Archive for the ‘research’ Category

Study of Biofilm Could Lead to New Class of Anti-Infective Drugs

https://www.ncbi.nlm.nih.gov/pubmed/31784893

2019 Nov 29. doi: 10.1007/s00430-019-00644-3. [Epub ahead of print]

Interaction with the host: the role of fibronectin and extracellular matrix proteins in the adhesion of Gram-negative bacteria.

Abstract

The capacity of pathogenic microorganisms to adhere to host cells and avoid clearance by the host immune system is the initial and most decisive step leading to infections. Bacteria have developed different strategies to attach to diverse host surface structures. One important strategy is the adhesion to extracellular matrix (ECM) proteins (e.g., collagen, fibronectin, laminin) that are highly abundant in connective tissue and basement membranes. Gram-negative bacteria express variable outer membrane proteins (adhesins) to attach to the host and to initiate the process of infection. Understanding the underlying molecular mechanisms of bacterial adhesion is a prerequisite for targeting this interaction by “anti-ligands” to prevent colonization or infection of the host. Future development of such “anti-ligands” (specifically interfering with bacteria-host matrix interactions) might result in the development of a new class of anti-infective drugs for the therapy of infections caused by multidrug-resistant Gram-negative bacteria. This review summarizes our current knowledge about the manifold interactions of adhesins expressed by Gram-negative bacteria with ECM proteins and the use of this information for the generation of novel therapeutic antivirulence strategies.

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For more:  https://madisonarealymesupportgroup.com/2019/07/19/biofilms-what-are-they-how-do-they-impact-chronic-infections/

https://madisonarealymesupportgroup.com/2018/09/29/microscopy-of-spirochaete-biofilm/

https://madisonarealymesupportgroup.com/2019/05/29/mixed-borrelia-burgdorferi-helicobacter-pylori-biofilms-in-morgellons-disease-dermatological-specimens/

https://madisonarealymesupportgroup.com/2019/04/19/first-study-showing-borrelia-chlamydia-mixed-biofilms-in-infected-human-skin-tissues/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721268/  Bartonella & Brucella – Weapons and Strategies for Stealth Attack

Great article on Biofilm: https://www.bayarealyme.org/blog/straight-talk-biofilms-new-answer-treating-lyme-disease/

Another one on possible treatments: https://www.tiredoflyme.com/biofilm.html

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

https://madisonarealymesupportgroup.com/2016/01/03/bartonella-treatment/

Some patients have found remarkable improvement after addressing biofilms. This is what can make heparin such a help for those with hyper coagulation (thick blood).

 

 

 

 

 

Patterns, Drivers, and Challenges of Vector-Borne Disease Emergence

https://www.liebertpub.com/doi/10.1089/vbz.2018.2432

Vector-Borne and Zoonotic DiseasesAhead of Print

Patterns, Drivers, and Challenges of Vector-Borne Disease Emergence

Andrea Swei, lisa I. Couper, Lark L. Coffey, Durrell Kapan, and Shannon Bennett

Published Online:https://doi.org/10.1089/vbz.2018.2432

Vector-borne diseases are emerging at an increasing rate and comprise a disproportionate share of all emerging infectious diseases. Yet, the key ecological and evolutionary dimensions of vector-borne disease that facilitate their emergence have not been thoroughly explored. This study reviews and synthesizes the existing literature to explore global patterns of emerging vector-borne zoonotic diseases (VBZDs) under changing global conditions. We find that the vast majority of emerging VBZDs are transmitted by ticks (Ixodidae) and mosquitoes (Culicidae) and the pathogens transmitted are dominated by Rickettsiaceae bacteria and RNA viruses (Flaviviridae, Bunyaviridae, and Togaviridae). The most common potential driver of these emerging zoonoses is land use change, but for many diseases, the driver is unknown, revealing a critical research gap. While most reported VBZDs are emerging in the northern latitudes, after correcting for sampling bias, Africa is clearly a region with the greatest share of emerging VBZD. We highlight critical gaps in our understanding of VBZD emergence and emphasize the importance of interdisciplinary research and consideration of deeper evolutionary processes to improve our capacity for anticipating where and how such diseases have and will continue to emerge.

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**Comment**

Regarding ticks, it’s birds that are doing the damage:  https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/

Excerpt:

But birds facilitate the spread of ticks, picking them up in Maryland, Connecticut and other eastern states as they fly north in the spring, Lubelczyk explained.

