Archive for the ‘research’ Category

Longitudinal Analysis Shows Durable & Broad Immune Memory After SARS-CoV-2 Infection With Persisting Antibody Responses and Memory B & T Cells

https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00203-2?s=03#secsectitle0020

Longitudinal analysis shows durable and broad immune memory after SARS-CoV-2 infection with persisting antibody responses and memory B and T cells

Open AccessPublished: July 14, 2021DOI:https://doi.org/10.1016/j.xcrm.2021.100354

Highlights

  • Most recovered COVID-19 patients mount broad, durable immunity after infection
  • Neutralizing antibodies show a bi-phasic decay with half-lives >200 days
  • Spike IgG+ memory B cells increase and persist post-infection
  • Durable polyfunctional CD4 and CD8 T cells recognize distinct viral epitope regions

Summary

Ending the COVID-19 pandemic will require long-lived immunity to SARS-CoV-2. Here, we evaluate 254 COVID-19 patients longitudinally up to 8 months and find durable broad-based immune responses. SARS-CoV-2 spike binding and neutralizing antibodies exhibit a bi-phasic decay with an extended half-life of >200 days suggesting the generation of longer-lived plasma cells. SARS-CoV-2 infection also boosts antibody titers to SARS-CoV-1 and common betacoronaviruses. In addition, spike-specific IgG+ memory B cells persist, which bodes well for a rapid antibody response upon virus re-exposure or vaccination. Virus-specific CD4+ and CD8+ T cells are polyfunctional and maintained with an estimated half-life of 200 days. Interestingly, CD4+ T cell responses equally target several SARS-CoV-2 proteins, whereas the CD8+ T cell responses preferentially target the nucleoprotein, highlighting the potential importance of including the nucleoprotein in future vaccines.
Taken together, these results suggest that broad and effective immunity may persist long-term in recovered COVID-19 patients.

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**Comment**

Please watch numerous doctors state how the COVID response is out of step with medicine and science. 

Previously, Dr. Beda M Stadler, former director of the Institute for Immunology at the University of Bern, a biologist and professor emeritus is on record stating:

  • Firstly, it was wrong to claim that this virus was novel.
  • Secondly, It was even more wrong to claim that the population would not already have some immunity against this virus.
  • Thirdly, it was the crowning of stupidity to claim that someone could have Covid-19 without any symptoms at all or even to pass the disease along without showing any symptoms whatsoever.

Dr. Rodger Hodkinson, a medical specialist in pathology which includes virology, chairman of the Royal College of Physicians and Surgeons Committee in Ottawa, and CEO of a large private medical laboratory in Edmonton, Alberta and chairman of a medical biotechnical company stated:

“This is the greatest hoax ever perpetrated on an unsuspecting public.

There is absolutely nothing that can be done to contain this virus other than protecting older more vulnerable people.  It should be thought of as nothing more than a bad flu season. This is not Ebola, it’s not SARS.  It’s politics playing medicine and that’s a very dangerous game.

I’m absolutely outraged that this has reached this level.  It should all stop tomorrow.”

And many, many more have been outspoken of the COVID fiasco.

For more:

Category:

research, vaccines, Viruses

What is Borrelia miyamotoi?

https://danielcameronmd.com/what-is-borrelia-miyamotoi/

WHAT IS BORRELIA MIYAMOTOI?

What is Borrelia miyamotoi

What is Borrelia miyamotoi? This tick-borne illness, transmitted by deer ticks, is believed to be underrecognized and a growing concern, as studies indicate a B. miyamotoi infection may be as common as anaplasmosis and babesiosis. Researchers randomly tested 250 individuals living in Manitoba, Canada and found that 10% were seropositive for B. miyamotoi. [1]

By 

Borrelia miyamotoi (B. miyamotoi) was first reported in the United States in 2013 but has become increasingly more common.  The tick-borne illness can be transmitted by the same tick that carries Borrelia burgdorferi, the Lyme disease pathogen. In their article, Della-Giustina and colleagues² address the question, “What is Borrelia miyamotoi?” and concerns surrounding this growing threat.

Where is B. miyamotoi found?

