Archive for the ‘Lyme’ Category

Lyme Borreliosis & Associations With Mental Disorders & Suicidal Behavior: A Nationwide Danish Cohort Study

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2021.20091347

Lyme Borreliosis and Associations With Mental Disorders and Suicidal Behavior: A Nationwide Danish Cohort Study

Published Online:28 Jul 2021https://doi.org/10.1176/appi.ajp.2021.20091347

Abstract

Objective:

Lyme borreliosis is a tick-borne infectious disease that may confer an increased risk of mental disorders, but previous studies have been hampered by methodological limitations, including small sample sizes. The authors used a nationwide retrospective cohort study design to examine rates of mental disorders following Lyme borreliosis.

Methods:

Using Denmark’s National Patient Register and the Psychiatric Central Research Register, and including all persons living in Denmark from 1994 through 2016 (N=6,945,837), the authors assessed the risk of mental disorders and suicidal behaviors among all individuals diagnosed with Lyme borreliosis in inpatient and outpatient hospital contacts (N=12,156). Incidence rate ratios (IRRs) were calculated by Poisson regression analyses.

Results:

  • Individuals with Lyme borreliosis had higher rates of any mental disorder (IRR=1.28, 95% CI=1.20, 1.37)
  • of affective disorders (IRR=1.42, 95% CI=1.27, 1.59)
  • of suicide attempts (IRR=2.01, 95% CI=1.58, 2.55)
  • and of death by suicide (IRR=1.75, 95% CI=1.18, 2.58) compared with those without Lyme borreliosis

The 6-month interval after diagnosis was associated with the highest rate of any mental disorder (IRR=1.96, 95% CI=1.53, 2.52), and the first 3 years after diagnosis was associated with the highest rate of suicide (IRR=2.41, 95% CI=1.25, 4.62). Having more than one episode of Lyme borreliosis was associated with increased incidence rate ratios for mental disorders, affective disorders, and suicide attempts, but not for death by suicide.

Conclusions:

Individuals diagnosed with Lyme borreliosis in the hospital setting had an increased risk of mental disorders, affective disorders, suicide attempts, and suicide. Although the absolute population risk is low, clinicians should be aware of potential psychiatric sequelae of this global disease.

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For more:

Category:

Lyme, Psychological Aspects, research

Tickborne Illnesses in Finland

https://www.lymedisease.org/ticks-finland-2/

TOUCHED BY LYME: Tick-borne illnesses in Finland

April 28, 2021

Guest blogger C.M. Rubin interviews two European scientists about the prevalence of Lyme disease and other tick-borne infections in Finland.

The Global Search for Education: Finland — Ticks

by C M Rubin as featured in the Huffington Post

Lyme disease is caused by a bacterium transmitted to humans via a tick bite. The CDC (Center for Disease Control) claims that Lyme Borreliosis is the most common and fastest growing infectious illness in the United States. The disease can cause a variety of flu-like symptoms such as fever, achy joints, fatigue and headache. Additionally, Anaplasmosis/Ehrlichiosis, Babesiosis, Rocky Mountain Spotted Fever, Bartonella, Tularemia, and more recently, Borrelia Miyamotoi (a distant relative of Lyme Borreliosis) are other recognized tick-borne infectious diseases in the United States.

Experts have been unable to agree for decades on whether a case definition called chronic Lyme disease exists. Yet, some Lyme victims, even after taking the standard treatment of antibiotics, continue to suffer from long-term and often serious health problems for years after they first contract the disease. Does chronic Lyme disease exist, or is the condition which some patients experience an autoimmune or nervous system response triggered by the infection, or indeed is it a bit of both? These are some of the major questions researchers are trying to figure out as they take on the enormous challenges of identifying better Lyme diagnostic tools and treatment plans for what is becoming a growing global public health crisis.

Today in The Global Search for Education, I take a look at tick-borne illnesses in Finland. I am joined by Docent Jarmo Oksi, Finland’s leading researcher in the field of Lyme disease, who is based at the University of Turku in Finland. In addition, I welcome Markku Kuusi, Chief Medical Officer from Finland’s National Institute for Health and Welfare.

2013-04-25-cmrubinworldticks1400.jpg“The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories.” — Markku Kuusi
What is the annual incidence of Lyme disease in Finland and in Europe at large?Jarmo: Laboratory reports on Lyme Borreliosis cases (based on positive serology) have doubled in 10 years and are now about 1,500. The estimated number of Lyme Borreliosis infection cases is about four times this number — i.e. estimated incidence in Finland is 5,000-6,000 annually (population 5.5 million), which is about 100 per 100,000 inhabitants per year. However there are areas in the Southwestern Archipelago with incidence of 1000 per 100,000 inhabitants per year.

