Archive for the ‘research’ Category

Study Says Only About 18% of Children With Lyme Recall Tick Bite

https://www.sciencedirect.com/science/article/abs/pii/S1877959X18304965

A minority of children diagnosed with Lyme disease recall a preceding tick bite

online 26 February 2019

Abstract

Of 1770 children undergoing emergency department evaluation for Lyme disease, 362 (20.5%) children had Lyme disease. Of those with an available tick bite history, only a minority of those with Lyme disease had a recognized tick bite (60/325; 18.5%, 95% confidence interval 14.6–23.0%). Lack of a tick bite history does not reliably exclude Lyme disease.

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**Comment**

While this information isn’t shocking to me in the least, what does concern me is that only about 20% were found to have Lyme.  The abstract does not give the diagnostic criteria; however, it is typically the 2-tiered CDC serological (blood) testing which misses over half of all cases.  

So many of these children have Lyme and are now undiagnosed and will go on to develop chronic/persistent symptoms.

While I’m thankful the authors conclude that lack of recollection of a tick bite does not exclude infection, I’m highly concerned for those that perhaps are infected but couldn’t mount an appropriate immune response to show antibodies.

 

 

 

Lyme & its Known Involvement in Mental Health

https://www.morgellonssurvey.org/borreliosis-lyme-disease-and-its-known-involvement-in-mental-health/

Borreliosis (Lyme Disease) and its known involvement in Mental Health

Borreliosis (Lyme Disease) and its known involvement in Mental Health

 

Scientists and physicians across the world have discovered that the growing numbers of people with mental illness and diseases of the nervous system are being cured or improved by treatment with antibiotics. In other words, it is now known that bacteria can make you mentally ill as well as physically ill!

From Croatia to California, from Sweden to Sicily, conditions such as Schizophrenia and Multiple Sclerosis, even Alzheimer’s disease and Stroke, are being found to have common to all one of the most insidiously infective bacteria on the planet, namely Borrelia.

This organism is similar to the bacterium that causes Syphilis, which was once the major cause of mental ill health before the days of penicillin. Both bacteria are large and spiral in shape, but Borrelia is turning out to be far worse than its cousin. Syphilis could be detected fairly easily and then killed with antibiotics, but Borrelia is harder to find, and then it is even more difficult to eradicate. Because it causes such a wide range of symptoms, from mild ‘flu-like fever to a rapid onset of psychosis, or from strange rashes to sudden heart-block, this nasty bacterium has spread without most of us realising it, around the world, in what is now being called a pandemic.

Perhaps its most miserable victims are those with hallucinations, panic disorders, manic depressive illness and ADHD, as well as those with the labels of Chronic Fatigue Syndrome and Myalgic Encephalomyelitis; for although the latter two conditions are recognised to be of a bacterial / viral cause by the World Health Organisation, the British medical establishment employees predominantly psychological intervention alone. Imagine being confined to a secure mental hospital, or treated with powerful antipsychotic drugs, or living for decades struggling to maintain normal memory and behaviour patterns, when all along there has been an infection secretly living in your brain and nerves. This bacterium may sometimes be the cause of anorexia, while in some of its victims it has been known to cause episodes of uncontrollable rage.

Other bacteria and viruses can wreak similar havoc: some of the ones that live harmlessly in our throats and on our skin are also able to invade our brains. Doctors and scientists are quite ready to acknowledge and search for things like HIV, Streptococcus and Herpes. But it is only recently that they are becoming aware that the Borrelia bug, one of the hardest to positively identify because of its so-called “stealth ” behaviour, must be high on the list for diagnosis.

European countries such as Austria, Germany, Holland and France, have alerted their GPs and specialists to the growing problem of Borrelia. Germany has twice polled every doctor in the country to determine the probable infection rate, and has found that it has doubled in the last 10 years. The Dutch have carried out similar surveys. In Austria, every GP’s waiting room has warning signs about Borreliosis. The disease is being spread by ticks that are carried on birds, on wild animals and on pets such as cats and dogs, even on horses. It has been found inside the stomachs of biting flies such as horse flies and cleggs and also in mosquitos and mites.

