostics Laboratory:  http://www.dnalymetest.com/lymediseasednatesting.html  
Milford Medical Laboratory offers the first reliable DNA test for Lyme disease bacteria and B. miyamotoi, the spirochete causing a Lyme disease-like infection.
http://www.dnalymetest.com

 

Tickborne Diseases – Confronting a Growing Threat

https://www.nejm.org/doi/full/10.1056/NEJMp1807870

Tickborne Diseases — Confronting a Growing Threat

Catharine I. Paules, M.D., Hilary D. Marston, M.D., M.P.H., Marshall E. Bloom, M.D., and Anthony S. Fauci, M.D.

July 25, 2018, at NEJM.org.

Every spring, public health officials prepare for an upsurge in vectorborne diseases. As mosquito-borne illnesses have notoriously surged in the Americas, the U.S. incidence of tickborne infections has risen insidiously, triggering heightened attention from clinicians and researchers.

nejmp1807870_f1

Common Ticks Associated with Lyme Disease in North America.

According to the Centers for Disease Control and Prevention (CDC), the number of reported cases of tickborne disease has more than doubled over the past 13 years.1 Bacteria cause most tickborne diseases in the United States, and Lyme disease accounts for 82% of reported cases, although other bacteria (including Ehrlichia chaffeensis, Anaplasma phagocytophilum, and Rickettsia rickettsii) and parasites (such as Babesia microti) also cause substantial morbidity and mortality. In 1982, Willy Burgdorfer, a microbiologist at the Rocky Mountain Laboratories of the National Institute of Allergy and Infectious Diseases, identified the causative organism of Lyme disease, a spirochete eponymously named Borrelia burgdorferi. B. burgdorferi (which causes disease in North America and Europe) and B. afzelii and B. garinii (found in Europe and Asia) are the most common agents of Lyme disease. The recently identified B. mayonii has been described as a cause of Lyme disease in the upper midwestern United States. Spirochetes that cause Lyme disease are carried by hard-bodied ticks (see graphic), notably Ixodes scapularis in the northeastern United States, I. pacificus in western states, I. ricinus in Europe, and I. persulcatus in eastern Europe and Asia. B. miyamotoi, a borrelia spirochete found in Europe, North America, and Asia, more closely related to the agents of tickborne relapsing fever, is also transmitted by I. scapularis and should be considered in the differential diagnosis of febrile illness occurring after a tick bite.

Patterns of spirochete enzootic transmission are geographically influenced and involve both small-mammal reservoir hosts, such as white-footed mice, and larger animals, such as white-tailed deer, which are critical for adult tick feeding. The rising incidence and expanding distribution of Lyme disease in the United States are probably multifactorial, but increased density and range of the tick vectors play a key role. The geographic range of I. scapularis is apparently increasing: by 2015, it had been detected in nearly 50% more U.S counties than in 1996.

Lyme disease’s clinical manifestations range from relatively mild, nonspecific findings and classic erythema migrans rash in early disease to more severe manifestations, including neurologic disease and carditis (often with heart block) in early disseminated disease, and arthritis, which may occur many months after infection (late disease). Although most cases are successfully treated with antibiotics, 10 to 20% of patients report lingering symptoms after receiving appropriate therapy.2 Despite more than four decades of research, gaps remain in our understanding of Lyme disease pathogenesis, particularly its role in these less well-defined, post-treatment symptoms.

Meanwhile, tickborne viral infections are also on the rise and could cause serious illness and death.1 One example is Powassan virus (POWV), the only known North American tickborne encephalitis-causing flavivirus.3 POWV was recognized as a human pathogen in 1958 after being isolated from the brain of a child who died of encephalitis in Powassan, Ontario. People infected with POWV often have a febrile illness that can be followed by progressive and severe neurologic manifestations, resulting in death in 10 to 15% of cases and long-term sequelae in 50 to 70% of survivors.3 An antigenically similar virus, POWV lineage II, or deer tick virus, was discovered in New England in 1997. Both POWV subtypes are linked to human disease, but their distinct enzootic cycles may affect their likelihood of causing such disease. Lineage II seems to be maintained in an enzootic cycle between I. scapularis and white-footed mice — which may portend increased human transmission, because I. scapularis is the primary vector of other serious pathogens, including B. burgdorferi. Whereas only 20 U.S. cases of POWV infection were reported before 2006,3 99 were reported between 2006 and 2016. Other tickborne encephalitis flaviviruses cause thousands of cases of neuroinvasive illness in Europe and Asia each year, despite the availability of effective vaccines in those regions. The increase in POWV cases coupled with the apparent expansion of the I. scapularis range highlight the need for increased attention to this emerging virus.