Markku: Based on the National Infectious Disease Register, the incidence of Lyme disease in Finland has been about 30/100,000 during the past few years. In terms of the annual incidence in other Nordic countries, in Norway it has been about 6/100,000 and in Denmark, 1 – 2/100,000. It is hard to believe that there is such a difference in actual incidence, so that is why I believe the diagnostic criteria are truly different. The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories; so it is difficult to say whether the symptoms of our cases really are compatible with Lyme Borreliosis.

Would you comment on the annual incidence of any of the other tick-borne illnesses which are endemic in Finland in addition to Lyme.

Markku: Tick-borne Encephalitis (TBE) is another important tick-borne disease in Finland. The incidence has been particularly high on Aland Island and therefore TBE vaccination is included in the national immunization program. Before the vaccination program, the annual incidence was up to 100/100,000 population. Now it has decreased substantially. It seems that in other parts of Finland (apart from Aland Island), the incidence is increasing, and therefore other areas may also be included in the immunization program in the near future (for example, the Archipelago around the city of Turku).

Do you believe that chronic Lyme disease exists or that it is a misnomer for other diseases triggered by Lyme disease?

Markku: This is a difficult question. I think it is clear that some patients have a prolonged course of the disease which may last several months. The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection. Even after adequate treatment, some patients have symptoms due to immunological mechanisms, but it is very hard to say whether these symptoms are related to Borrelia infection or to some other causes.

2013-04-25-cmrubinworldlabra_182.JPG_3420500.jpg“The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection.”— Markku Kuusi
If you believe in chronic Lyme disease, what do you believe are the most effective ways to treat it?Jarmo: If you mean chronic infection, I think that this entity after standard antibiotic therapy is very very seldom (I see about one case in five years). However, if detected –e.g. with cultivation or PCR (the most specific way to detect), the treatment I give is individual antibiotic treatment — maybe double the length compared to the initial treatment.

What do you believe is the most effective way to treat symptoms triggered by the infection, e.g. chronic auto-immune reaction?

Jarmo: During the first months I wait for gradual improvement. If there is no improvement after six to 12 months, I then start low-dose corticosteroid treatment for a certain subset of patients. Some other subsets may get help from, for example, amitriptyline, which raises the threshold for pain sensation.

What tests currently available to the general public, other than the Western Blot test, do you believe provide a better degree of certainty?

Jarmo: PCR (and culture) are useful in some situations (culture only in research settings), but even PCR is not sensitive enough to detect all cases — e.g. in CSF (cerebrospinal fluid) of neuroborreliosis cases. Besides Western Blots, ELISA tests based on C6 peptide are generally good as confirmatory tests.

2013-04-25-cmrubinworld_P6Q5372.JPG_198500.jpg“We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for 3 weeks vs. oral Doximycin for 4 weeks. Hopefully this study will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.”— Jarmo Oksi
Are you aware of any other promising tests in development?Markku: Last year, a Finnish group reviewed the diagnostic tests in our country. It is my understanding that right now there are not unfortunately any new reliable tests available. So we shall have to wait awhile for them.

To what research do you believe scientists around the world must give priority in order to overcome the challenges the public faces with finding a cure for Lyme disease?

Markku: I think it is important to better understand the mechanism behind the sequelae of acute borreliosis. Therefore, we need more research on the immunology of the disease. In other words, how does the bacteria actually cause joint symptoms or neurologic symptoms. I think this will help us to develop better diagnostic tests and hopefully better drugs. I believe antibiotics are not the only solution.

What is the focus of your research and how does it relate to the challenges of identification and cure of Lyme disease and diseases triggered by Lyme?

Jarmo: We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for three weeks vs. oral Doximycin for four weeks. Hopefully this study (with control CSF specimens) and long follow-ups of patients also will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.

How can technology help us find a cure for Lyme disease faster?

Markku: This is not really a field in which I am knowledgeable, but I believe that better molecular and immunological methods may give possibilities for new diagnostics and for the development of new drugs. What I really hope is that there will be better and more specific laboratory tests for Lyme Borreliosis in the future. I think that one of the key issues is to harmonize the laboratory methods so that we can get a better understanding of the epidemiology of Lyme disease in Finland.

