Archive for the ‘research’ Category

Lyme Podcast: Boy With Severe Cardiac Lyme Disease

https://danielcameronmd.com/boy-with-severe-cardiac-lyme-disease/

LYME PODCAST: A BOY WITH SEVERE CARDIAC LYME DISEASE

A 15-year-old boy with severe cardiac Lyme disease

I will be discussing a 15-year-old boy with severe cardiac Lyme disease in this Inside Lyme podcast.
By
See link for Podcast

Nawrocki and his colleague first discussed this case in the Air Medical Journal  in 2018.

A 15-year-old boy experienced an episode of exertional syncope while at a trampoline park. Syncope is a temporary loss of consciousness.

He had a history of an attention-deficit/hyperactivity disorder.

His friends immediately called 911. They were not sure how long he was unconscious.

The boy was pale with a heart rate of 300 beats per minute, according to the medics. His EKG showed a wide complex tachyarrhythmia. That means that the heart is fast, and the QRS parts of his EKG were wide.

He was given a dose of amiodarone, but the ventricular tachycardia remained a problem. Amiodarone is a medicine used to treat and prevent irregular heartbeats.

At the hospital, he was dizzy and was short of breath. His heart rate remained between 290 and 300. His blood pressure dropped to 66/30 mm Hg.

He required synchronized cardioversion. Synchronized cardioversion is a procedure similar to electrical defibrillation. Synchronized cardioversion uses low energy synchronized with the heart.

His EKG changed to a third-degree heart block. That occurs when there is a complete block of impulses from the atrium to the ventricle. The atrium is the top of the heart, and the ventricle is the bottom. He had pacing pads placed.

He was flown to a cardiac intensive care unit (ICU) at a children’s tertiary care hospital via rotary-wing aircraft staffed with two flight nurses.

He continued to have a complete heart block with a fast rhythm.

CARDIAC LYME DISEASE

Doctors suspected Lyme disease and prescribed intravenous ceftriaxone. The diagnosis of Lyme disease was confirmed by “anti-Lyme titers” and Western blot tests.

His low heart rate and low pressure continued. The doctors inserted a transvenous pacemaker to control the heart rate.

He had three additional episodes of ventricular tachycardia. He was cardioverted twice.

But after several days of intravenous antibiotics, the boy’s heart block gradually resolved, and the pacemaker was removed.
He completed 28-days of IV treatment. He remains well on a one-year follow-up, according to the authors.

The authors note that conduction problems have been reported previously in untreated Lyme disease. The list of conduction abnormalities includes first and second-degree AV block, ST and T wave changes, prolonged QT, junctional tachycardia, and complete heart block.

There was no mention of conduction problems in patients who have been treated. I have not seen conduction problems in patients I have treated.

What can we learn from these cases?

  1. Cardiac Lyme disease or more commonly known as Lyme carditis, can lead to life-threatening rhythm disturbances.
  2. The conduction problems with cardiac Lyme disease can rapidly change.
  3. Antibiotic treatment was helpful.
  4. A pacemaker was necessary in this case. The doctor was able to remove the pacemaker after treatment with antibiotics.

What questions do these cases raise?

  1. How often does cardiac Lyme disease occur?
  2. Are there cases of cardiac Lyme disease cases that are not diagnosed?
  3. Were there any warning signs of cardiac Lyme disease that would have allowed treatment before the young man collapsed?
  4. 4. Would the doctors have been able to recognize cardiac Lyme disease early before the need for hospitalization, air transport, and cardioversion?

TREATING TICK-BORNE DISEASE IN MY PRACTICE

In my practice, each individual requires a careful assessment. That is why I order a broad range of blood tests for other illnesses in addition to tick-borne infections. I also arrange consultations with specialists as needed.

Many patients are complex, as highlighted in this Inside Lyme Podcast series.

We need more doctors with skills recognizing Lyme carditis. We hope that professionals evaluating individuals with Lyme carditis can use this case to remind them to look for tick-borne illnesses and treat accordingly.

Inside Lyme Podcast Series

This Inside Lyme case series will be discussed on my Facebook and made available on podcast and YouTube.  As always, it is your likes, comments, and shares that help spread the word about this series and our work. If you can, please leave a review on iTunes or wherever else you get your podcasts.

Sign up for our newsletter to keep up with our cases.

References:
  1. Nawrocki PS, Poremba M. A 15-Year-Old Male With Wide Complex Tachyarrhythmia. Air Med J. 2018;37(6):383-387.