“As they’re migrating, they’re either dropping the ticks off as they fly or when they land. They’re kind of seeding them along migration patterns.

https://madisonarealymesupportgroup.com/2016/10/02/the-role-of-birds-in-tickborne-illness/

Excerpt:

Birds play a central role in the ecology of tick-borne pathogens. They expand tick populations and pathogens across vast distances and serve as reservoirs that maintain and amplify transmission locally.

 

Latest Research on Vitamin C

https://www.deannaminich.com/latest-research-on-vitamin-c/

by | Sep 17, 2018

Vitamin C is no stranger to the spotlight when it comes to powerful nutrients. When you get a cold, you might turn to vitamin C to give your immune system a boost, or you might supplement with it to help combat oxidative stress.

Many of vitamin C’s functions are well studied and can be found in any nutritional textbook and articles out in the blogosphere. As a quick recap, here are some of vitamin C‘s most recognized roles in the body:

– Immune system support
– Collagen synthesis
– L-carnitine synthesis
– Neurotransmitter synthesis
– Antioxidant that also regenerates other antioxidants, specifically vitamin E
– Increases non-heme (plant based) iron absorption

Scurvy, common among sailors in the 15th and 16th centuries, is a disease that arises when there is a deficiency of vitamin C. The early symptoms include fatigue, lethargy, and malaise. As it progresses, it causes anemia, bone pain, easy bruising, swelling, poor wound healing, mood changes, depression, and other symptoms. It can become very serious and even lead to death if not treated.

Although a true deficiency might be rare today, having insufficient levels also leads to poor health. Our knowledge regarding the important actions and roles that vitamin C has in the body—and why it is important to have sufficient quantities—continually expands. So, let’s take a look at what’s new with vitamin C with a quick research roundup of some of the more recent studies in the literature.

Neurodegeneration and Alzheimer’s Disease

Recent studies on vitamin C’s potential to help prevent and perhaps even alleviate Alzheimer’s Disease and other disorders caused by neurodegeneration found:

  • A reduced risk of developing cognitive decline. Using data from a cohort study, researchers reviewed the impact of taking vitamin E and C supplements on cognitive decline. Supplementing with vitamin C and E resulted in roughly three-quarters the risk of developing cognitive impairment, not dementia, and there was just under two-thirds the risk of developing Alzheimer’s disease and all-cause dementia. For those who appreciate the science, the adjusted hazard ratio was 0.77 for cognitive impairment, not dementia; 0.60 for Alzheimer’s disease; and 0.62 for all-cause dementia, all of which were significant and remained so in fully adjusted models other than cognitive impairment, not dementia.
  • In another study, lower plasma levels of vitamin C correlated with a higher risk of increased carotid intima-media thickness (IMT). Increased IMT has been shown to increase the risk of cardiovascular disease and cognitive impairment. This points to a potentially protective effect of vitamin C against Alzheimer’s disease and similar vascular and cognitive aging.

Based on these two studies, it appears as though having sufficient vitamin C plays a key role in protecting the brain. This makes it especially important for you to consume plenty of vitamin-C rich foods as you age.

Cardiovascular Disease 

Several studies have come out in the past decade or so looking at the association between vitamin C and heart health. Below are highlights of a couple recent studies:

  • A meta-analysis found vitamin C treatment after cardiac surgery was safe and potentially effective in reducing the incidence of postoperative atrial fibrillation. This is the most common surgical complication, and it can lead to twice the incidence of heart failure and stroke. Finding ways to prevent postoperative atrial fibrillation could contribute to better surgical outcomes and reduced mortality.
  • Patients with metabolic syndrome have lower plasma levels of vitamin C, as well as the other key antioxidant vitamins (vitamins A and E). Low levels were not associated with their dietary intake, but weight did play a role. Those who had a higher BMI also had a lower level of vitamin C, pointing to antioxidant deficiency or impairment. Therefore, regardless of the diet, those who were overweight or obese still had lower levels of vitamin C in their blood, most likely due to increased antioxidant needs. Therefore, it is even more important for those with a higher BMI to focus on consuming sufficient antioxidants, especially vitamin C, through their diet and possibly supplementation.

A healthy diet, especially one rich in vegetables and fruit, is an important component of heart health. One reason might be that the vitamin C in plant foods helps ensure you have a large enough antioxidant capacity when you are stressed, whether from a surgery or excess body fat.