We present here several medical studies published in recent literature, which link mental illness and brain disease to known Borreliosis infection. There were few to be found that had been carried out in Britain; those quoted here are from the rest of Europe and the United States.


a) In a controlled study undertaken at Columbia University Department of Psychiatry, 20 children were examined following known infection of Borrelia burgdorferi (Bb), and were found to have significantly more psychiatric and cognitive difficulties. Their cognitive abilities were found to be below that of 20 matched healthy control subjects, even taking into account any effects due to anxiety, depression and fatigue during education. The study also discussed the long-term effects of the children’s infection with Borrelia, which had brought about neuropsychiatric disturbances and caused significant psychosocial and academic impairment.


b) An elderly lady treated at the Emperor Franz Josef hospital, Vienna, was initially admitted with suspected Motor Neuron Disease. Testing of fluid from her spinal column indicated the presence of Bb. Following antibiotic treatment, improvement was seen in the patient’s clinical symptoms, and further testing of spinal fluid demonstrated a positive response to the antibiotic treatment. The preliminary diagnosis of amyotrophic lateral sclerosis (ALS) was revised to one of chronic neuroborreliosis, the term given to infection of the central nervous system (CNS) by Bb.


c) A 64-year old woman was admitted to the psychiatric ward of the Sophia Ziekenhuis at Zwolle, in Holland. She was suffering from psychosis, with visual hallucinations, disorientation in time and space, and associative thinking. Psychotropic drugs failed to produce any improvement in her condition and further, neurological, symptoms developed. A lumbar puncture revealed the presence of Borrelia burgdorferi and after treatment with penicillin all of her psychiatric and neurological symptoms were resolved. From the history, which the woman was then able to communicate, it appeared she had been bitten by ticks. Her husband, aged 66, passed through a similar episode of disease.


d) In a comparative study carried out at the Prague Psychiatric Center, the blood of 926 psychiatric patients and that of 884 healthy control subjects was screened for four different types of antibodies to Borrelia burgdorferi. Of 499 matched pairs (meaning of similar age and gender but from patient and control group respectively) 166 (33%) of the psychiatric patients and 94 (19%) of the healthy comparison subjects were seropositive in at least one of the four test assays for Bb. This study supports the hypothesis that there is an association between an infection of Borrelia burgdorferi and psychiatric morbidity.


e) It has been well documented in numerous published medical studies of Borrelia’s ability to cause many recognized personality disorders and forms of depression; such as anxiety, depression, confusion, aggressive behaviour, mild to moderate cognitive deficits, fatigue, memory loss, and irritability. As such, the American Psychiatric Associations recommends that specialist doctors and councillors alike should seek to rule out Borreliosis as a possible differential diagnosis before commencing with any form of psychological intervention.


f) At the University of Rostock in Germany, a 42-year old female patient presented with schizophrenia-like symptoms but a complete lack of neurological signs. A brain scan and investigation of the spinal fluid led to the diagnosis of Lyme disease. There was complete relief of symptoms after antimicrobial therapy.


g) In a study of patients at a Boston, MA, hospital, scientists looked at patients with a history of Lyme disease who had been treated with short courses of antibiotics. As well as many physical symptoms, such as musculoskeletal impairment, the Lyme sufferers were found to have highly significant deficits in concentration and memory. Those who had received treatment early in the course of the illness had less long-term impairment.


h) At the Kanazawa University School of Medicine in Japan, a 36-year old woman with severe chronic Encephalomyelopathy was shown to have a very high level of antibodies to Borrelia burgdorferi. She showed severe cerebellar ataxia (walking and balance difficulties due to disease in the cerebellum) and profound mental deterioration. The disease had probably been acquired while she had been in the USA. The autopsy 4 years later showed the presence of spirochaetes throughout the brain and spinal cord, which together with the antibody evidence, demonstrated that the Lyme bacteria had caused this encephalitic form of neuroborreliosis.


i) Dr B. A. Fallon and his team at Columbia University Medical Centre in New York have done extensive studies on both adults and children with Lyme disease. They describe numerous psychiatric and neurological presentations of the disease, and show that it can mimic attention deficit hyperactivity disorder (ADHD), depression and multiple sclerosis. In another study, the same team found panic disorder and mania could be caused by Borrelial infection.


j) Scientists from Vancouver, Canada, and Lausanne, Switzerland, recently looked at post-mortem brain tissue samples from 14 patients who had had Alzheimer’s disease and compared them with 13 controls. All of the Alzheimer’s brains had infection with Borrelia-type organisms, compared to none of the controls. From 3 of the Alzheimer’s cases, they were able to carry out genetic and molecular analyses of these spirochaetes to prove beyond a doubt that they were Borrelia.