Borrelia miyamotoi (B. miyamotoi) can be found in various ticks including the deer tick. It has been detected in ticks located in the northeastern and northern Midwestern United States, California, Europe, and Asia.

What stage of deer ticks transmit B. miyamotoi?

Borrelia miyamotoi can be transmitted from all stages of a tick including the larval stage. The larval tick can harbor and transmit B. miyamotoi by passing the pathogen from the parent to the offspring, a process called transovarial transmission.

How fast can B. miyamotoi be transmitted?

Quickly, according to the authors.  “B. miyamotoi can be transmitted 10% of the time within the first 24 hours of attachment, increasing steadily to reach 73% for a complete feeding.  Thus, transmission of B. miyamotoi is more rapid than transmission of B. burgdorferi.”²

Symptoms of B. miyamotoi

The symptoms that have been described include fever, malaise, headache, and myalgias.  Some cases present with an elevated liver test, low white count and abnormal liver tests that have been described in Anaplasmosis, another tick-borne illness.  Only 11% of patients presented with an erythema migrans rash, according to findings from a case series.

Making the diagnosis

It can be difficult to diagnose B. miyamotoi.  “No test specific to B. miyamotoi has been approved by the United States Food and Drug Administration as of October 2020,” the authors explain.

“The most specific test currently available in several public health and commercial laboratories is polymerase chain reaction (PCR) testing of blood or cerebrospinal fluid for the B. miyamotoi GlpQ enzyme.”

“Serologic testing of B. miyamotoi IgM and IgG antibodies is possible by a few commercial laboratories.” Unfortunately, it can be hard to interpret these tests, as they may cross-react to other spirochetes.  (The authors did not address the risk of cross reactions.)

“One test using this approach, the TBD serochip, is an array-based assay testing for 8 different tick-borne diseases, including B. miyamotoi. Developed in 2018, it is promising but has not yet become widely available.”

Treatment of B. miyamotoi 

There are no evidence-based trials to determine the best treatment for B. miyamotoi. Doxycycline has been suggested, as Lyme disease patients have improved with doxycycline.  “In vitro analysis has shown the susceptibility of B. miyamotoi to ceftriaxone, azithromycin, and doxycycline, with resistance to amoxicillin,” the authors explain.

Prophylactic treatment

Since B. miyamotoi can be transmitted rapidly, it may be prudent to consider prophylactic antibiotic treatment immediately, even if the tick has not been attached for 24 to 36 hours.

“Understanding this more rapid transmission of infection of B. miyamotoi may be a consideration in determining prophylactic treatment for tick bites with a shorter time of attachment in endemic areas for B. miyamotoi.”

Related Articles:

Could Borrelia miyamotoi infections explain persistent symptoms in Lyme disease patients?

C6 peptide test may indicate Borrelia miyamotoi infection

The best antibiotics to treat Borrelia miyamotoi?

References:
  1. Kadkhoda K, Dumouchel C, Brancato J, Gretchen A, Krause PJ. Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study. CMAJ Open. 2017;5(3):E690-E693.
  2. Della-Giustina D, Duke C, Goldflam K. Underrecognized Tickborne Illnesses: Borrelia Miyamotoi and Powassan Virus. Wilderness Environ Med. Jun 2021;32(2):240-246. doi:10.1016/j.wem.2021.01.005

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**Comment**

I’m always extremely skeptical of ALL information given on transmission times as reality has shown a far different picture.  For more on this:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/   Important to note: minimum transmission time has never been determined and reality shows it can happen within a few hours.  Certain coinfections can happen within minutes.

Since Borrelia miyamotoi is not a reportable illness to the CDC, no one has any clue about prevalence but reports are coming in continually that it’s highly likely to be a much bigger problem than ‘authorities’ believe.

It was recently discovered that:

Category:

Borrelia Miyamotoi (Relapsing Fever Group), research, Testing, Ticks, Transmission, Treatment

IPM Tick Academy in September

Tick IPM Working Group Presenting Second Annual Tick Academy

IPM tick academyThe Tick IPM Working Group is presenting the second annual Tick Academy, September 13-15, 2021 from 10 AM until 2 PM each day.

The Tick Academy is the premier event for educators, students, researchers, pest control professionals, public health professionals, public-space managers, and citizen scientists, who want to learn more about what they can do to stop the spread of ticks and tickborne diseases in their respective communities.