Fighting Infections 

We already know that supporting the immune system is an important task of vitamin C. New research provides even more evidence, as shown below:

  • One randomized, controlled pilot study found that taking probiotics with 50 mg of vitamin C reduced the incidence rate of upper respiratory tract infections in preschool children compared to the placebo group. There was also a reduction in the days absent from school and the number of days for which medication was needed compared to the placebo group.
  • In a randomized control trial, vitamin C supplementation (500 mg) was found to help men with below adequate or deficient vitamin C status at the beginning of the study overcome a cold faster. After taking vitamin C, the duration of infection with the common cold was reduced 59 percent compared to the control group. The vitamin C group also experienced a modest increase in the physical activity score and increased fasting serum vitamin C levels.

Other Promising Findings

There are many other studies pointing to possible benefits from this antioxidant vitamin. Some interesting and promising findings include:

  •  A recent study analyzed data from 3,283 adults in the Korea 2012 National Health and Nutrition Examination Survey. Low intakes of vitamin C, as well as other nutrients, had a significant association with COPD (chronic obstructive pulmonary disease). Low vitamin C intake was one of four elements that had a significant independent risk factor; the other four were being male, older, and a smoker. The study found that higher vitamin C intake is protective, independent of smoking.
  • In patients with hypothyroidism and gastritis (which contributes to malabsorption of thyroid medication), taking vitamin C helped improve absorption of levothyroxine, which in turn improved their serum TSH, free T4, and T3 levels. These are the thyroid hormones that play an important role in regulating metabolism, growth and development, and neural differentiation.
  • A cohort study found that high levels (over 30 grams) of intravenous vitamin C over a treatment period that lasted 90 minutes reduced blood pressure 6 to 7 mmHg and 8 to 9 mmHg in prehypertensive patients.
  • A cross-sectional study looking at middle-aged and older adults found an inverse association between vitamin C intake (adjusted for energy intake) and risk for developing non-alcoholic fatty liver disease.

These studies point to the importance of ensuring you have an adequate supply at all times for your general health and well being. As an added bonus, you protect yourself from an early death. A report reviewing two cohort studies found an inverse association between vitamin C intake and all-cause and cardiovascular disease mortality in adults in China.

How to Get Sufficient Vitamin C 

It is easy to boost your vitamin C intake: just add some fruits and vegetables to your diet, especially if you fall short of the recommended 9 to 14 servings. In a study combining four randomized-controlled trials conducted under similar guidelines by the same research team, there was a 24 percent increase in vitamin C intake per one additional portion of fruit and vegetable added to the diet, which was statistically significant. For a targeted increase, try some of the following foods, which are rich in vitamin C and listed in descending order:

– Acerola cherries
– Orange juice
– Guavas
– Red, green, and yellow peppers
– Peaches
– Mustard spinach
– Tomato juice
– Lychees
– Kiwis
– Oranges
– Sun-dried tomatoes
– Broccoli
– Strawberries

One thing this list has in common is that they are colorful foods! Make a point to eat a colorful diet made up of every color of the rainbow. This ensures you provide your body with a wide variety of nutrients, including vitamin C.

If you struggle to consume enough vitamin-C rich foods, you might wish to turn to supplements. There are a few things you need to know¹:

  • Most supplements use ascorbic acid, which has a similar bioavailability to what you find in food.
  • The body starts to absorb less vitamin C once you go above doses of 1,250 mg. That is why for maximum absorption, it is generally recommended to split high doses to two or three throughout the day.
  • The most common side effect is diarrhea, and you might also experience abdominal pain. Typically, these symptoms are dose related. This means they are more likely to occur the higher the dose. This is another reason to split high doses.
  • Vitamin C increases the absorption of non-heme iron, which is the iron found in plants such as lentils, soy, quinoa, and leafy greens. Therefore, if you are at risk of an iron overload, do not take vitamin C when you consume these foods. Conversely, if you are iron deficient, increase your non-heme iron absorption through consuming vitamin C rich foods and/or supplements.
  • As with any supplement, discuss potential medication interactions and other risk factors with your doctor or pharmacist before taking the supplement.
  • Make sure to have bioflavonoids included in your vitamin C supplement for a complete complement of vitamin C activity.

