Archive for the ‘research’ Category

Study Shows Increase of Non-Lyme Tick-Borne Diseases

https://lymediseaseassociation.org/wp-content/uploads/2020/01/EL-Lyme-Article.pdf Study found here

https://lymediseaseassociation.org/news/study-shows-increase-of-non-lyme-tick-borne-diseases/

Study Shows Increase of Non-Lyme Tick-Borne Diseases

A study by Elizabeth Lee-Lewandrowski, PhD, MPH, et al, published in The American Journal of Clinical Pathology from the Department of Pathology, Massachusetts General Hospital and Harvard Medical School, evaluated trends in non-Lyme disease tick-borne disease (NLTBI) blood testing at Quest Diagnostics laboratory located in New Jersey.

The study took place over the course of seven years and included polymerase chain reaction (PCR) and serological tests. Testing data from Quest Diagnostics were analyzed both nationally and at the state level from 2010 through 2016.

The study showed that:

  • testing and positivity for most NLTBIs increased dramatically over the course of the study,
  • testing criteria was not as stringent as required for public health reporting, but the study showed that the number of positive cases generally exceeds those reported by the Centers for Disease Control and Prevention (CDC),
  • frequency of NLTBI in US is seasonal but testing activity and positive test results are present throughout all months of the year, and
  • positive results for NLTBI testing originated primarily from a limited number of states, signifying a geographic concentration and distribution.

The study shows a significant increase in the number of reported cases of many NLTBI from 2004 to 2016, including a

  • 6.6-fold (875 to 5,750) increase in anaplasmosis and ehrlichiosis combined.
  • It also uncovered a significant underreporting of Lyme disease and Q fever to the CDC.
Since reporting for tick-borne illnesses (TBI) generally use the same reporting system as Lyme disease,  the researchers indicate the possibility that underreporting also occurs for other TBI.

The study outlines laboratory-developed tests (LDTs) that have not been cleared by the US Food and Drug Administration (FDA) but have been approved by Clinical Laboratory Improvement Amendments (CLIA) regulations.

Said LDA President Pat Smith,

“Although the findings are not surprising to many in the Lyme community, it is imperative that we have this data to support the increases in many of these non-Lyme tick-borne diseases. Increased awareness will result in medical professionals being more likely to consider other tick-borne diseases in people who have been bitten by ticks.”

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

Excerpt:

For the first time, Garg et al. show a 85% probability for multiple infectionsincluding not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.

I’m thankful they included Bartonella as that one is often omitted but definitely a player.  I’m also thankful for the mention of viruses as they too are in the mix.  The mention of the persister form must be recognized as well as many out there deny its existence.

Key Quote:  “Our findings recognize that microbial infections in patients suffering from TBDs do not follow the one microbe, one disease Germ Theory as 65% of the TBD patients produce immune responses to various microbes.”

But there is another important point.

According to this review, 83% of all commercial tests focus only on Lyme (borrelia), despite the fact we are infected with more than one microbe.

https://madisonarealymesupportgroup.com/2017/05/01/co-infection-of-ticks-the-rule-rather-than-the-exception/

 

 

 

Category:

research

Is Prolonged Treatment For Lyme Disease The New Norm?

https://danielcameronmd.com/is-prolonged-treatment-for-lyme-disease-the-new-norm/

IS PROLONGED TREATMENT FOR LYME DISEASE THE NEW NORM?

The Infectious Diseases Society of America (IDSA) guidelines recommend a 3- to 4-week course of antibiotics for the treatment of Lyme disease. But a new study by the Centers for Disease Control and Prevention (CDC) indicates that nearly 2 out of every 3 patients with Lyme disease are treated longer than 4 weeks.

By

According to an annual, cross-sectional, nationwide survey,

  • 20.3% were treated for 5 to 8 weeks, while
  • 35.6% were treated for more than 8 weeks.
The CDC authors were surprised at the number of Lyme disease (LD) cases being treated with prolonged therapy.