The public health burden of tickborne pathogens is considerably underestimated. For example, the CDC reports approximately 30,000 cases of Lyme disease per year but estimates that the true incidence is 10 times that number.1 Multiple factors contribute to this discrepancy, including limitations in surveillance and reporting systems and constraints imposed by available diagnostics, which rely heavily on serologic assays.4 Diagnostic utility is affected by variability among laboratories, timing of specimen collection, suboptimal sensitivity during early infection, imperfect use of diagnostics (particularly in persons with low probability of disease), inability of a single test to identify coinfections in patients with acute infection, and the cumbersome nature of some assays. Current diagnostics also have difficulty distinguishing acute from past infection — a serious challenge in diseases characterized by nonspecific clinical findings. Moreover, tests may remain positive even after resolution of infection, leading to diagnostic uncertainty during subsequent unrelated illnesses. For less common tickborne pathogens such as POWV, serologic testing can be performed only in specialized laboratories, and currently available tests fail to identify novel tickborne organisms.
Such limitations have led researchers to explore new technologies. For example, one of the multiplex serologic platforms that have been developed can detect antibodies to more than 170,000 distinct epitopes, allowing researchers to distinguish eight tickborne pathogens.4 In addition to its utility in screening simultaneously for multiple pathogens, this assay offers enhanced pathogen detection, particularly in specimens collected during early disease. Further studies are needed to determine such assays’ applicability in clinical practice.

Nonserologic platform technologies may also improve diagnostic capabilities, particularly in identifying emerging pathogens. Two previously unknown tickborne RNA viruses, Heartland virus and Bourbon virus, were discovered by researchers using next-generation sequencing to help link organisms with sets of unexplained clinical symptoms. The development and widespread implementation of next-generation diagnostics will be critical to understanding the driving factors behind epidemiologic trends and the full clinical scope of tickborne disease. In addition, sensitive, specific and, where possible, point-of-care assays will facilitate appropriate clinical care for infected persons, guide long-term preventive efforts, and aid in testing of new therapeutics and vaccines.

In the United States, prevention and management of tickborne diseases include measures to reduce tick exposure, such as avoiding or controlling the vector itself, plus prompt, evidence-based treatment of infections. Although effective therapies are available for common tickborne bacteria and parasites, there are none for tickborne viruses such as POWV.

The biggest gap, however, is in vaccines: there are no licensed vaccines for humans targeting any U.S. tickborne pathogen. One vaccine that was previously marketed to prevent Lyme disease, LYMErix, generated an immune response against the OspA lipoprotein of B. burgdorferi, and antibodies consumed by the tick during a blood meal targeted the spirochete in the vector.5 Nonetheless, the manufacturer withdrew LYMErix from the market for a combination of reasons, including falling sales, liability concerns, and reports suggesting it might be linked to autoimmune arthritis, although studies supported the vaccine’s safety. Similar concerns will probably affect development of other Lyme disease vaccines.5

Historically, infectious-disease vaccines have targeted specific pathogens, but another strategy would be to target the vector.5 This approach could reduce transmission of multiple pathogens simultaneously by exploiting a common variable, such as vector salivary components. Phase 1 clinical trials are under way to evaluate mosquito salivary-protein–based vaccines in healthy volunteers living in areas where most mosquito-borne diseases are not endemic. Since tick saliva also contains proteins conserved among various tick species, this approach is being explored for multiple tickborne diseases.5