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For more:  https://madisonarealymesupportgroup.com/2018/11/16/advanced-heart-block-in-children-with-lyme-disease-2/

https://madisonarealymesupportgroup.com/2019/12/09/study-identifies-189-children-with-lyme-carditis/

https://madisonarealymesupportgroup.com/2019/06/04/how-vector-borne-diseases-impact-heart-health/

https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/

https://madisonarealymesupportgroup.com/2019/11/04/suspect-lyme-carditis-start-empiric-antibiotics-case-report-suggest-and-lyme-carditis-is-not-rare/

https://madisonarealymesupportgroup.com/2019/03/10/when-lyme-hurts-your-heart-warning-signs-solutions/

Category:

Heart Issues, Lyme, research, Testing, Treatment

World-first Trial To Test Benefit of Intravenous Zinc in COVID-19 Fight

https://neurosciencenews.com/zinc-coronavirus-16121/

World-first trial to test benefit of intravenous zinc in COVID-19 fight

Previous studies have shown zinc is effective at slowing the rate of other respiratory infections, such as SARS.
FeaturedNeuroscience

·

Summary: University of Melbourne researchers are conducting trials to see if intravenous administration of zinc chloride will help combat some of the effects of COVID-19. Previous studies have shown zinc is effective at slowing the rate of other respiratory infections, such as SARS.

Source: University of Melbourne

A world-first trial will see researchers from Austin Health and the University of Melbourne use intravenous zinc to fight the symptoms of coronavirus (COVID-19).

The trial will be led by Dr Joseph Ischia from Austin Health, along with Dr Oneel Patel from the Department of Surgery at the University of Melbourne, who has a long history of investigating the protective effects of intravenous zinc against organ damage induced by lack of oxygen.

Dr Ischia said COVID-19 is especially dangerous because it replicates inside a patient’s body which can lead to respiratory conditions like bronchitis and pneumonia.

“If COVID-19 enters a patient’s lungs then they often need to be placed on a ventilator to help their breathing and, in severe cases, COVID-19 can cause multiple organ failure and brain injury due to a lack of oxygen,” Dr Ischia said.

Dr Patel said studies have shown that zinc is very effective at slowing the rate that similar viruses such as SARS (Severe Acute Respiratory Syndrome) and common cold (a type of coronavirus) replicate in the body.

“Our published studies have also shown that high doses of zinc can protect vital organs such as the heart, kidneys and liver against the damage caused by a lack of oxygen,” Dr Patel said.

The clinical trial has been fast-tracked to test whether receiving a daily injection of zinc chloride will benefit patients with coronavirus.

“There is currently no specific treatment available for patients who have COVID-19 and are at high risk of respiratory failure, which means this study has the potential to have an enormous positive impact on their clinical outcomes,” Dr Ischia said.

“Importantly, we hope to show that we can save lives by limiting the impact of the symptoms. We are expecting to have preliminary results of the trial available after only seven days so we will know very quickly how effective this treatment is.”

The trial is the culmination of a rapid collaboration between surgeon scientists as well as intensive care, infectious diseases and respiratory medicine doctors at Austin Health, working with the Australian pharmaceutical firm, Phebra.

This shows an IV bag
The clinical trial has been fast-tracked to test whether receiving a daily injection of zinc chloride will benefit patients with coronavirus. The image is adapted from the University of Melbourne news release.

Phebra Chief Executive Officer Dr Mal Eutick said intravenous (IV) zinc injections, manufactured at Phebra’s multi-purpose sterile injectables plant in Sydney, would be used in the trial.

“Zinc has been proven to be effective in treating severe pneumonia and other viruses although not COVID-19 to date. This trial is an extraordinary opportunity to discover if IV zinc can help us respond to the current pandemic,” Dr Eutick said

“If successful this could save lives and with this trial we should know in a short time frame. In particular, it could be very important for those high risk elderly patients and also help reduce the level of general anxiety in the community.”

However, both Dr Ischia and Dr Eutick warned of the need to manage the risk of zinc overdose for patients.

“Zinc can be toxic and it will be carefully administered as part of the trial to ensure patients are safe,” Dr Ischia explained.

About this COVID-19 research article

Source:
University of Melbourne
Media Contacts:
Media team – University of Melbourne
Image Source:
The image is adapted from the University of Melbourne news release.

Feel Free To Share This Coronavirus News.