C M Rubin is a child and family health and education advocate.  She is the author of a number of award winning books as well as the widely read online series THE GLOBAL SEARCH FOR EDUCATION.

Follow C. M. Rubin on Twitter: www.twitter.com/@cmrubinworld

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**Comment**

I disagree with two tenets in this paper:

  • Chronic Lyme is rare.  I personally, as well as my husband, and most I deal with have improved immensely or even reached remission with lengthy treatment utilizing numerous antimicrobials and other modalities.  As they say, “The proof is in the pudding.”  Lyme spirochetes have been found in the autopsied brain despite treatment.  There are also extensive global research showing the persistence of the organism in 700 peer-reviewed papers (as well as coinfections that often come with Lyme): Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy  Please keep in mind that everything is rigged against reporting chronic infection. Globally, doctors work under the CDC/IDSA’s myopic focus on the acute phase and frank denial of persistent infection.  It doesn’t surprise me at all that a Finnish researcher also cow-tows to this thinking.  It’s rampant.
  • That we need yet more research on the acute phase of Lyme.  Frankly, that’s about all we have.  We desperately need researchers to quit myopically focusing on this phase of the illness and study the thousands upon thousands with chronic/persistent symptoms who often do to not test positive on the abysmal CDC 2-tiered testing, which is rigged to not pick up chronic infection, and do not have the “classic” EM rash.  These two variables have kept the sickest patients from being studied.

Category:

Anaplasmosis, Babesia, Bartonella, Borrelia Miyamotoi (Relapsing Fever Group), Lyme, Rocky Mountain Spotted Fever, Ticks, Tularemia

Assessing the Need for Multiplex & Multifunctiounal Tick-borne Disease Test in Routine Clinical Lab Samples From Lyme Disease & Febrile Patients With History of Tick Bite

https://pubmed.ncbi.nlm.nih.gov/33803065/

Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite

Kunal Garg 1, T Sakari Jokiranta 2, Sanna Filén 2, Leona Gilbert 1
Affiliations expand

Free PMC article

Abstract

Human polymicrobial infections in tick-borne disease (TBD) patients is an emerging public health theme. However, the requirement for holistic TBD tests in routine clinical laboratories is ambiguous. TICKPLEX® PLUS is a holistic TBD test utilized herein to assess the need for multiplex and multifunctional diagnostic tools in a routine clinical laboratory. The study involved 150 specimens categorized into Lyme disease (LD)-positive (n = 48), LD-negative (n = 30), and febrile patients from whom borrelia serology was requested (n = 72, later “febrile patients”) based on reference test results from United Medix, Finland. Reference tests from DiaSorin, Immunetics, and Mikrogen Diagnostik followed the two-tier LD testing system.

  • A comparison between the reference tests and TICKPLEX® PLUS produced 86%, 88%, and 87% positive, negative, and overall agreement, respectively.
  • Additionally, up to 15% of LD and 11% of febrile patients responded to TBD related coinfections and opportunistic microbes.

The results demonstrated that one (TICKPLEX® PLUS) test can aid in a LD diagnosis instead of four tests. Moreover, TBD is not limited to just LD, as the specimens produced immune responses to several TBD microbes. Lastly, the study indicated that the screening of febrile patients for TBDs could be a missed opportunity at reducing unreported patient cases.

Conflict of interest statement

K.G and L.G. have a financial and business interest in Tezted Ltd. Further, S.J and S.F do not have commercial or financial relationships that could be construed as potential conflicts of interest. The funding source mentioned in the Funding and Acknowledgements section and Tezted Ltd. had no role in the experimental design, reporting of the results, or the decision to publish.

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For more:

Category:

Lyme, research, Testing

Avril Lavigne’s Comeback From Lyme

https://www.the-sun.com/entertainment/3133702/avril-lavigne-age-lyme-disease-2/

How old is Avril Lavigne and when was she diagnosed with Lyme disease?

Joe Brophy

Jun 22 2021

AVRIL Lavigne is about to drop her huge comeback album Head Above Water after years spent battling Lyme disease.

The iconic noughties star opened up about her experience with the life-threatening disease that kept her out of the limelight for several years. Here’s all you need to know… (See link for article)

Avril Lavigne has opened up about her battle with Lyme disease
Avril Lavigne has opened up about her battle with Lyme disease  Credit: AP:Associated Press

Important excerpts:

  • The pop-rock star left the spotlight after being diagnosed with the life-threatening illness in 2015.
  • The process is far longer and more difficult than most realize.
  • She wrote: “Five years have gone by since I released my last album. I spent the last few years at home sick fighting Lyme disease.”