The burden of tickborne diseases seems likely to continue to grow substantially. Prevention and management are hampered by suboptimal diagnostics, lack of treatment options for emerging viruses, and a paucity of vaccines. If public health and biomedical research professionals accelerate their efforts to address this threat, we may be able to fill these gaps. Meanwhile, clinicians should advise patients to use insect repellent and wear long pants when walking in the woods or tending their gardens — and check themselves for ticks when they are done.
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**Comment**

While this article repeats much of the same verbiage that’s been repeated for years, particularly the vaccine push, they are ignoring the following:

  1. Many TBI’s are congenitally transmitted:  https://madisonarealymesupportgroup.com/2018/06/19/33-years-of-documentation-of-maternal-child-transmission-of-lyme-disease-and-congenital-lyme-borreliosis-a-review/https://madisonarealymesupportgroup.com/2018/07/24/congenital-transmission-of-lyme-myth-or-reality/https://madisonarealymesupportgroup.com/2018/02/26/transplacental-transmission-fetal-damage-with-lyme-disease/
  2. There is a real probability of sexual transmission:  https://madisonarealymesupportgroup.com/2018/02/06/lyme-in-the-southern-hemisphere-sexual-transmission/https://madisonarealymesupportgroup.com/2017/02/24/pcos-lyme-my-story/
  3. While they mention Ehrlichia, Anaplasma, Rickettsia, and Babesia, there are many other players that are hardly getting a byline.  For a list to date:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/.  This is an important issue because to date the medical world is looking at this complex illness as a one pathogen one drug illness when nothing could be further from the truth.  No one has done any research on the complexity of being infected with more than one pathogen.  It will reveal the CDC’s guidelines of 21 days of doxy to be utter stupidity.
  4. Also, worth mentioning is that only a few of these are reportable illnesses so there is absolutely no data on how prevalent any of this is.  Surveillance is a real problem.
  5. Regarding what ticks are where….this ancient verbiage needs to change.  Ticks are moving everywhere.  This is on record in numerous places:  https://madisonarealymesupportgroup.com/2018/07/16/ticks-that-carry-lyme-disease-are-spreading-fast/https://madisonarealymesupportgroup.com/2018/07/10/we-have-no-idea-how-bad-the-us-tick-problem-is/https://madisonarealymesupportgroup.com/2018/07/22/citizen-scientists-help-track-tick-borne-illness-exposure/
  6. No tick is a good tick.  They all need blood meals and have the potential to transmit disease.  
  7. This article is silent about the Asian Longhorned tick that propagates itself by cloning and can drain cattle of their blood.  Found in six states so far it was recently found on a child in New Jersey:  https://www.northjersey.com/story/news/environment/2018/07/24/bergen-county-nj-child-may-first-carrying-longhorned-tick-us/825744002/.  Word in the tick world is it had NOT bitten the child and tested negative for pathogens.  What is concerning is that it is known to transmit SFTS virus and Japanese spotted fever in Asia. This story is a reminder that this tick is NOT just a livestock problem and that a normal child going about a normal day with NO contact with livestock had this tick on her.  Another clear reminder that it is foolish to put any of this in a box.
  8. They need to emphasize that the “classic erythema migrans rash” while indicative of Lyme, is unseen or variable in many patients.
  9. Constraints in testing is a true problem but an even bigger problem is untrained and uneducated medical professionals.  This stuff may never test clearly.  Get over it.  Get trained to know what to look for!
  10. The Lyme vaccine was a bust.  It still is.  Unless safety concerns are dealt with we want nothing to do with any vaccine.
  11. All I know is that mosquitoes and Zika get more attention that this modern day 21st century plague that is creeping everywhere and is a true pandemic.  It still isn’t being seriously dealt with or researched.  What research is being done is same – o – same -o stuff we already know.  Study the tough stuff – the unanswered questions or things that are just repeated as a mantra for decades.
We need answers out here not repeated gibberish that isn’t helping patients.
Afterthought:

The one thing I didn’t deal with that I will point out now is this regurgitated number in the NEJM article of 10-20% of patients moving on to chronic/persistent Lyme. The following informative article written by Lorraine Johnson points out this number to be considerably higher which corresponds to my experience as a patient advocate: https://madisonarealymesupportgroup.com/2018/07/22/lyme-costs-may-exceed-75-billion-per-year/. Excerpt below:

Besides the staggering financial cost to this 21st century plague, this paper, based on estimates of treatment failure rates associated with early and late Lyme, estimates that 35-50% of those who contract Lyme will develop persistent or chronic disease.