 

 

 

 

 

Category:

Activism, research, Treatment, Viruses

Lyme in the South: 4 Kids Infected at 1 Camp

https://danielcameronmd.com/lyme-in-the-south-children-infected-camp/

LYME DISEASE IN THE SOUTH: 4 CHILDREN INFECTED AT ONE CAMP

lyme in the south

Some doctors have questioned the existence of Lyme disease in the south, but in their “Morbidity and Mortality Weekly Report,” published January 2020, the Centers for Disease Control and Prevention (CDC) describe 4 cases of Lyme disease in young children who attended a wilderness day camp in North Carolina. [1]

By

The number of tick-borne diseases, including Lyme, has been steadily rising in the South as tick populations expand into new territories. One study reports, “The trends in these data paint a clear picture of southward expansion of Lyme disease.” As a result, communities once considered non-endemic for Lyme disease will be at risk, including those in the south, the study warns. [2]

The CDC recently reported several children infected with Lyme disease at a single camp, located in the south. The children, who were between the ages of 6 and 8, attended the wilderness day camp at least 1 day a week in the Fall and Spring. Three of the four children were homeschooled but attended the camp. Three children had ticks removed.

“Further investigation identified an earlier camp participant who had received a diagnosis of Lyme disease in 2017,” the authors explain.

READ MORE: Culture Evidence of Lyme disease in antibiotic-treated patients living in the Southeast

Using a “flagging and dragging” method across 0.27 acres of the camp, investigators collected 37 Ixodes Scapularis ticks, commonly called deer ticks.

Study Results

Out of 35 ticks tested, 6 were positive for B. burgdorferi sensu stricto, the causative agent of Lyme disease.

“Results indicated that nymphal ticks collected at the campsite had a B. burgdorferi infection prevalence of 17%,” the authors write.

Additionally, 1 of the 6 ticks tested positive for Borrelia miyamotoi.

None of the ticks tested positive for the pathogens responsible for Anaplasmosis or Babesia microti.

In 3 of the 4 children, blood tests confirmed a Lyme disease diagnosis. Two of the children had an erythema migrans (bull’s eye) rash. One was considered probable because the test was positive by ELISA and IgM Western blot but not IgG Western blot.

Symptoms and Treatment

The clinical presentations included brief, recurrent attacks of joint swelling, arthralgia, fever, headaches, loss of appetite, and fatigue. One had radiculoneuropathy and Bell’s palsy.

All were treated with doxycycline. The authors did not indicate how long they treated the young children or the outcome of treatment.

Authors Conclude

“Clinicians should be aware of the risk for transmission of Lyme disease in North Carolina and consider recommended diagnostic testing and treatment.”

Other studies have also identified ticks infected with the causative agent of Lyme disease in the south. One study reports, “The trends in these data paint a clear picture of southward expansion of Lyme disease.” As a result, communities once considered non-endemic for Lyme disease will be at risk, including the southeastern United States, the study warns. [2]

Editor’s note: I hope this cluster of cases in children attending a single camp in North Carolina will remind doctors of the tick-borne problems in the Southeastern USA.
Related Articles:

Northern immigrant ticks causing concern in the south

Kentucky is swarming with deer ticks: over 50% of counties infested

Southern nymphal deer ticks in hiding

References:
  1. Barbarin AM, Seagle SW, Creede S. Notes from the Field: Four Cases of Lyme Disease at an Outdoor Wilderness Camp — North Carolina, 2017 and 2019. MMWR Morb Mortal Wkly Rep. 2020 Jan 31; 69(4): 114–115.
  2. Lantos PM, Nigrovic LE, Auwaerter PG, et al. Geographic Expansion of Lyme Disease in the Southeastern United States, 2000–2014. Open Forum Infectious Diseases. 2015;2(4):ofv143. doi:10.1093/ofid/ofv143. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4629694/

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**Comment**

Lyme disease still is not recognized for the pandemic it truly is. This study demonstrates how authorities are still hanging on to ancient data that never was accurate to begin with.