k) Following the detailed statistical analysis of all published literature on schizophrenia, (with the criterion that each study had to have detailed histories for at least 3000 patients), Swiss scientist Dr Mark Fritzsche was able to demonstrate that: “globally there is a striking correlation between seasonal and geographical clusters of both Multiple Sclerosis and Schizophrenia with the worldwide distribution of the Lyme bacteria.” Yearly birth-excesses of such illnesses were found to mirror, with an intervening nine-month period, both the geographical and seasonal patterns of various types of Ixodes tick. He also went on to further state “In addition to known acute infections, no other disease exhibits equally marked epidemiological clusters by season and locality, nurturing the hope that prevention might ultimately be attainable.”


l) Chronic fatigue syndrome has been found to be associated with infection by Borrelia. A study by the Department of Neurology at the University Hospital of Saarland in Homburg, Germany, investigated blood samples from 1,156 healthy young males, without knowing which ones were suffering from CFS. They saw a significant number with CFS sufferers who had Borrelia antibodies even though there were no other signs of borreliosis symptoms. They state that antibiotic therapy should be considered in patients with Chronic Fatigue Syndrome who show positive Borrelia serology.


m) Dr R. C. Bransfield in New Jersey, has found a significant number of Lyme patients exhibit aggression. Patients were described with decreased frustration tolerance, irritability, and some episodes of explosive anger which he terms “Lyme rage”. In relatively rare cases, there was uncontrollable rage, decreased empathy, suicidal tendencies, suicide, homicidal tendencies, interpersonal aggressiveness, homicide and predatory aggression.

The World Health Organisation has warned that mental illness appears to be increasing globally, and that depression will soon become the second biggest cause of disease on the planet. In Britain, it is estimated that new-onset psychoses have reached the annual level of 30 per 100,000 of the population. According to recent announcements, although there are at present about 900 consultant psychiatrists employed in the UK, with 400 posts vacant, there are plans to recruit 7,500 new psychiatrists in the next 5 years, a massive 5-fold increase.

The European Committee for Action on Lyme Borreliosis (EUCALB) has published epidemiological studies showing that there is a serious problem with tick-borne Borreliosis in Europe. For example, the UK’s nearest neighbour, Holland, has found 73 cases per 100,000 of the population per year, with an unknown number of missed diagnoses. The published figures for England, Ireland and Wales appear to be nearly 2 orders of magnitude lower than this, with only 0.3 cases per 100,000. Are cases of Lyme disease / Borreliosis not being found in Britain because it is still regarded as a rare disease in this country? Or do we genuinely have the lowest incidence in the world? Diagnosis of borreliosis is difficult, with tests for antibodies to the bacteria being the subject of great controversy at present. If a consultant has to look at a suspected case of the disease and believes it to be rare, and blood tests are unreliable, then the diagnosis will be biased, quite understandably, towards the patient having some other condition.

It is hoped that health professionals at all levels, and in all disciplines, will come to realise that Human Borreliosis is the fastest-growing, most prevalent zoonotic disease in the world, and has been called a modern pandemic by several authors, including epidemiologists, rheumatologists, neurologists and infectious disease experts. There seems to be little awareness in the UK at present about this situation, but we urge that it be recognised sooner rather than later, in the hope that both mental and physical illnesses due to Borrelia are successfully diagnosed and treated.

References

a)         A Controlled Study of Cognitive Deficits in Children with Chronic Lyme disease.

Tager, F.A., Fallon, B.A., Keilp,  J., Rissenberg, M., Jones, C.R., Liebowitz, M.R.

J Neuropsychiatry Clin. Neurosci. 2001;  Fall; 13(4): 500-7.

b)         ALS- Like  Sequelae in Chronic Neuroborreliosis.

Hansel, Y., Ackerl, M., Stanek, G.

Wien. Med. Wochenschr. 1995; 145(7-8): 186-8.

c)         Lyme Psychosis.

van den Bergen, H.A., Smith, J.P., van der Zwan, A.

Ned. Tijdschr. Geneeskd. 1993; 137(41): 2098-100.

d)         Higher Prevalence of Antibodies to Borrelia burgdorferi in Psychiatric Patients than in Healthy Subjects.

Hajek, T.,  Paskova, B., Janovska, D., Bahbouh, R., Hajek, P., Libiger, J., Hoschl, C.

Am. J. Psychiatry 2002; 159(2): 297-301.

e)            Highlights of the 2000 Institute on Psychiatric Services.

Guardiano, J.J., von Brook, P.