Let that sink in.

And in the Hopkins study found 63% developed late/chronic Lyme symptoms.

For some time I’ve been rankled by the repeated CDC statement that only 10-20% of patents go on to develop chronic symptoms. This mantra in turn is then repeated by everyone else.

While still an estimate, I’d say 35 to over 60% is a tad higher than 10-20%, wouldn’t you? It also better reflects the patient group I deal with on a daily basis. I can tell you this – it’s a far greater number than imagined and is only going to worsen.

 

 

Citizen Scientists Help Track Tick Borne Illness Exposure

https://www.sciencedaily.com/releases/2018/07/180712141710.htm

Who got bit? By mailing in 16,000 ticks, citizen scientists help track disease exposures

Study offers new insight into potential exposure to tick-borne diseases

Date:  July 12, 2018
Source:  Colorado State University
Summary:
A bite from a disease-carrying tick can transmit a serious, potentially fatal infection, such as Lyme disease. But many ticks go unnoticed and unreported. Now, with the help of citizen scientists, ecologists are offering better insight into people’s and animals’ potential exposure to tick-borne diseases — not just the disease reporting and prevalence that’s only tracked when people get sick.

Western black-legged ticks.
Credit: Ervic Aquino/California Department of Public Health

A bite from a disease-carrying tick can transmit a serious, potentially fatal infection, such as Lyme disease. But many ticks go unnoticed and unreported.

Now, with the help of citizen scientists, ecologists at Colorado State University and Northern Arizona University are offering better insight into people’s and animals’ potential exposure to tick-borne diseases — not just the disease reporting and prevalence tracking that only occur when people get sick.

The result is a study published in the open-access journal PLOS ONE. The team was funded by the Bay Area Lyme Foundation, a nonprofit organization dedicated to informing the public about Lyme disease and finding a cure. Foundation officials urge people to take tick bites seriously, since early detection is key to treating most conditions.

The study’s lead authors are Daniel Salkeld, a research scientist in CSU’s Department of Biology, and longtime collaborator Nathan Nieto of Northern Arizona University.

“Our study may be a new way of understanding exposure to tick-borne diseases,” explained Salkeld, a disease ecologist. “Normally the approach is to rely on reported disease cases, or to look at ticks in natural habitats. Our data represent that in-between, middle ground: It shows when people or animals got bitten, and where, and what they got exposed to.”

Salkeld and Nieto’s study examined over 16,000 ticks sent in by citizen scientists from 49 states (all but Alaska) and Puerto Rico. Nearly 90 percent of the ticks were reported to have been removed from either humans or dogs. The researchers tested for several bacteria, including those that cause Lyme disease and babesiosis. One of the pathogens they tested for, Borrelia miyamotoi, was discovered relatively recently, and is not typically tracked by public health officials.

In their data, the researchers found 83 counties, in 24 states, where ticks carrying disease-causing bacteria had never been previously documented. The scientists’ original goal was to collect about 2,000 ticks, and they expected most to come from California’s San Francisco Bay Area. The nationwide response to their experiment underscores the public’s intense interest in better understanding tick diseases.

“The overwhelming participation from residents throughout the country and the surprising number of counties impacted demonstrates that a great need exists throughout the country for this information,” said Nieto, who led the diagnostic testing of each tick received in the mail. “This study offers a unique and very valuable perspective, as it looks at risk to humans that goes beyond the physician-reported infection rates and involved ticks that were found on or near people.

The researchers stress that citizen science data has limitations; some of their findings may be tied to human error, or lack of access to information. For example, the citizen scientists reported where they lived, and where the ticks were found, but not where they had traveled recently.

Tick scientists like Salkeld and Nieto can typically collect around 100 ticks for a localized study. Inviting citizen scientists to send in ticks opened up a whole new way of seeing how such ticks are distributed, and their activity patterns. Approaches like this could lead to new insights such as how diseases spread, and new human pathogens yet to be discovered.