“A surprisingly large proportion of respondents reported receiving more than 8 weeks of antibiotic treatment for LD,” writes Hook in the journal Ticks and Tick-borne Diseases.

Prolonged therapy for Lyme disease is not new. “Many respondents reporting receiving prolonged therapy is concordant with other reports of providers’ non-adherence to or unfamiliarity with LD treatment guidelines,” writes Hook.

The CDC authors were not able to address the rationale for extended treatment without having access to the attending physician or patient charts. Instead, they cited the familiar dogma regarding Lyme disease treatment.

  • “There is no scientific evidence of clinical benefit from antibiotic treatment longer than current guidelines recommend.”
  • “In patients with persistent symptoms and a history of LD, several controlled trials showed no benefit in prolonged antibiotic therapy.”

The authors postulate that prolonged therapy for Lyme disease could be stopped with education.

“Our results indicate that providers in LD endemic areas may benefit from education regarding the duration of therapy needed, especially in light of the risk of antibiotic-related complications and development of resistance.”

Editor’s note: I find that most doctors are well aware of the IDSA and CDC opposition to more than a 4-week course of antibiotics. The evidence behind the IDSA and CDC recommendations is flawed. I am an author of the International Lyme and Associated Diseases Society (ILADS) guidelines, which recommend prolonged therapy for Lyme disease if needed.

Related Articles:

Failure rates still too high for the treatment of Lyme disease

Over 20% of Lyme disease patients still remain ill after treatment

John Hopkins’ study supports early identification of Lyme disease patients for re-treatment

References:
  1. Hook SA, Nelson CA, Mead PS. U.S. public’s experience with ticks and tick-borne diseases: Results from national HealthStyles surveys. Ticks Tick Borne Dis. 2015 Jun;6(4):483-8.

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**Comment**

All I can say is “THANK GOD FOR ILADS!”

To understand the shady biased back story on why we are in the straits we are in:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Also worth noting are the severe conflicts of interest within the CDC, the very people making treatment guidelines:

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ConflictReport  Go to part III

I just posted this excellent article on the backstory of the Lymerix vaccine which also uncovers shady dealings, dishonesty, and conflicts of interest:  https://madisonarealymesupportgroup.com/2020/02/10/the-bitter-feud-over-lymerix/

 

Category:

Lyme, research, Treatment

A Vote Against Lyme Disease

https://now.tufts.edu/articles/vote-against-lyme-disease

A Vote Against Lyme Disease

Cast your ballot for the best new ideas in fighting a growing health problem
A deer tick lurking on a grass stem. Tufts students are competing to find the best new ideas for fighting the tick-borne illness Lyme disease.
Participants in the challenge have come up with some creative ways to keep deer ticks like this one from spreading illness. Photo: Shutterstock
By Julie Flaherty
January 9, 2020

In the video, Kobe the German Shepherd is getting his check-up at the veterinarian’s office. His owner says the dog is doing well, but she does mention,

“We’re starting to see a lot of ticks on him after his walks.”

After sharing some tips on keeping Kobe tick-free, the veterinarian adds:

“Do you think about doing tick checks on yourself?” It’s a good practice, the vet says, along with wearing insect repellant and treating clothes and shoes with the pesticide permethrin.

Dog owners already talk with vets about preventing ticks on their pets, so why not have vets share some info on protecting the rest of the family from tick bites?

The short video is one of four proposals that students developed as part of the Tufts Lyme Disease Challenge. The competition, the brainchild of Tufts trustee Hugh Roome, A74, F77, AG74, FG80, FG80, A11P, F15P, A18P, seeks to build on Tufts University’s long history of leadership in Lyme disease research. It draws on the broad scope of research at Tufts to develop novel approaches to preventing, diagnosing, treating and eradicating one of the fastest growing infectious diseases in the United States. Each year, an estimated 300,000 new cases are diagnosed.

Check out the video proposals and vote for your favorites. The top vote-getting team will receive $1,000.