The event will take place virtually and will feature twelve presentations over three, four-hour sessions during which the presenters will share the latest information about:

  • tick management
  • tickborne disease prevention
  • recent discoveries of emerging pathogens
  • public perceptions of risk, diversity, identification of ticks
  • ongoing research on control and vaccine developments

For more details, please view the Tick Academy Announcement Flyer.

To register for this virtual event, click the registration link at the bottom of the flyer or visit tickacademy.brownpapertickets.com.

For more IPM information: IPM Pest Alert-Asian longhorned tick

Category:

Activism, Prevention, research, Ticks, vaccines

Doctors Warn CDC, “It’s Not All COVID” And Anchoring Bias is Causing Doctors To Miss Tick-Borne Infections

https://wwwnc.cdc.gov/eid/article/27/8/21-1107_article

Volume 27, Number 8—August 2021
Research Letter

COVID-19 and the Consequences of Anchoring Bias

Harold W. HorowitzComments to Author , Caren Behar, and Jeffrey Greene
Author affiliations: Weill Cornell Medicine, New York, New York, USA (H.W. Horowitz); New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, USA (H.W. Horowitz); New York University Langone School of Medicine, New York (C. Behar, J. Greene)

Abstract

Suspicion of coronavirus disease in febrile patients might lead to anchoring bias, causing misdiagnosis of other infections for which epidemiologic risks are present. This bias has potentially severe consequences, illustrated by cases of human granulocytic anaplasmosis and Lyme disease in a pregnant woman and human granulocytic anaplasmosis in another person.

Coronavirus disease (COVID-19) took the United States by force during the first quarter of 2020, affecting the economy, societal norms, and the delivery of medical care (1,2). As fear of COVID-19 has spread, diagnosing COVID-19 in febrile persons has been prioritized, and patients may be presumed to have COVID-19 pending results of testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This mindset has had unintended consequences, including delaying of evaluations for other infectious diseases, potentially leading to adverse outcomes. We describe 2 cases that illustrate this point.

In the first case, a 35-year-old man left New York, New York, USA, to go hiking in Maryland during June 5–June 7, 2020. He experienced fever, body aches, and fatigue during June 10–13 that resolved but left him fatigued and weak. He was seen on June 19; laboratory results were unremarkable, but lymphopenia was detected. He tested negative for SARS-CoV-2 on June 19 and June 25 by PCR. On June 25, ELISA for Lyme disease was positive, and reflex to Western blot revealed IgM 41-kD, 39-kD, and 23-kD bands but no IgG bands. Fever up to 38°C recurred on June 22 and lasted until June 29; he also experienced persistent fatigue and myalgia. Further testing on July 6 revealed serologic results for Lyme similar to results from June 25 and Anaplasma phagocytophilum titers of IgM 1:320 and IgG 1:1260. Anaplasma PCR was negative on that date. He was treated with doxycycline for 10 days and recovered.

In the second case, a 31-year-old woman who was 6 months pregnant left New York at the end of May 2020 to rent a house in Ulster County, New York. On June 3, she removed a tick from her neck. On June 9, she experienced severe headaches and the next day had low-grade fever, chills, and body aches. She had no cough, shortness of breath, or sore throat. On June 10, she tested negative for SARS-CoV-2 by PCR. She continued to have extreme fatigue, myalgia, and low-grade fever. She was prescribed oseltamivir by her obstetrician on June 11. On June 14, she felt better. Repeat PCR testing for SARS-CoV-2 on June 15 was negative. She continued to improve until June 23, when she experienced recurrent fever up to 38.9°C, chills, and lethargy. She contacted her obstetrician and was told she had a presumptive diagnosis of COVID-19. On June 30, she saw her internist and underwent laboratory testing for tickborne illnesses; she was treated empirically with amoxicillin because of her risks for Lyme disease. PCR for A. phagocytophilum was positive, as was a second test on July 8. Serologic results for Lyme were positive for 41-kD, 39-kD, and 23-kD bands with no IgG bands. Platelets were 140,000 (previously 336,000), aspartate aminotransferase was 95, and alanine aminotransferase was 81. Several weeks later, studies revealed anaplasma IgM 1:256 and IgG 1:1,280. Lyme disease C6 antibody was positive. After discussion, the patient and her physicians chose not to treat for anaplasmosis because she was clinically improving. The patient has remained well, and the child was born healthy by normal spontaneous vaginal delivery.