“For example, we could start to look at what species of ticks are active, when, and where,” Salkeld said. “And how does this differ from across the north or south, or the Midwest to California? There could be all kinds of subtle variations.”

Story Source:

Materials provided by Colorado State University. Note: Content may be edited for style and length.


Journal Reference:

  1. Nathan C. Nieto, W. Tanner Porter, Julie C. Wachara, Thomas J. Lowrey, Luke Martin, Peter J. Motyka, Daniel J. Salkeld. Using citizen science to describe the prevalence and distribution of tick bite and exposure to tick-borne diseases in the United States. PLOS ONE, 2018; 13 (7): e0199644 DOI: 10.1371/journal.pone.0199644
__________________
Related article:
  • ticks in places they weren’t supposed to be
  • ticks are born carrying disease and do not require a blood meal to pick it up 
  • ALL life stages of common ticks (deer, Western black-legged, and lone star) carry the bacteria that cases Lyme disease
  • they found Babesia in 26 counties across 10 states which
  • isn’t even a reportable illness to the public health department  
  • all of this blows holes in commonly held doctrine 

Canada is also making use of citizen scientists for the tick borne illness problem:  https://madisonarealymesupportgroup.com/2018/04/10/canadian-citizen-scientists-helping-with-tick-surveillance/

 

 

 

We Have No Idea How Bad the US Tick Problem Is

https://www.wired.com/story/we-have-no-idea-how-bad-the-us-tick-problem-is/
AUTHOR: MEGAN MOLTENIMEGAN MOLTENI
SCIENCE
7.04.18

WE HAVE NO IDEA HOW BAD THE US TICK PROBLEM IS

WHEN RICK OSTFELD gets bitten by a tick, he knows right away. After decades studying tick-borne diseases as an ecologist at the Cary Institute of Ecosystem Studies in Millbrook, New York, Ostfeld has been bitten more than 100 times, and his body now reacts to tick saliva with an intense burning sensation. He’s an exception. Most people don’t even notice that they’ve been bitten until after the pest has had time to suck up a blood meal and transfer any infections it has circulating in its spit.

Around the world, diseases spread by ticks are on the rise. Reported cases of Lyme, the most common US tick-borne illness, have quadrupled since the 1990s. Other life-threatening infections like anaplasmosis, babesiosis, and Rocky Mountain spotted fever are increasing in incidence even more quickly than Lyme. Meat allergies caused by tick bites have skyrocketed from a few dozen a decade ago to more than 5,000 in the US alone, according to experts. And new tick-borne pathogens are emerging at a troubling clip; since 2004, seven new viruses and bugs transmitted through tick bite have shown up in humans in the US.

Scientists don’t know exactly which combination of factors—shifting climate patterns, human sprawl, deforestation—is leading to more ticks in more places. But there’s no denying the recent population explosion, especially of the species that carries Lyme disease: the black-legged tick.

“Whole new communities are being engulfed by this tick every year,” says Ostfeld. “And that means more people getting sick.

Tick science, surveillance, and management efforts have so far not kept pace. But the country’s increasingly dire tick-borne disease burden has begun to galvanize a groundswell of research interest and funding.

In 1942, Congress established the CDC specifically to prevent malaria, a public health crisis spreading through mosquitoes. Which is why many US states and counties today still have active surveillance programs for skeeters. The Centers for Disease Control and Prevention uses data from these government entities to regularly update distribution maps, track emerging threats (like Zika), and coordinate control efforts. No such system exists for ticks.

Public health departments are required to report back to the CDC on Lyme and six other tick-borne infections. Those cases combined with county-level surveys and some published academic studies make up the bulk of what the agency knows about national tick distribution. But this data, patchy and stuck in time, doesn’t do a lot to help public health officials on the ground.

“We’ve got national maps, but we don’t have detailed local information about where the worst areas for ticks are located,” says Ben Beard, chief of the CDC’s bacterial diseases branch in the division of vector-borne diseases. “The reason for that is there has never been public funding to support systematic tick surveillance efforts.