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For more:

Category:

Activism, Lyme, Uncategorized

Can A Tick Be Tested For Lyme Disease? And How I Overcame My Fear of Ticks

https://danielcameronmd.com/cant-count-testing-engorged-ticks/

CAN A TICK BE TESTED FOR LYME DISEASE?

Researchers examined the prevalence of ticks in the Quebec region, along with the frequency of engorged ticks carrying Borrelia burgdorferi (Bb), the causative agent of Lyme disease. Their findings suggest that tick testing may not always be an effective tool in determining the risk of infection.

By 
Ticks can be tested for the Lyme disease bacteria and other tick-borne pathogens. But the accuracy of test results may depend on a ticks lifecycle stage.

A study by Gasmi et al. found that results may not be accurate when testing ticks which are engorged. [1] The authors examined 4,596 I. scapularis (blacklegged) ticks removed from individuals living in Quebec.

They found that 24.9% of the non-engorged blacklegged ticks were infected with Borrelia burgdorferi (Bb), the causative agent of Lyme disease.

Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower with only 8.9% of engorged ticks testing positive for the Lyme disease agent. These findings are consistent with those from another Canadian study. [2]

Engorged ticks were expected to have an even higher rate of infection with the Lyme disease bacteria. But the prevalence was much lower.

It is still unclear why testing of engorged ticks is not accurately revealing the higher prevalence of Bb infection. The authors suggest that it could be due to the presence of inhibitors in the blood meal [3] or problems with the collection and transportation of engorged ticks.

Perhaps these findings were “due to simpler reasons such as the greater likelihood that un-engorged ticks remained alive up to DNA extraction, while engorged ticks may well have died days or weeks before testing,” noted Gasmi.

In other words, a tick can be tested for Lyme disease but it isn’t always a reliable tool in determining your risk of infection. If an engorged tick is removed and tested, it is likely to be negative for the Borrelia burgdorferi bacteria.

References:
  1. Gasmi S, Ogden NH, Leighton PA, Lindsay LR, Thivierge K. Analysis of the human population bitten by Ixodes scapularis ticks in Quebec, Canada: Increasing risk of Lyme disease. Ticks Tick Borne Dis. 2016.
  2. Dibernardo A, Cote T, Ogden NH, Lindsay LR. The prevalence of Borrelia miyamotoi infection, and co-infections with other Borrelia spp. in Ixodes scapularis ticks collected in Canada. Parasit Vectors. 2014;7:183.
  3. Wilson IG. Inhibition and facilitation of nucleic acid amplification. Appl Environ Microbiol. 1997;63(10):3741-3751.

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**Comment**

Great reminder that yet again, testing is an imperfect tool for all things Lyme/MSIDS related. This inability to positively identify the presence of infections has plagued doctors and patients alike, but must be accepted and contended with, which is why experienced doctors understand the importance of diagnosing patients clinically based upon symptoms.

Further, I often remind frustrated patients that even IF their test or tick test were to come back positive, it’s highly unlikely they will be treated appropriately as there is often coinfection involvement which requires different medications as well as the fact 28 days or less of the doxycycline monotherapy has failed repeatedly – yet is still used despite evidence to the contrary.  

If you suspect you are infected, get to a Lyme literate doctor asap.  It will save you money, time, and heartache in the end.

For more:

https://rawlsmd.com/health-articles/overcome-your-fear-of-ticks-and-get-outside?

by Dr. Bill Rawls
Updated 6/25/21

Considering that my life was totally disrupted by chronic Lyme disease for more than ten years, you might find it alarming to learn that I walk in the woods with bare legs. And although this might sound risky, I haven’t had any tick bites since my recovery. I’ve had ticks on me, but I haven’t been bitten.

Like many people who contract Lyme, my aversion to ticks kept me removed from nature. So what finally changed my fear?

I became tick aware — doubling down on prevention and keeping tabs on where I go, how I go, when I go, and what I do before and after I go to minimize risk factors. And in the end, my love of the outdoors prevailed. Being in nature is where I’ve always gained strength, and I had to find my way back to heal fully.

Finding My Way Back Nature

My first foray back into nature began at the beach at a state park near my home. Long walks were perfect for generating endorphins, and the sea air did me good. However, as my strength improved, I needed more of a challenge, so I began venturing onto the trails that wove through the tall grasses of the sand dunes and maritime forests of the park.  (See link for article)

Category:

Lyme, research, Testing, Ticks