The competition kicked off on November 1 with expert talks, panel discussions and brainstorming sessions to discuss what’s most needed in the fight against Lyme, from educational outreach to basic knowledge of the bacteria that causes the disease. Over 100 Tufts students, post-doctoral fellows, faculty and staff participated in the half-day event commented,

“It was great to have so much energy in the room and hear so many terrific ideas,” said Linden Hu, a Lyme disease researcher at Tufts University School of Medicine. “The goal now is to keep the momentum going and really have Tufts make a difference in eradicating Lyme disease.”

Since the event, smaller teams of students have worked with Lyme disease researchers at Tufts to develop their proposals. The four students from Cummings School of Veterinary Medicine at Tufts who submitted the Kobe video say that well visits with the vet could be a new way to spread education about Lyme Disease prevention.

In another video, a group of medical and biomedical engineering students propose a way to prevent tick bites from turning into disease. Lyme bacteria are amazingly cagey in their ability to avoid detection by the immune system. The students propose using nanoparticle infused therapeutics to boost a person’s immunity, essentially preventing the bacteria that cause Lyme Disease from starting a full-blown infection in the body.

The videos are impressive in their wide range of approaches. A group of biomedical engineering students suggest using the power of pheromones to create a tick-attracting trap; the first step would be enhancing tick pheromones so they last longer and can spread over a larger area.

The fourth video aims at one of the significant gaps in Lyme research: a thorough understanding of Borrelia, the bacteria that causes it. Borrelia is difficult to grow in a lab. One solution, the video offers, is to use a drug printing robot to make dozens of growth media with different combinations of nutrients, to quickly see which recipe is the best for culturing the bacteria.

You can vote once per email per day. Voting closes at midnight on February 24.

Julie Flaherty can be reached at julie.flaherty@tufts.edu.

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**Comment**

When you click onto the link called “Video Proposals,” you will be sent to a page where four videos explain the different research topics.

They include:

  • Vets Against Lyme: Combating Lyme Disease by harnessing the human animal bond

 

  • Team Diamond: Finding a growth media for borrelia & high throughput screening techniques  To me this appears very important because if researchers can’t culture Bb, nothing else really matters.

 

  • Team HMK: Nanoparticle and immunotherapy: Paradigm shifting Lyme treatments.  Please be aware that the researchers claim 70% of patients get the EM rash, which is untrue.  It varies from 25-80% and may even be lower than that. Research to date has required patients to test positive on antibody testing that misses over half of all cases and have the EM rash, despite many never getting the rash. They also only mention the Bull’s eye rash when many patients have a variety of rashes. They also push the PTLDS paradigm (post treatment Lyme disease syndrome) but at least present the two opposing viewpoints (hay-wire immune system vs. persistent infection)

 

  • Sour to Sweet: Tick prevention – using pheromone to attract ticks so they can be killed. I appreciate the presenter’s statement that ticks can fall out of trees.  This is denied by most authorities, yet patients commonly report becoming infected this way.

Category:

Activism, Lyme, research, Ticks

Severe Babesia Infection Leads to Exchange Transfusion

https://danielcameronmd.com/severe-babesia-infection-exchange-transfusion/

SEVERE BABESIA INFECTION LEADS TO EXCHANGE TRANSFUSION

Babesia infection, transfusion

Babesiosis is a parasitic disease transmitted primarily through the bite of an infected tick but it can also be spread through tainted blood transfusions or less frequently via organ transplantation or perinatally. The severity of Babesia can range from asymptomatic to life-threatening. In immunocompromised patients or in those who have contracted the disease through blood transfusions, a Babesia infection has a fatality rate of about 20%. [1,2]

By

Although the majority of Babesia cases are treated with antimicrobial agents, patients with severe cases may require an exchange transfusion (ET). In their article, “Repeat exchange transfusion for treatment of severe babesiosis,” Radcliffe and colleagues describe the case of a 73-year-old woman with an extreme case of a Babesia infection, who was immunocompromised. [3]

The woman ultimately required 2 exchange transfusions, along with prolonged anti-parasitic therapy to successfully treat the Babesia microti infection.