That’s something Beard is trying to change. He says the CDC is currently in the process of organizing a nationwide surveillance program, which could launch within the year. It will pull data collected by state health departments and the CDC’s five regional centers about tick prevalence and the pathogens they’re carrying to build a better picture of where outbreaks and hot spots are developing, especially on the expanding edge of tick populations.

The CDC is also a few years into a massive nationwide study it’s conducting with the Mayo Clinic, which will eventually enroll 30,000 people who’ve been bitten by ticks. Each one will be tested for known tick diseases, and next-generation sequencing conducted at CDC will screen for any other pathogens that might be present. Together with patient data, it should provide a more detailed picture of exactly what’s out there.

Together, these efforts are helping to change the way people and government agencies think about ticks as a public health threat.

“Responsibility for tick control has always fallen to individuals and homeowners,” says Beard. “It’s not been seen as an official civic duty, but we think it’s time whole communities got engaged. And getting better tick surveillance data will help us define risk for these communities in areas where people aren’t used to looking for tick-borne diseases.”

The trouble is that scientists also know very little about which interventions actually reduce those risks.

“There’s no shortage of products to control ticks,” says Ostfeld. “But it’s never been demonstrated that they do a good enough job, deployed in the right places, to prevent any cases of tick-borne disease.”

In a double-blind trial published in 2016, CDC researchers treated some yards with insecticides and others with a placebo. The treated yards knocked back tick numbers by 63 percent, but families living in the treated homes were still just as likely to be diagnosed with Lyme.

Ostfeld and his wife and research partner Felicia Keesing are in the middle of a four-year study to evaluate the efficacy of two tick-control methods in their home territory of Dutchess County, an area with one of the country’s highest rates of Lyme disease. It’s a private-public partnership between their academic institutions, the CDC, and the Steven and Alexandra Cohen Foundation, which provided a $5 million grant.

Ostfeld and Keesing are blanketing entire neighborhoods in either a natural fungus-based spray or tick boxes, or both. The tick boxes attract small mammal hosts, which get a splash of tick-killing chemicals when they venture inside. They check with all the human participants every two weeks for 10 months of the year to see if anyone’s gotten sick. By the end of 2020 the study should be able to tell them how well these methods, used together or separately on a neighborhood-wide scale, can reduce the risk of Lyme.

“If we get a definitive answer that these work the next task would be to figure out how to make such a program more broadly available. Who’s going to pay for it, who’s going to coordinate it?” says Ostfeld. “If it doesn’t work then perhaps the conclusion is maybe environmental control just can’t be done.”

In that case, people would be stuck with pretty much the same options they have today: protective clothing, repellants, and daily partner tick-checks. It’s better than nothing. But with more and more people getting sick, the US will need better solutions soon.

________________

**Comment**

Great article pointing out the scary fact that only 6 pathogens transmitted by ticks are being reported on.  There are currently 18 pathogens and counting…..so the numbers are woefully inadequate.

Here’s the list so far:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/

Babesiosis
Bartonellosis
Borrelia miyamotoi
Bourbon Virus
Colorado Tick Fever
Crimean-Congo hemorrhagic Fever
Ehrlichiosis/Anaplasmosis
Heartland Virus
Meat Allergy/Alpha Gal
Pacific Coast Tick Fever: Richettsia philipii
Powassan Encephalitis
Q Fever
Rickettsia parkeri Richettsiosis
Rocky Mountain Spotted Fever
STARI: Southern Tick-Associated Rash Illness
Tickborne meningoencephalitis
Tick Paralysis
Tularemia

And the number keeps growing…..but nobody’s keeping score.

Where Ticks Are and What They Carry – Science Conversation With Dr. Cameron

http://danielcameronmd.com/lyme-disease-science-conversation-ticks-diseases-they-carry/  Approx. 50 Min

Dr. Daniel Cameron, a leading Lyme disease expert, discusses where are the ticks and what are the diseases they carry.

________________

**Comment**

The word is finally getting out.  TICKS ARE EVERYWHERE!