When you choose a supplement, you want to make sure that it is high quality. One of the best ways to do that is to look for those certified by a third-party, such as Consumer Labs, the Natural Products Association, NSF International, and US Pharmacopeia. Always review the active and inactive ingredients so that you know what is in the supplement. Be wary of “proprietary” blends that do not detail the ingredients. Other ingredients to avoid include wheat, gluten, lactose, hydrogenated oils, sweeteners, artificial colors, and anything else you generally would not wish to ingest.

There will always be more research looking into additional benefits of consuming vitamin C, and there’s no time like the present to focus on your intake so that you benefit from all that vitamin C does to the body, both the actions currently known and those that will only be revealed in the future.  Always check with your healthcare practitioner on whether you need more vitamin C from your diet or from a supplement.

Additional Sources: 

  1. Gaby, A.R. (2011). Chapter 22:Vitamin C.In Nutritional Medicine (1st ed.) [eBook version]. Concord, NH: Fritz Perlberg Publishing. Available from https://doctorgaby.com/the-book/.

Bracing for the Worst – Range Expansion of the Lone Star Tick in the Northeastern United States

https://www.nejm.org/doi/full/10.1056/NEJMp1911661?

Perspective

Bracing for the Worst — Range Expansion of the Lone Star Tick in the Northeastern United States

List of authors.

  • Goudarz Molaei, Ph.D.,
  • Eliza A.H. Little, Ph.D.,
  • Scott C. Williams, Ph.D.,
  • and Kirby C. Stafford, Ph.D.

Ticks and tickborne diseases are increasingly becoming a major health concern for humans, domesticated animals, and livestock. Reported cases of bacterial and protozoan tickborne disease doubled in the United States between 2004 and 2016. More than 90% of the nearly 60,000 cases of nationally notifiable vectorborne diseases reported in 2017 were linked to ticks. As the geographic ranges of multiple tick species continue to expand, invasive tick species are being discovered, new tickborne pathogens are emerging, and coinfections in ticks are surging. Rising global temperatures, ecologic changes, reforestation, and increases in commerce and travel are all important underlying factors influencing the rate and extent of range expansion for ticks and tickborne pathogens.

Both blacklegged (Ixodes scapularis) and lone star (Amblyomma americanum) ticks may be recolonizing areas where they thrived historically, before rampant deforestation and substantial local reduction of key hosts. Linked, in part, to a warming climate, there has been an increase in the number of ticks and associated diseases recorded in the United States and Canada,1 as well as in Europe.

Persistently warming temperatures may not only lead to the continued geographic range expansion of some ticks but may also extend their active season, thereby altering host availability and abundance; interactions among vectors, pathogens, and hosts; and the prevalence of infection in ticks. A warming climate and other environmental changes will affect abundance, distribution, seasonal activity patterns, and interactions among species differently for various ticks.

Lone star ticks of all life stages (larva, nymph, and adult) feed predominantly on large mammals, especially white-tailed deer. Larvae and nymphs also feed on birds. The resurgence of lone star ticks is linked to increased populations of deer, eastern coyotes, and wild turkeys. In addition to occupying its established range, the lone star tick has expanded into the upper midwestern and northeastern United States and eastern Canada.2,3 Since lone star ticks can lay several thousand eggs, even the dispersal of a small number of gravid females may be sufficient to establish populations in areas with abundant reproductive hosts, suitable habitats, and conducive temperatures.

Current Populations of Lone Star Ticks (Amblyomma americanum) in the Northeastern United States.

Lone star ticks have been established in the southeastern United States for well over a century; southern New Jersey was historically recognized as their northern range limit.4 Some reports of lone star ticks in the northeastern United States and more recently in eastern Canada may not necessarily reflect established breeding populations.2,3 In the past few decades, however, documented breeding populations have expanded into some parts of the Northeast. Such populations were reported in Suffolk County, New York, as early as 1971; Newport County, Rhode Island, in 1986; Somerset and Middlesex Counties, New Jersey, in 2017; Fairfield and New Haven Counties, Connecticut, in 2018 and 2019, respectively; and Barnstable, Nantucket, and Dukes Counties, Massachusetts, in 2019 (see map).2,4,5

Current environmental and climatic conditions favor the establishment and expansion of lone star ticks along the southern New England coast. Moderate maritime climates may be more conducive to the establishment of lone star tick populations than the climates inland, areas where immature ticks may not survive cold winters. Investigations of lone star ticks that can be traced back to an established southern population show that adults can successfully survive the winter in mainland Connecticut, however, and population simulations using current climate conditions suggest that southern Canada is already suitable for their establishment. Although the northward range expansion of the lone star tick is consistent with climate change, a recent study revealed that tick populations in New York are genetically distinct from those occupying the species’ historical range. This finding suggests the possibility of adaptive evolution causing or coinciding with this range expansion and probably favoring pathogen transmission.