  1. It demonstrates a Southerly tick expansion.  We’ve been told ad nauseam that ticks are expanding Northward due to climate change. Well, it’s already hot in the South so there goes that theory.  Also, independent research has already blown that theory out of the water some time ago, yet it isn’t accepted because it doesn’t fit the narrative: https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/ This researcher claims the narrative is widely held because researchers working at institutions need ‘accepted’ topics to receive funding for their work.  In essence, those with little research experience call the shots. Ticks laugh at the weather. They just don’t care. They will find a way to survive.  https://madisonarealymesupportgroup.com/2019/06/17/ontario-public-health-officials-called-out-on-shoddy-biased-research-utilizing-an-erroneous-climate-change-model-to-program-a-futuristic-tick-problem/
  2. Lyme disease STILL isn’t widely accepted and treated appropriately.  It’s even worse in the South: https://madisonarealymesupportgroup.com/2019/04/22/its-just-crazy-why-is-lyme-disease-treatment-so-difficult-to-find-in-mississippi/, https://madisonarealymesupportgroup.com/2016/09/24/arkansas-kids-denied-lyme-treatment/, https://madisonarealymesupportgroup.com/2018/05/31/no-lyme-in-the-south-guess-again/
  3. Even with a 17% tick infection rate with Bb, 4 kids got infected. It isn’t always a linear connection between tick infection rates and human infection rates. Trust me, if you’re the sorry sucker who gets infected – it matters!
  4. Notice not all found ticks, got the EM rash, and tested positive on serology – yet those parameters are still held like an iron curtain in mainstream medicine to prove infectivity.
  5. The symptoms these kids had are hallmark Lyme symptoms.

Category:

Lyme, research, Ticks, Transmission, Treatment

Anaplasma in Early Lyme Manifested by EM Skin Lesions

https://pubmed.ncbi.nlm.nih.gov/32247015/

[Online ahead of print]

Assessment of Anaplasma Phagocytophilum Presence in Early Lyme Borreliosis Manifested by Erythema Migrans Skin Lesions

Anna Moniuszko-Malinowska 1, Justyna Dunaj 2, Martin O Andersson 3, Piotr Czupryna 2, Joanna Zajkowska 2, Katarzyna Guziejko 2, Adam Garkowski 2, Sambor Grygorczuk 2, Maciej Kondrusik 2, Sławomir Pancewicz 2

Abstract

Background: To investigate to what extent early Lyme borreliosis patients with erythema migrans are infected with Anaplasma phagocytophilum.

Methods: 310 patients from Poland with erythema migrans were included in the study. One hundred and eighty-three patients (59%) agreed to have both skin biopsy and blood samples analysed for Borrelia burgdorferi, A. phagocytophilum and ‘Candidatus Neoehrlichia mikurensis’, with PCR. Positive samples were confirmed with sequencing.

Results:

  • B. burgdorferi DNA was detected in 49.7% of the skin samples 
  • B. b was detected in 1.1% of the blood samples
  • A. phagocytophilum DNA was found in 7.1% blood samples
  • A. phagocytophilium was found 8.2% of the skin biopsies
  • in four patients, A. phagocytophilum DNA was detected only in blood
  • in one case A. phagocytophilum DNA was found simultaneously in blood and skin and additionally in this patients’ blood Borrelia DNA was detected.
  • in four skin samples B. burgdorferi DNA was detected simultaneously with A. phagocytophilum DNA, indicative of a co-infection.

Conclusions: A. phagocytophilum may be present in early Lyme borreliosis characterized by erythema migrans and should always be considered as a differential diagnostic following a tick bite and considered in treatment schemes, as these differs (in early stage of Lyme borreliosis doxycycline, amoxicillin, cefuroxime axetil and azithromycin are recommended, while in anaplasmosis the most effective courses of treatment are doxycycline, rifampin and levofloxacin). Consequently, the role of A. phagocytophilum in erythema migrans should be further studied.

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**Comment**

Please note that only 1% of patients had Bb in the blood – yet blood tests are precisely what our renowned CDC uses as the determination of infection.  Having the EM rash is clinical PROOF you have Lyme disease.  Period.  No testing required. End of discussion. Unfortunately, many never have the rash:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Also note that one again the EM rash IS required criteria for the study as well as being an early Lyme patient.

There’s oodles and oodles of research on this patient group. What we desperately need is for researchers to wake up and do work on those who don’t get the rash and are left to smolder for months and years before being diagnosed.

As to the rash, anywhere from 25%-80% get it despite the CDC stating 80% get it:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/ and 1976circularletterpdf (first ever patient group – only 25% had the rash)

Rashes-larger-blog-3

For more:  https://madisonarealymesupportgroup.com/category/lyme-disease-treatment/

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

https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/

 

Category:

Anaplasmosis, Lyme, research

How Do Lyme Disease Symptoms Persist Long Term?

https://danielcameronmd.com/lyme-disease-symptoms-persist-long-term/

HOW DO LYME DISEASE SYMPTOMS PERSIST LONG TERM?

woman with Lyme disease symptoms long term has headacheding her head

Multiple studies have shown that as many as 34% to 62% of patients have Lyme disease symptoms that persist long term despite treatment. [1,2] These patients can suffer for years with debilitating symptoms.