Approximately 1 month after camping in New Hampshire, the woman developed malaise, headaches, weakness, anorexia, and nausea, which lasted for 4 days. She did not recall having a tick bite.

The patient had a history of splenectomy, an autoimmune disorder, and immunosuppression therapy. “Her medical history was significant for longstanding rheumatoid arthritis treated with weekly etanercept and prior splenectomy for immune-mediated thrombocytopenia,” writes Radcliffe.

A blood smear revealed a parasitic burden of 43% and anemia with hemoglobin 9.2 mg/dL. “She was started on azithromycin and clindamycin and transferred to our hospital,” writes Radcliffe.

Case report: Severe Babesia in a 73-year-old woman resolves after 2 exchange transfusions. CLICK TO TWEETThe woman was admitted to the intensive care unit for hypotension. She initially needed fluids and vasopressors, as well as supplemental oxygen for a pulse oximetry of 88%.

Her treatment for the Babesia infection was changed to include: IV clindamycin, oral quinine sulfate, and oral doxycycline, as empiric treatment for possible co-infection with Lyme disease and/or anaplasmosis.

And on day 1, she received a red blood cell exchange transfusion of 12 units. This dropped the parasite load to 7.6%.

However, “despite a post-exchange drop in parasitemia to 7.6%, it rebounded to 11.4% on hospital day 5 accompanied by new onset high fevers and hypoxia,” explains Radcliffe.

On day 5, she received her second exchange transfer, which lowered parasitemia to 2.2%.

“She improved after a second exchange transfusion and ultimately resolved her infection after 12 weeks of anti-babesial antibiotics,” writes Radcliffe.

She underwent extended treatment for the Babesia infection, in part due to a parasitemia at day 9 of 1.7% and <1% at day 19.

“Antibiotics were discontinued as follows: atovaquone/proguanil at 61 days post-discharge, doxycycline at 72 days post-discharge, and azithromycin at 86 days post-discharge,” writes Radcliffe.

There are only 6 other cases in the literature documenting exchange transfusions in patients with Babesia. Unfortunately, one of those patients died.

“Our present case is instructive,” the authors explain, “because two ETs were necessary for cure despite a marked lowering of parasitemia after the first ET (81.5% reduction) and an extended anti-parasitic regimen…”

The authors conclude: “These cases highlight the need to remain vigilant when managing babesiosis in highly immunocompromised patients.”

Editor’s note: This patient’s case should serve as a reminder of the risk Babesia poses for immunocompromised patients with autoimmune disorders such as rheumatoid arthritis.

Related Articles:

Case series looks at the complexity of Babesia

Case report: Various clinical presentations of Babesia

Healthy people may be unaware they are infected with Babesia

References:
  1. Krause PJ. Human babesiosis. Int J Parasitol 2019;49(2):165–74.
  2. Krause PJ, Gewurz BE, Hill D, Marty FM, Vannier E, Foppa IM, et al. Persistent and
    relapsing babesiosis in immunocompromised patients. Clin Infect Dis 2008;46(3):370–6.
  3. Radcliffe C, Krause PJ, Grant M. Repeat exchange transfusion for treatment of severe babesiosis. Transfus Apher Sci. 2019 Sep 5. pii: S1473-0502(19)30189-2.

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**Comment**

According to Dr. Horowitz, Babesia is one of the most tenacious coinfections he treats and he recommends treating for 9 months to a year.  In my experience, with a lengthy, overlapping treatment using numerous antimicrobials, you can cure Babesia.  For treatment options:  https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/  I include the treatment that was effective for us.