It’s unclear how the lone star tick will compete and interact directly or indirectly with other tick species in the Northeast, and the nature of these interactions may vary depending on evolutionary context and changing environmental and climatic conditions. In the southeastern United States, range expansion of the lone star tick coincided with diminished populations of the American dog tick (Dermacentor variabilis). In New Jersey, populations of the lone star tick have increased in areas where it is endemic while blacklegged tick populations have remained static.4 Field studies indicate that the lone star tick establishes populations in habitats with specific humidity ranges and that tick abundance is associated with the presence of invasive plants. Areas colonized by invasive plants are frequented by white-tailed deer, a prominent tick host and pathogen reservoir. Lone star ticks will traverse long distances when searching for a mammalian host, thereby accelerating their establishment in new areas.2

Previously considered aggressive nuisance pests, lone star ticks have now been associated with several human diseases and medical conditions, including tularemia (Francisella tularensis), ehrlichiosis (Ehrlichia chaffeensis, E. ewingii, and Panola Mountain Ehrlichia), Heartland virus disease (Heartland virus), southern tick–associated rash illness, or STARI (pathogen unknown), and red meat allergy (alpha-gal syndrome) and are probably also associated with Bourbon virus disease (Bourbon virus).2 Lone star ticks have also been commonly found to be infected with Rickettsia amblyommatis; however, serologic evidence suggests that humans develop a robust immune response to this bacterium, though it may cause symptoms in some people. Local abundance of lone star ticks and the likelihood of getting multiple bites can be highly irritating, even in the absence of disease transmission.

Although lone star ticks don’t transmit Borrelia burgdorferi — the principal bacterium that causes Lyme disease in North America — symptoms of STARI and early Lyme disease are similar, and STARI may be misdiagnosed as Lyme disease in areas with both lone star ticks and blacklegged ticks. Reported cases of human ehrlichiosis have increased, but this disease is largely underrecognized and underreported. Infections of E. chaffeensis in lone star ticks have been identified in Connecticut, Rhode Island, and Massachusetts, but few cases of human disease have been attributed to this pathogen.

Most reports of lone star ticks in the northeastern United States come from tick submissions by the public to passive surveillance programs, which serve as an early warning system. Active surveillance is important for accurate determination of the extent of the northern range expansion of this vector, however. To be effective, active surveillance should be designed specifically for lone star ticks and should include targeting of areas with emerging populations identified by passive surveillance.3 In many areas of the mid-Atlantic region and emerging areas of the Northeast, coexistence of lone star and blacklegged ticks complicates management strategies. Rodent-targeted approaches used for the control of blacklegged ticks aren’t necessarily effective for lone star ticks, since small mammals aren’t major hosts for immature members of this species. By contrast, application of acaricides to deer by means of four-poster feeding stations has reduced the abundance of host-seeking lone star and blacklegged ticks.

Abundant reproductive hosts, an increasingly hospitable climate, and genetic plasticity of the lone star tick support the continued invasion and establishment of this tick in the Northeast. Increasing population densities and subsequent range expansion, in conjunction with nondiscriminating biting habits and the capacity to transmit diverse pathogens, position the lone star tick as an important emerging health threat to humans, domesticated animals, and wildlife. It’s also plausible that the lone star tick will displace local tick species, transmit different pathogens than those species, and alter the tickborne disease landscape. We believe it’s essential for practitioners and the public to develop a heightened awareness of the health risks associated with emergent tick vectors such as the lone star tick and their potential for changing the dynamics of tickborne diseases in the northeastern United States and elsewhere.

Disclosure forms provided by the authors are available at NEJM.org.

Author Affiliations

From the Department of Environmental Sciences (G.M.), the Center for Vector Biology and Zoonotic Diseases and Northeast Regional Center for Excellence in Vector-borne Diseases (G.M., E.A.H.L., S.C.W., K.C.S.), the Department of Entomology (E.A.H.L., K.C.S.), and the Department of Forestry and Horticulture (S.C.W.), the Connecticut Agricultural Experiment Station, and the Department of Epidemiology of Microbial Diseases, Yale School of Public Health (G.M.) — all in New Haven, CT.