Beaches:  https://madisonarealymesupportgroup.com/2018/06/07/ticks-on-beaches/

Rocks and picnic benches:  https://madisonarealymesupportgroup.com/2017/03/13/ticks-found-on-rocks/

Caves:  https://madisonarealymesupportgroup.com/2018/04/23/tick-borne-relapsing-fever-found-in-austin-texas-caves/, and https://madisonarealymesupportgroup.com/2017/10/27/israeli-kids-get-lyme-disease-from-ticks-in-caves/

Birds:  https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/

California:  https://madisonarealymesupportgroup.com/2018/05/19/infected-ticks-in-california-its-complicated/

In the South:  https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/, and https://madisonarealymesupportgroup.com/2017/10/06/remembering-dr-masters-the-rebel-for-lyme-patients-who-took-on-the-cdc-single-handedly/, and https://madisonarealymesupportgroup.com/2017/03/02/hold-the-press-arkansas-has-lyme/

Southern Hemisphere:  https://madisonarealymesupportgroup.com/2018/02/06/lyme-in-the-southern-hemisphere-sexual-transmission/

Australia:  https://madisonarealymesupportgroup.com/2016/11/03/ld-not-in-australia-here-we-go-again/

And everywhere else…..

Remember, there are 300 strains and counting of Borrelia worldwide and 100 strains and counting in the U.S.  Current CDC two-tiered testing tests for ONE strain!  Do the math….

For more:  https://madisonarealymesupportgroup.com/2018/05/27/study-conforms-permethrin-causes-ticks-to-drop-off-clothing/

https://madisonarealymesupportgroup.com/2018/06/06/mc-bugg-z/

 

 

 

 

Update on TBD’s in Travelers

https://www.ncbi.nlm.nih.gov/m/pubmed/29789953/

Update on Tick-Borne Bacterial Diseases in Travelers.

Review article

Eldin C, et al. Curr Infect Dis Rep. 2018.

Abstract

PURPOSE OF REVIEW: Ticks are the second most important vectors of infectious diseases after mosquitoes worldwide. The growth of international tourism including in rural and remote places increasingly exposes travelers to tick bite. Our aim was to review the main tick-borne infectious diseases reported in travelers in the past 5 years.

RECENT FINDINGS: In recent years, tick-borne bacterial diseases have emerged in travelers including spotted fever group (SFG) rickettsioses, borrelioses, and diseases caused by bacteria of the Anaplasmataceae family. African tick-bite fever, due to Rickettsia africae, is the most frequent agent reported in travelers returned from Sub-Saharan areas. Other SFG agents are increasingly reported in travelers, and clinicians should be aware of them. Lyme disease can be misdiagnosed in Southern countries. Organisms causing tick-borne relapsing fever are neglected pathogens worldwide, and reports in travelers have allowed the description of new species. Infections due to Anaplasmataceae bacteria are more rarely described in travelers, but a new species of Neoehrlichia has recently been detected in a traveler. The treatment of these infections relies on doxycycline, and travelers should be informed before the trip about prevention measures against tick bites.

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**Comment**

This review clearly shows how much work still needs to be done.  To boil down this complex illness to a round of doxycycline shows a simplistic understanding of these pathogens on steroids.  Mainstream researchers still haven’t gotten the memo that Eva Sapi reported about doxy throwing the spirochete into the non-cell wall form or the information that both pathologist Alan McDonald and microbiologist Tom Greer are finding spirochetes hiding in worms in the brains of folks with dementia and Alzheimer’s.

To announce doxy as the “one side fits all” treatment is truly uninformed.

While doxy is a great front-line drug, patients need to be monitored closely for symptoms.  Since testing is so poor, doctors should also be educated on:  https://madisonarealymesupportgroup.com/2017/09/05/empirical-validation-of-the-horowitz-questionnaire-for-suspected-lyme-disease/  Print out and complete the symptom check lists and take them with you to your appointment.

Remember, Lyme is the rock star we all know by name.  There are many wanna-be’s just as powerful often at play:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/  The number is actually 18 and counting.