Authorities state that patients are more likely to get Babesia or Bartonella if they are immunocompromised.  What they aren’t considering is that having Lyme or other tick-borne illnesses CAUSES patients to be immunocompromised and sets them up to be targets for other pathogens that are either transmitted directly from a tick bite OR reactivates a latent infection that the immune system was able to keep in check until a trigger suppresses the immune system causing it to fail, allowing a activation of a latent infection.  Their heads are in the sand.

Category:

Babesia, research, Treatment

A Joint Effort: The Interplay Between the Innate and the Adaptive Immune System in Lyme Arthritis

https://www.ncbi.nlm.nih.gov/pubmed/31930745/

2020 Jan 13. doi: 10.1111/imr.12837. [Epub ahead of print]

A joint effort: The interplay between the innate and the adaptive immune system in Lyme arthritis.

Brouwer MAE1, van de Schoor FR1, Vrijmoeth HD1, Netea MG1,2, Joosten LAB1.

Abstract

Articular joints are a major target of Borrelia burgdorferi, the causative agent of Lyme arthritis. Despite antibiotic treatment, recurrent or persistent Lyme arthritis is observed in a significant number of patients. The host immune response plays a crucial role in this chronic arthritic joint complication of Borrelia infections. During the early stages of B. burgdorferi infection, a major hinder in generating a proper host immune response is the lack of induction of a strong adaptive immune response. This may lead to a delayed hyperinflammatory reaction later in the disease. Several mechanisms have been suggested that might be pivotal for the development of Lyme arthritis and will be highlighted in this review, from molecular mimicry of matrix metallopeptidases and glycosaminoglycans, to autoimmune responses to live bacteria, or remnants of Borrelia spirochetes in joints. Murine studies have suggested that the inflammatory responses are initiated by innate immune cells, but this does not exclude the involvement of the adaptive immune system in this dysregulated immune profile. Genetic predisposition, via human leukocyte antigen-DR isotype and microRNA expression, has been associated with the development of antibiotic-refractory Lyme arthritis. Yet the ultimate cause for (antibiotic-refractory) Lyme arthritis remains unknown. Complex processes of different immune cells and signaling cascades are involved in the development of Lyme arthritis. When these various mechanisms are fully been unraveled, new treatment strategies can be developed to target (antibiotic-refractory) Lyme arthritis more effectively.

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For more: Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy

https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/

Excerpt:

By combining the PTLDS group with the third group, there are 60% of patients ending up with chronic symptoms, a number that more closely matches my experience as a patient advocate (9).

THIS IS AN IMPORTANT POINT AS RESEARCHERS CONTINUE TO DOWNPLAY THE ASPECT OF PERSISTENT SYMPTOMS BY USING THE FALSELY SKEWED LOW PERCENTAGES.
  • Burrascano found Lyme disease has a 4-week cycle, where every 4 weeks patients experience a symptom flair. Burgdorfer found this in mice studies, and IGeneX found the same thing in urine antigen studies.Borrelia grow and are active, then become inactive.Four weeks later they activate.This has been shown recently in vitro. Think of Bb as a slow relapsing fever.This nuance is important because antibiotics only kill during the active phase.You need a minimum of a month to bracket a whole generation cycle.

 

  • When patients reach a plateau, he recommends cycling therapy where you discontinue antibiotics until symptoms return.Then, return to full treatment until symptoms are gone. He states that many patients become symptom free after 4 of these cycles.He also used this on himself with success.

In brief, all the research to date has used faulty study parameters.  Typically you must test positive on the 2-tiered testing and have the EM rash to even enter the study – leaving out a large patient population.  When you study the organism for any length of time at all you realize this is not your average bacteria.  Treatment must address this complexity.  The idea that 3 weeks of the mono therapy of doxycycline “curing” this is asinine. Also, little research has been done on concurrent infection.  Many researchers feel this is a rare event, yet in the real world many, many patients have far more than Lyme.  What little we know shows that concurrent infection is more severe and of a longer duration, yet these studies don’t ever touch this.

Current testing uses one species of borrelia when researchers are discovering a new species every year – which testing will never pick up.

Category:

Lyme, research