By

According to one study, at their six-month follow-up visit, “36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties.” [3]

So, how could Lyme disease symptoms persist long term? There have been many theories, including recent findings that suggest persistent symptoms may be due to antigenic variation.

A new study reports that antigenic variation may explain why some Lyme disease patients continue to have chronic symptoms. CLICK TO TWEET

In their article “Changing of the guard: How the Lyme disease spirochete subverts the host immune response,”Chaconas and colleagues [4] explain how antigens, or proteins on the surface of the spirochetal bacteria, play a sort of “cat and mouse” game with the immune system.

Other pathogens use antigen variation 

Antigen variation is not unique to Lyme disease, Chaconas writes. Rather, it’s a “common pathogenic ruse employed by several bacterial, protozoan, and fungal pathogens.”

In fact, “Many bacterial and protozoal pathogens have developed antigenic variation systems in which surface antigens can be continually altered as a means of evading the constant onslaught of adaptive antibody and T cell responses,” Chaconas writes.

The immune system is designed to recognize these antigens and kill the spirochete. But, the spirochetal bacteria can change these antigens, thereby evading the immune system’s attack.

“This process involves changes in a prominent surface antigen such that it is no longer recognized by the host acquired immune response,” Chaconas writes.

Altering the immune response

By changing the antigens, the spirochetes buy time. This may explain why Lyme disease symptoms continue long term in some individuals. As the authors explain, “By the time the host has assembled and produced antibodies to clear an infecting organism, new variants have appeared, which fly under the radar in terms of immune surveillance.”

The process is like a cat-and-mouse game, “which can often continue for the long haul, resulting in persistent infection by pathogenic organisms, and provides an efficient mechanism whereby they can avoid clearance by the host immune system.”

Spirochetes buy even more time by changing the antigens yet again. “By the time a new generation of antibody molecules has been fashioned to clear the variant pathogens, yet another collection of organisms with prominent but unrecognizable surface antigens has appeared,” the authors write.

Vls gene responsible for antigenic variation

The gene vls locus enables antigenic variation.

“The vls system is required for long-term survival of Lyme Borrelia in infected mammals and represents an important mechanism of immune evasion,” writes Norris in Microbiology Spectrum. [5]

“The vls locus is akin to a perpetual motion machine for antigenic variation in Lyme Borrelia species,” Norris writes.

Authors conclude: Additional studies are needed to examine vls locus, given there have been reports of persistent infections in treated animals.

“If there is a link, then the development of a drug blocking recombinational switching at vlsE would offer a promising response to drug-surviving spirochetes and would provide a direct block to the development of long-term persistence.”

Related Articles:

Persistent Lyme infection or inflammatory immune response?

Is suppressing the immune system harmful to Lyme patients?

Can Lyme disease trigger an autoimmune disease?

References:
  1. Shadick NA, Phillips CB, Logigian EL, et al. The long-term clinical outcomes of Lyme disease. A population-based retrospective cohort study. Ann Intern Med. 1994;121(8):560-567.
  2. Asch ES, Bujak DI, Weiss M, Peterson MG, Weinstein A. Lyme disease: an infectious and postinfectious syndrome. J Rheumatol. 1994;21(3):454-461.
  3. Aucott JN, Rebman AW, Crowder LA, Kortte KB. Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here? Qual Life Res, 22(1), 75-84 (2013).
  4. Chaconas G, Castellanos M, Verhey TB. Changing of the guard: How the Lyme disease spirochete subverts the host immune response. J Biol Chem. 2020 Jan 10;295(2):301-313.
  5. Norris SJ. vls Antigenic Variation Systems of Lyme Disease Borrelia: Eluding Host Immunity through both Random, Segmental Gene Conversion and Framework Heterogeneity. Microbiol Spectr. 2014 Dec;2(6).

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**Comment**

Please take note of the following:

Multiple studies have shown that as many as 34% to 62% of patients have Lyme disease symptoms that persist long term despite treatment. [1,2]

This is a far cry more than the oft touted 10-20% stated by authorities.

This is important for two reasons: 1) there are many more suffering than is commonly thought 2) this should translate into more research dollars going toward this exact issue – not irrelevant climate data.

According to this article, up to 60% of all Lyme patients go onto develop long-term if not life-long symptoms:  https://madisonarealymesupportgroup.com/2019/02/25/medical-stalemate-what-causes-continuing-symptoms-after-lyme-treatment/

 

 

Category:

Lyme, research, Treatment