Jan. 2001, 52(1): 37-42.

f)          Borrelia burgdorferi Central Nervous System Infection Presenting as Organic Psychiatric Disorder.

Hess, A., Buchmann, J., Zettel, U.K., et al.

Biol. Psychiatry 1999; 45(6): 795.

g)         The Long-term Clinical Outcomes of Lyme disease. A Population-based Retrospective Cohort Study.

Shadick, N.A., Phillips, C.B., Logigian, E.L., Steere, A.C. et al.

Ann. Intern. Med. 1994; 121(8): 560-7.

h)         Borrelia burgdorferi Seropositive Chronic Encephalomyelopathy: Lyme Neuroborreliosis? An Autopsied Report.

Kobayashi, K., Mizukoshi, C., Aoki, T., Muramori, F.et al.

Dement. Geriatr. Cogn. Disord. 1997; 8(6): 384-90.

i)    (1) Late Stage Neuropsychiatric Lyme Borreliosis.

Fallon, B.A., Schwartzburg, M., Bransfield, R., Zimmerman, B. et al.

Psychosomatics 1995; 36(3): 295-300

(2) Functional Brain Imaging and Neuropsychological Testing in Lyme Disease.

Fallon, B.A., Das, S., Plutchok, J.J., Tager, F. et al.

Clin. Infect. Dis. 1997; Suppl.1: 557-63.

j)          Borrelia burgdorferi Persists in the Brain in Chronic Lyme Neuroborreliosis and may be associated with Alzheimer disease.

Miklossy, J., Khalili, K., Gern, L.,  Ericson, R.L., et al.

J. Alzheimer’s Dis. 2004; 6(6): 639-649. 

k)   (1) Chronic Lyme Borreliosis at the root of Multiple Sclerosis – is a cure with Antibiotics attainable?

Fritzsche, M.

Med Hypotheses 2005; 64(3): 438-48.

(2) Geographical and Seasonal Correlation of Multiple Sclerosis to Sporadic Schizophrenia.

Fritzsche, M.

Int. J. Health Geog. 2002; 1: 5.

l)          Chronic Fatigue Syndrome in Patients with Lyme Borreliosis.

Treib, J., Grauer, M.T., Haas, A., Langenbach, J. et al.

Eur. Neurol. 2000;  43(2): 107-9. 

m)            Aggression & Lyme disease.

Bransfield, R.C.

14th International Scientific Conference on Lyme Disease and other Tick-borne Disorders. April 22-23, 2001, Hartford, Connecticut.

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For More:  https://madisonarealymesupportgroup.com/2015/10/18/psychiatric-lymemsids/

https://madisonarealymesupportgroup.com/2018/12/20/diagnosing-ld-in-children-with-neuropsychiatric-illness/

https://madisonarealymesupportgroup.com/2019/02/16/lyme-is-all-in-your-head-a-wake-up-call-to-mental-health-professionals/

https://madisonarealymesupportgroup.com/2018/08/25/neuropsychiatric-lyme-borreliosis-an-overview-with-a-focus-on-a-specialty-psychiatrists-clinical-practice/

https://madisonarealymesupportgroup.com/2018/06/04/ld-diagnosis-took-forever-because-of-mental-health-stigma/

https://madisonarealymesupportgroup.com/2017/04/11/hidden-invaders-infections-can-trigger-immune-attacks-on-kids-brains-provoking-devastating-psychiatric-disorders/

Why Your Kid’s Strep Throat Keeps Coming Back

http://sciencemission.com/site/index.php?page=news&type=view&id=health-science%2Fwhy-your-kid-s-strep

Why your kid’s strep throat keeps coming back

Why your kid's strep throat keeps coming backEach year, some 600 million people around the world come down with strep throat. But for some children (and their parents) it’s more than an occasional misery. It’s a recurring nightmare. Yet, it was unclear why some kids are prone to repeated bouts of strep throat while others appear to be more or less immune. The latest study by researchers provides the first clues why some children are more susceptible than others to contracting recurrent group A strep tonsillitis, better known as strep throat.

Their findings, published in the issue of Science Translational Medicine, suggest that recurrent tonsillitis is a multifactorial disease where immunological factors combined with an underlying genetic susceptibility allow group A strep to invade the throats of certain individuals time and again. Gaining a better understanding of why some children fail to develop protective immunity also opens the door to developing a vaccine to protect against strep throat, the researchers predict.