COVID-19 has had devastating effects on the medical system and led to widespread changes in the practice of medicine. We believe that the imperative to rule out COVID-19 led to diagnostic anchoring bias in these cases. Such biases are among the most common in the heuristic decision-making process (3,4). Of note, in these 2 cases (case 1, human granulocytic anaplasmosis [HGA]; case 2, co-infection with Lyme disease and HGA), COVID-19 was ruled out without considering other diagnoses, even though the patients were visiting areas to which tickborne diseases are endemic. Given the incidence of such diseases in these areas and widespread attempts to educate healthcare providers about these diseases, failure to evaluate for tickborne infections would be difficult to imagine before COVID-19. Although both of these patients have done well, serious consequences to the fetus could have occurred if Lyme disease had gone undiagnosed and untreated (5). Although transmission of A. phagocytophilum during pregnancy has been reported (6) and treatment during pregnancy in a limited number of cases has possibly prevented transmission (7), in this instance the patient cleared the anaplasma without treatment, and the child was born disease-free. Clearance of infection without treatment has been reported in other studies, but we are unaware of cases describing the outcome of pregnancy in untreated women with acute HGA (8).

We appreciate the devastating effects that a missed COVID-19 diagnosis can have on a person, as well as the epidemiologic implications thereof. However, failing to diagnose tickborne illnesses and other infections also can have serious consequences. Healthcare providers must keep an open mind to diagnoses other than COVID-19 in febrile patients and not fall prey to misdiagnosis because of current pressures to evaluate for COVID-19.

Dr. Horowitz is clinical professor of medicine at Weill Cornell Medicine and chief of infectious diseases at New York-Presbyterian Brooklyn Methodist Hospital. He has been involved in clinical practice for the past 38 years, and his research has focused on immune-suppressed patients, tickborne diseases, and, more recently, antimicrobial stewardship and hospital-acquired infections.

References

  1. CDC. COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. MMWR Morb Wkly Rep. 2020;69:343–6.
  2. Hollander  JE, Carr  BG. Virtually Perfect? Telemedicine for Covid-19. N Engl J Med. 2020;382:1679–81. DOIExternal LinkPubMedExternal Link
  3. Sapersnik  G, Redelmeier  D, Ruff  CC, et a. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak. 2016;16:138. DOIExternal LinkPubMedExternal Link
  4. Ogdie  AR, Reilly  JB, Pang  WG, Keddem  S, Barg  FK, Von Feldt  JM, et al. Seen through their eyes: residents’ reflections on the cognitive and contextual components of diagnostic errors in medicine. Acad Med. 2012;87:1361–7. DOIExternal LinkPubMedExternal Link
  5. Waddell  LA, Greig  J, Lindsay  LR, Hinckley  AF, Ogden  NH. A systematic review on the impact of gestational Lyme disease in humans on the fetus and newborn. PLoS One. 2018;13:e0207067. DOIExternal LinkPubMedExternal Link
  6. Horowitz  HW, Kilchevski  E, Haber  S, et al. Brief report: Perinatal transmission of the human granulocytic ehrlichiosis agent. N Engl J Med. 1998;339:375–8. DOIExternal LinkPubMedExternal Link
  7. Dhand  A, Nadelman  RB, Aguero-Rosenfeld  ME, Haddad  F, Stokes  D, Horowitz  HW. Human granulocytic anaplasmosis in pregnancy: case series and review of literature. Clin Infect Dis. 2007;45:589–93. DOIExternal LinkPubMedExternal Link
  8. Bakken  JS, Haller  I, Riddell  D, Walls  JJ, Dumler  JS. The serological response of patients infected with the agent of human granulocytic ehrlichiosis. Clin Infect Dis. 2002;34:22–7. DOIExternal LinkPubMedExternal Link

DOI: 10.3201/eid2708.211107

Original Publication Date: July 01, 2021

Category:

Anaplasmosis, Lyme, research

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