Please encourage doctors to become educated.  It’s our only hope.

https://madisonarealymesupportgroup.com/2018/02/19/calling-all-doctors-please-become-educated-regarding-tick-borne-illness-heres-how/

Here is an example of good Lyme treatment:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

Type other pathogens into the search bar to get other treatment suggestions.  Feel free to copy these off and share with your practitioner.

 

 

 

 

Panel Says TBI’s Have Reached Epidemic Levels

https://m.medicalxpress.com/news/2018-04-tick-borne-diseases-epidemic-panel.html

Tick-borne diseases reach epidemic levels, panel says

April 16, 2018
by Delthia Ricks, Newsday
Lyme disease
Adult deer tick, Ixodes scapularis. Credit: Scott Bauer/public domain

Tick-borne infections have reached epidemic proportions on Long Island, where children are disproportionately affected by Lyme disease and other infections transmitted by the eight-legged creatures, a panel of top scientists announced recently.

“Lyme disease is mostly a disease of children and curiously mostly a disease of boys,” Jorge Benach said at a recent symposium at Stony Brook University School of Medicine. Benach, who discovered the bacterium that causes Lyme disease, is a molecular geneticist at Stony Brook University School of Medicine.

His observation that Lyme disease is mostly an  of children was corroborated by Dr. Christy Beneri, a pediatrician at Stony Brook Children’s Hospital. She said her institution encountered a wide range of tick-borne illnesses annually and that boys tended to outnumber girls in the number of infections. The most likely reason for the disparity, Beneri said, is the tendency among boys to play outdoors in wooded areas where ticks thrive.

In the extensive pediatric research Beneri presented at the symposium was evidence of some children developing Bell’s palsy, a temporary facial paralysis that occurs when the Lyme bacterium affects a cranial nerve. The paralysis resolves with antibiotic treatment, Beneri said.

Beyond the Lyme bacterium, ticks on Long Island have been found to harbor babesia and anaplasma.

Babesia are protozoa, or parasitic, infectious agents that hone in on red blood cells, similar to the way a malaria parasite invades the same cells.

Anaplasmosis is an infection caused by the bacterium Anaplasma phagocytophilum. It can trigger aches, fever, chills and confusion.

Beneri and Benach were among five leading Stony Brook experts, including university president Dr. Samuel Stanley, who addressed what they described as a mounting epidemic of infections caused by the ever-expanding range of ticks. Stanley, who was the first speaker, is a specialist in infectious diseases.

“New York bears a disproportionate impact from tick-borne diseases,” Stanley said at the symposium, which was held in a lecture hall in the university’s health sciences building. “This is a regional and state problem.”

New York has the highest number of confirmed Lyme  cases nationwide, according to the U.S. Centers for Disease Control and Prevention, which has cataloged more than 95,000 Lyme infections in the state since 1986. Suffolk County has long been ground zero for the ailment on Long Island, studies consistently have shown.

“Cases in Suffolk County hover between 500 and 700 and this is just for the reported cases,” Benach said, noting that Suffolk has among the highest rates of many tick-transmitted infections because of the dense infiltration of the insects in county.

Typical Lyme symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans, said Dr. Luis Marcos, a specialist in internal medicine and infectious diseases.

Marcos presented data showing the wide range of illnesses caused by ticks throughout the region, including Borrelia miyamotoi, a corkscrew-shaped bacterium identified in recent years as the cause of a relapsing fever.

Dr. Eric Spitzer, a pathologist, discussed the many laboratory tests that Stony Brook used to arrive at a diagnosis of a tick-transmitted illness. He said that for years, doctors nationwide sent specimens to the university for analysis because of its well-known precision. Testing of those specimens earned the university $32 million over a 20-year period, he said.

Panelists identified the most prevalent ticks on Long Island as the American dog tick; the invasive lone star tick, which migrated from Southern states; and the blacklegged tick, known as deer tick.

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For more:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

https://madisonarealymesupportgroup.com/2016/03/08/anaplasmosis/

http://danielcameronmd.com/best-antibiotics-treat-borrelia-miyamotoi/ The study authors demonstrated that B. miyamotoi is susceptible to doxycycline, azithromycin, and ceftriaxone but resistant to amoxicillin in vitro. The next step would be to show whether these drugs work in patients.

 

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