“Repeated strep throat is the second most common indication for the removal of tonsils in children. Like every surgery it carries certain risks but there is recent data suggesting that tonsillectomy may increase the risk of upper respiratory tract diseases in the long term,” says senior co-author Matthew. “My hope is that as we learn more about the causes behind recurrent strep infections we’ll be able to intervene before they happen.”

Strep throat is one of a diverse array of conditions caused by the bacterium Streptococcus pyogenes, better known as group A Streptococcus (GAS). It can cause pneumonia, scarlet fever, impetigo, which results in highly infectious skin sores, and necrotizing fasciitis, the feared flesh-eating disease. Unlike necrotizing fasciitis, strep throat is easily treated with antibiotics. But if left undiagnosed, it, too, can lead to serious complications.

Trying to understand the longstanding mystery why some children are predisposed to frequent bouts of GAS tonsillitis and what their immune response looks like, the researchers turned to the tonsils themselves. Tonsils are lymph-node like structures located on each side of the back of the throat. Small pockets, or crypts, on their surface collect and sample microbes and can become the breeding ground for GAS.

The authors collected tonsil tissues from a cohort of children aged 5 – 18 who had their tonsils removed either because they suffered from repeated bouts of strep throat or underwent tonsillectomies for unrelated reasons such as sleep apnea. They were particularly interested in germinal centers, the central hubs where B cells have to team up with so-called follicular helper T cells (Tfh cells) to start producing antibodies.

In addition to a significant decrease in the frequency of both B and follicular helper T cells, tonsils from children with recurrent tonsillitis had consistently smaller germinal centers areas overall. “These kids have a poor germinal center response,” says the author. “Interestingly it is associated with a particularly poor antibody response to SpeA, which is an important aspect of protective immunity.”

Short for streptococcal pyrogenic exotoxin, SpeA is not an essential component of the GAS genome. However, a particularly potent version of the toxin arose in the bacteria in the 1980s and these strains quickly swept the globe to become the most prevalent cause of strep throat. Children in the control group had high anti-SpeA antibody titers, which indicated that they had been exposed to the bacteria but did not get sick.

Among children with recurrent GAS tonsillitis the disease was likely to run in the family, suggesting a genetic component. Genetic testing revealed two specific genetic variants in the HLA region, which determines how pathogens interact with the immune system, that were associated with increased susceptibility to recurrent tonsillitis and one that protected against the disease.

“Since the immunological connection as well as the genetic connection are all tied to an insufficient antibody response against SpeA it suggests that recognizing this factor is actually a key problem for these kids,” says the author. “Having a vaccine that trains the immune system in advance might be able stimulate a protective immune response that can prevent recurring bouts of tonsillitis.”

http://stm.sciencemag.org/content/11/478/eaau3776

__________________

**Comment**

This is important as strep can lead to PANDAS:  https://madisonarealymesupportgroup.com/2018/01/05/scary-side-of-childhood-strep/

A highly respected LLMD here in Wisconsin has found that 80% of his PANDAS/PANS kids also have Lyme/MSIDS (borrelia and other coinfections).  There’s much that is still unknown about this life-changing illness but tick borne illness (TBI’s) can definitely cause or exacerbate PANDAS/PANS.

https://madisonarealymesupportgroup.com/2018/07/28/stories-of-pandas/

https://madisonarealymesupportgroup.com/2018/12/17/my-kid-is-not-crazy-study-shows-1-3-kids-with-pans-have-hallucinations/

https://madisonarealymesupportgroup.com/2019/01/27/pans-pandas-autoimmune-encephalitis-rickert-hong/

https://madisonarealymesupportgroup.com/2017/12/01/guidelines-for-treating-pans-its-real/

https://madisonarealymesupportgroup.com/2018/10/29/neuropsych-disorders-in-kids-an-interview-with-co-founder-of-the-stanford-pans-clinic-dr-kiki-chang/

 

 

 

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Tick-Borne Relapsing Fever in Arizona

https://wwwnc.cdc.gov/eid/article/25/4/18-1369_article

Volume 25, Number 4—April 2019

Tick-Borne Relapsing Fever in the White Mountains, Arizona, USA, 2013–2018

Neema Mafi, Hayley D. Yaglom, Craig Levy, Anissa Taylor, Catherine O’Grady, Heather Venkat, Kenneth K. Komatsu, Brentin Roller, Maria T. Seville, Shimon Kusne, John Leander Po, Shannon Thorn, and Neil M. Ampel