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**Comment**

Despite the articles continual mention of climate change, research has shown this to be a moot point regarding tick proliferation:  https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/

What is a problem is the fact birds are transporting ticks everywhere:  https://madisonarealymesupportgroup.com/2019/03/09/danish-study-shows-migrating-birds-are-spreading-ticks-their-pathogens-including-places-without-sustainable-tick-populations/

The weather doesn’t bother ticks at all:  https://madisonarealymesupportgroup.com/2016/01/20/polar-vorticks/  The video in this link shows ticks surviving in 3 degrees overnight under snow cover.  When ticks are threatened they seek out leaf litter, bark mulch, or snow cover.

 Southern advocates tell me STARI IS LYME.  The symptoms are one and the same.

Also, please note the authors in one breath want to say the climate keeps Lone Star ticks in certain areas and then in another breath they say they are moving everywhere – including Canada.  Which is it?  You can’t have it both ways.

It is my opinion, which has been substantiated by a tick researcher, that many researchers are using the climate change moniker for grand money because it’s a hot topic.  This is important as there are only so many research dollars available and it’s high time we start having unbiased, accurate research that helps suffering patients.  More climate data is NOT going to do that.

 

 

Study Identifies 189 Children With Lyme Carditis

https://danielcameronmd.com/study-identifies-189-children-with-lyme-carditis/

STUDY IDENTIFIES 189 CHILDREN WITH LYME CARDITIS

In reviewing medical records from a Pediatric Health Information System (PHIS) database between 2007 and 2013, clinicians identified 189 children diagnosed with Lyme carditis.

“The burden of Lyme disease and Lyme carditis in U.S. children’s hospitals has increased in recent years,” writes Beach and colleagues in Pediatric Cardiology.

In their article “Increasing Burden of Lyme Carditis in United States Children’s Hospitals,” Beach et al.¹ reveal the rise in Lyme carditis cases throughout the U.S. The largest increases, they write, were found in the Midwest, including the Ohio valley.

According to the authors, the children with Lyme carditis were older than children with Lyme disease, who did not have Lyme carditis. On average, they were 13 years old and more likely to be male.

“Encounters for Lyme carditis are dramatically costlier than those for Lyme disease without carditis,” the authors explain. In fact, the median cost of treating a child with Lyme carditis was $9,104 with a range of $3,741 to $19,003. The median cost of treating a child with Lyme disease without Lyme carditis was $922 with a range of $238 to $4,987.

None of the 189 children identified in the database died. However, the database did not include out-of-hospital outcomes.

In the study, there was a broad range of cardiac codes identified among the 189 children. The authors could not be sure of the accuracy of the cardiac codes or whether there were pre-existing cardiac cases.

The list of cardiac cases is much broader than heart block, as identified in the Centers for Disease Control and Prevention’s (CDC) surveillance case definition.

Cardiac codes for 189 children with Lyme carditis

Out of the 189 children, cardiac codes identified in the database included:

First degree AV block – 28%
Acute myocarditis – 27%
Complete AV block – 17%
Second degree AV block – 15%
Heart disease NOS – 9%
Non-specific ECG abnormality – 4%
Cardiomyopathy – 4%
Premature beats – 3%
Right bundle branch block – 3%
Acute pericarditis – 2%
Atrial fibrillation/flutter – 2%
Suspected cardiovascular disease – 2%
Paroxysmal ventricular tachycardia – 2%
Cardiac arrest – 2%
Congestive heart failure NOS – 2%
Conduction disorder NOS – 1%
Left bundle branch block – 1%
Anomalous AV excitation – 1%
Paroxysmal supraventricular tachycardia – 1%
Paroxysmal tachycardia – 1%
Pericardial disease NOS – 1%
Other cardiac dysrhythmias – 38%

Additional costs

The authors were not able to address other costs due to Lyme carditis. “In addition to this financial burden, it is important to consider the additional costs of missed school and work, long-term morbidity, and emotional distress when considering the importance of preventing, diagnosing, and treating Lyme carditis,” writes Beach.

“The increasing number of serious cardiac events and costs associated with Lyme disease emphasize the need for prevention and early detection of disease and control of its spread,” the authors conclude.