Abstract

Tick-borne relapsing fever (TBRF) is a bacterial infection transmitted by tick bites that occurs in several different parts of the world, including the western United States. We describe 6 cases of TBRF acquired in the White Mountains of Arizona, USA, and diagnosed during 2013–2018. All but 1 case-patient had recurrent fever, and some had marked laboratory abnormalities, including leukopenia, thrombocytopenia, hyperbilirubinemia, and elevated aminotransaminases. One patient had uveitis. Diagnosis was delayed in 5 of the cases; all case-patients responded to therapy with doxycycline. Two patients had Jarisch-Herxheimer reactions. The White Mountains of Arizona have not been previously considered a region of high incidence for TBRF. These 6 cases likely represent a larger number of cases that might have been undiagnosed. Clinicians should be aware of TBRF in patients who reside, recreate, or travel to this area and especially for those who sleep overnight in cabins there.

_______________

**Comment**

Do you see the trend yet?  Ticks, pathogens, and disease where they aren’t supposed to exist.  Yet they do.  This study also demonstrates that the Lyme caused by B. burgdorferi is NOT the only borrelia spirochete we need to be concerned about. While the study states,

“In the United States, B. hermsii is thought to be the most common cause of TBRF, and transmission is associated with the bite of soft O. hermsi ticks. Ornithodoros spp,” 

they are not the sole perps as seen below.  A U.S. solider acquired TBRF with the B. turicatae strain and in Europe the strain was caused by B. corocidurae.  The truly frightening aspect is the potential rapid transmission.

https://madisonarealymesupportgroup.com/2017/12/22/tbrf-in-texan-dogs-yep-despite-poor-tests-its-there/

https://madisonarealymesupportgroup.com/2019/01/10/relapsing-fever-found-at-popular-recreation-site-in-ca-ticks/

https://madisonarealymesupportgroup.com/2018/12/20/tick-borne-relapsing-fever-as-a-potential-veterinary-medical-problem/

https://madisonarealymesupportgroup.com/2017/05/04/us-soldier-aquires-tickborne-relapsing-fever-caused-by-b-turicatae-from-a-ornithodoros-turicata-tick/

https://madisonarealymesupportgroup.com/2019/03/17/first-case-of-b-corocidurae-in-native-european-presenting-as-meningitis-with-cranial-polyneuritis-cavernous-sinus-thrombosis/

https://madisonarealymesupportgroup.com/2018/12/28/relapsing-fever-spirochete-uniquely-adapted-to-highly-oxidative-salivary-glands-of-soft-bodied-tick/

A population persists in the salivary glands allowing for rapid transmission to mammalian hosts during tick feeding.

Much can be learned about Borrelia turicatae by reading this case study:  https://wwwnc.cdc.gov/eid/article/23/5/16-2069_article

We learn:

  • Ornithodoros turicata soft bodied ticks, are endemic to Texas and Florida
  • They are found in caves and ground squirrel or prairie dog burrows  https://madisonarealymesupportgroup.com/2018/04/23/tick-borne-relapsing-fever-found-in-austin-texas-caves/
  • Once infected, they remain infected for the rest of their lives, which can be up to ten years.
  • Attachment is painless
  • They are rapid night feeders (5-60min)
  • Due to their rapid feeding they are rarely found or leave lesions
  • Patient in study suffered with headache, nausea, & pain behind knees
  • Had numerous lesions which resolved after 6 days (without treatment)
  • Developed persistent fever
  • Developed thrombocytopenia (low platelets)
  • Developed elevated Erythrocyte sedimentation rate & C-reactive protein
  • Improved rapidly with doxycycline
  • Platelet count normalized within 2 weeks
  • Asymptomatic soldiers with similar exposure were treated prophylactically
  • TBRF is a neglected and probably underdiagnosed disease
  • Published cases in Texas have been supported by serology for the TBRF group, exposure location, and tick collections, but the authors state successful identification of B. turicatae in a human has not been reported
  • Military training groups in Israel have declared certain caves off limits because of heavy tick presence https://madisonarealymesupportgroup.com/2017/10/27/israeli-kids-get-lyme-disease-from-ticks-in-caves/ and have prophylactically administered doxycycline to those suspected to have been exposed
  • Asymptomatic patients given doxy don’t have a Jarisch-Herxheimer reaction but those with active illness do
ANOTHER STUDY DEMONSTRATING THE WILY AND ADAPTABLE NATURE OF SPIROCHETES.